I originally paid $450 per year for the Citi American Airlines AAdvantage Executive Card for the following benefits:

• 50,000 bonus miles
• Admiral's Club Membership (worth at least $350 per year)
• 10,000 Elite Qualifying Miles Based Upon Making $40,000 Annually in Purchases
• No Foreign Transaction Fees
• Priority Boarding and Priority Airport Screening (you will need it this summer).

There are other benefits too but since I obtained the card they have added a benefit to reimburse me up to $100 for my TSA Global Entry fee.

Now in terms of travel insurance, I previously purchased a policy for $120 per year for international coverage for emergency medical and evacuation insurance.  However, now the Citi American Airlines AAdvantage Executive Card covers this cost for me with these benefits:

• Emergency Medical Coverage Overseas (your domestic policy probably does not cover you for medical expenses overseas)
• Up to $100,000 in Medical Emergency Evacuation
• Trip Cancellation/Interruption:  Up to $5,000 for Incidents Such as Illness, Being Fired or Laid Off from Job, Call to Jury Duty, Pet Injury or Illness, Severe Weather, Missed Connections, Supplier Going Out of Business, Terrorist Incident at Traveler Destination.  For a complete explanation of benefits provided by this card, see: http://i.info4.citi.com/wpm/100164/PDF/Guide12.pdf

Disclaimer:  It is important to read and understand the coverages, limitations, exceptions, and conditions surrounding this and any other insurance policy you may purchase.

Is the $450 fee worth it?  For me it is.  When I figure my Admiral's Club fee is about $350 per year and I pay about $120 per year for overseas health insurance along with at least $100 every 5 years for Global Entry, this card is definitely worth it considering there are probably going to be fees for ANY card I get and with all the other perks the card gives me.