recommend? I am going on a hiking trip with my family. If I wanted to be medically evacuated back to the US, I would probably buy that insurance, but do I need the other things like trip cancellation insurance? Last time we went, our tour operator 'forgot' to book one of the rooms and we still got stuck with the cost and with negotiating the room with the innkeeper, so it didn't do us any good to have the insurance.

You are right. Travel Insurance would typically cover only emergencies and 'acts of god' [medically evacuated back to the US would be an example]. Some policies however do cover Trip Cancellation. However, you may have to check the fine print. Click on Free Policy Quote engine on the following website to read policy details online