boucharda - If you would read any of the links that I posted, a) YES a negative PCR test is required before the person is allowed onboard and b) YES people are required to do a Covid test before re-entering the US, as that is a US requirement and could not be waived by a cruise line, even if they wanted to. So, in short, in addition to everyone having been vaccinated, they have to do all the protocols that are required of land visitors, except the insurance, which is kind of illogical in this circumstance anyway.

With regard to the SXM insurance, to me, it's only practicality is for the cost of quarantine. There would be no need to quarantine anyone on land in SXM because on arrival, they would be coming in and going directly to the ship anyway. The vaunted medical evac supposedly provided would NOT be sufficient to evac someone off the island, at $20,000 for the evac. And if the person was that sick, that they needed evac, they would never be able to arrive on the plane to SXM to begin with. At the end of the cruise, the person could be sick, yes, but I assume, without knowing, that SXM has an agreement in place that the cruise line would get the person off the island. Those that are fully vaccinated should not be getting deathly ill anyway, so hopefully that shouldn't be an issue.

It could be also that the cruise line will require everyone to purchase insurance from THEM to cover Covid. Frankly, I would put a LOT more confidence in insurance through the cruise line, versus through SXM.