do you get trip insurance and from who?

Everyone has different needs when it concerns travel insurance.
Our main reason to get travel insurance is for medical insurance for my wife who is on Medicare.

A great website comparing many different companies is www.insuremytrip.com

As always, read the fine print. CAREFULLY. The more reasons it allows you to cancel, the pricier the policy will be. Could be 25% of your trip cost or more. Some risks aren't worth covering. There was a recent post of someone whose home severely damaged by the floods in Boulder, CO and they had to cancel a trip to deal with that. Their policy would not pay off as that was not a covered risk. They seemed a bit peeved, but the couple of grand in lost deposits and airline change fees was small potatoes compared to having their home flooded.
To my mind, the risks you want to cover are the very expensive kind. You are involved in an accident or have a severe illness and need to be evacuated home. That's big bucks and exactly the kind of risks that you should provide for, IMO.

Travel insurance is a multi-faceted proposition. You need to understand it; then, decide what you want/need. On the medical component: first thing to do is to check whether your health insurance covers you outside the country. No sense in replicating coverage. A potentially huge cost is medical repatriation. For example, some friends went to Paris last month. She tripped on a curb and sustained a compound fracture of a leg bone. Her travel insurance paid for doctor and hospital costs AND business class (she had to keep the leg elevated)return tickets for the three of them. Pay no attention to people who say they keep themselves healthy, so they don't need insurance. Anyone can be the victim of an accident.
As these things go, the cost of plane tickets is not so much. Usually, you can rebook for a fee.

It's also true that the amounts prepaid for accommodations or cancellation penalties are small potatoes, unless you have paid for a comprehensive tour. We never insure for any of these.
The last big category you'll encounter is insurance against loss or theft of belongings. Again, the first thing to do is check whether your homeowners' or renters' insurance already covers you. If not, consider how valuable your belongings are vs the price of the insurance. It's conventional wisdom to leave expensive jewelery, watches, etc. home, anyway. Thefts and luggage losses are not as common as some people seem to think. This is an area where being careful is good advice.
Two sites are often mentioned here as places to check for travel insurance: www.insuremytrip.com and www.squaremouth.com. They let you compare many companies and include prices and ratings. They also allow you to talk to reps, if you get confused. We used squaremouth for our last trip and were very pleased with their customer service.

The things I make for-darned-sure are covered by trip insurance are -
* Trip cancellation; we have elderly parents and who knows what could happen and when!
* Medical evacuation; I personally know three people who have had to do this w/o insurance; one had to be evacuated from Mexico - $25,000, and one from Guatemala - $35,000, one from Italy - $43,000. Stunningly expensive depending on the treatment and personnel required to care for the person enroute.
* Medical/dental expenses incurred overseas. Husband developed kidney stones in the Italian Alps. We had to pay for the ambulance, doctor's bill, medication, etc. Cheaper than the states but still not cheap. What a day that was.
* Lost luggage
* If I go to a dicey country I make sure that the trip also covers having to leave suddenly due to political unrest/acts of terrorism. probably won't need that in Italy though so don't pay extra for a policy that covers this.
Really just think about what could go wrong and look for a policy that covers those things. It's all about being prepared! insuremytrip.com is great because you get so many options, many of which are customizable.