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It depends a lot on your personal situation and what the insurance covers. If you're traveling with light luggage, you don't have tight connections, and your airline has a good reputation, honestly it's not that necessary. Most domestic flights take off on time, and if they cancel one on you, a lot of airlines will rebook you on another one at no extra cost. The problem is more when you're traveling with expensive luggage, you have a critical business trip, or you just need peace of mind. That's when it's worth checking exactly what it covers.
What you should definitely consider is what's included in your health insurance policy or whether your credit card already covers you during flights. A lot of people don't know their basic health insurance already has some coverage for medical emergencies while traveling. If you've already got that covered, domestic travel insurance often ends up being redundant. On the other hand, if the insurance is cheap and covers luggage, extended delays, and cancellations due to airline issues, it can be useful protection without much expense.
My advice is to get it only if the price is low compared to what you're spending on the trip overall, and if you really need that peace of mind. For a weekend trip 200 kilometers away, you probably don't need it. But if it's an important trip where a problem would ruin your plans or cost you extra money, then go for it.
Domestic travel insurance makes sense mainly if your airline is one that cancels flights frequently or if you're going somewhere where missing a connection would ruin your plans (like an important event, a wedding, something like that). Years ago I had a flight cancelled due to weather in the middle of a work trip and I had to pay out of pocket for an emergency hotel plus another flight the next day - if I'd had insurance it would've covered it. Now for short local flights where I'm in no rush and don't absolutely have to get there, I don't bother buying it, but if it's something critical or with an airline that makes me skeptical, I go for it.
Don't let yourself be pressured by what the airport shop is offering - that's where it gets most expensive. What nobody mentions is checking whether your credit card already covers flight cancellations or delays - lots of premium ones do it automatically. If you travel often in your country, pay attention to your airline's patterns during the time of year you're going; if it's rainy season or hurricane season in your region, that's when it's actually worth having that extra protection.
What a lot of people don't realize is that domestic travel insurance usually has pretty limited coverage compared to international plans, so you end up paying for something that barely covers anything useful. If you're really worried, first check what your credit card includes (like people already mentioned) and then actually read the fine print on the insurance: most of them don't cover cancellations due to bad weather or airline technical issues, which is exactly when you'd need it. For short domestic flights with no checked baggage and no complicated connections, honestly most of the time you're just throwing money away.
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