Travel insurance confusion: pre-existing condition waiver and whether excursions must be covered

I recently booked a cruise with Virgin Voyages and started looking into travel insurance, which has become confusing and stressful.

I want coverage that includes a pre-existing medical condition waiver. From what I understand, companies like Allianz require that I insure the full non-refundable trip cost to qualify.

When I contacted Allianz, I said I would insure the cruise fare, but I didn’t want to include optional shore excursions because they are refundable if canceled in advance. However, I was told that excluding excursions could void the pre-existing condition waiver, since they might become non-refundable trip costs later.

Now I’m trying to figure out if other insurance providers handle this differently, or if there are companies that offer pre-existing condition coverage without requiring optional excursions to be included in the insured trip cost.