Yes, travel insurance is worth carrying for a trip to Vieques, a small island off Puerto Rico's east coast best known for Mosquito Bay, one of the brightest bioluminescent bays anywhere, and the honest case for coverage here rests on access and logistics rather than any unusual danger on the ground. Vieques is reached only by ferry from Ceiba or a short flight from San Juan, and either leg can be interrupted by weather or mechanical delays with little warning, which matters more for a short island stay than most travelers expect.
Vieques has its own hospital, Susana Centeno, for routine care, but anything serious is typically stabilized there and then transferred to San Juan, Puerto Rico's real medical hub, either by ferry or a short flight depending on urgency. Confirm your policy covers inter-island medical transport, since that transfer - not treatment on Vieques itself - is the part most likely to involve real cost and coordination.
Night kayak tours on Mosquito Bay are the main draw for most visitors, and while the paddling itself is gentle, it happens after dark on open water, so check that your policy treats a guided bioluminescent tour as a covered activity rather than leaving it in a gray area between hiking and water sports. The same applies to any beach or snorkeling time on the island's quieter coves.
Hurricane season, roughly June through November, is a genuine consideration across Puerto Rico and the wider Caribbean, and it can disrupt the ferry schedule out of Ceiba or ground flights out of San Juan with little notice during an active storm. Trip-delay and cancellation cover is worth checking closely if your visit falls within this window.
Keep any clinic paperwork from Vieques or San Juan, ferry or airline delay notices, and receipts for unplanned accommodation if a crossing or flight is disrupted. Many policies treat weather-related transport cancellation as a standard delay claim, so check the wording for how it defines a disrupted crossing before assuming automatic reimbursement.