I assume that cruise ship passengers are generally aware of this and purchase med-evac insurance so that they get helo'ed and / or jetted to (e.g.) top hospital

I assume that cruise ship passengers are generally aware of this and purchase med-evac insurance so that they get helo'ed and / or jetted to (e.g.) top hospitals in Houston or Miami rather than (e.g.) Port-au-Prince. Or do passengers run into this as a regular problem?