Question one is impossible to answer. However, adding an agent between the provider (airline) and traveller isn't always the best option, as if things go wrong prior to departure they will have to deal with the agent rather than the airline.

'If the travel agent books the trip, do they still get mileage?' That depends on the ticket type booked. To ensure they earn miles or points they should book directly with the carrier.

'Is it less expensive to book a fully refundable ticket, or to buy unrefundable and purchase travel insurance?' Fully flexible tickets can be eyewateringly expensive. Depending on when they plan to travel, the cabin/class of service they'd like to book, their preferred carriers and the routing they choose they may find a less flexible ticket a better bargain.

As for travel insurance, buying it from an agent or airline is rarely recommended. http://www.insuremytrip.com is a good place to start as they can find a policy that suits their needs rather than an upsold policy that may not give the coverae they'd like.

If the travellers live in Tucson they'll need a positioning flight to PHX and travel on from there. Whether they choose BA from PHX to LHR (London Heathrow) and on to MAD or AA to ORD or JFK then an IB flight to MAD, taking an EU-based carrier will add a layer of protection under EU(EC) 261/2004 should things go amiss.

1- Could be $2, could be $2000. There's no standard.

2- If they have a loyalty account with whoever they travel with they will

3- Generally refundable tickets are more expensive. No one knows what insurance they may buy or is available to them. Your question is not answerable.

Thank you very much for the quick and thorough responses. They were all what I myself would think, but was not sure. There are always those, ifs, buts, maybes involved everywhere.

What a terrific suggestion about AAA! We've never used them for planning our travel for us, so completely forgot about them, but they do have a Travel Service Center in Tucson. These neighbors trust and like AAA, so they will be delighted, and will follow up with the suggestion. It made me a bit nervous for them to have someone book a trip for them at the Senior Center. Who knows how secure those computers are? I almost felt like I had to volunteer, but I would prefer not to get involved, and I just do not have the time.

Thank you again. I appreciate your help in this situation.

Old school travel agents do not charge the traveler anything - they get their money from airlines, hotels, etc. The only catch is that, for example, they won't be able to book low-cost carriers like Southwest who don't participate in the system that the majors do. (Irrelevant for this trip, but FYI.)

Last time I looked, AAA wouldn't charge a fee to anyone, but if they do, it may be waived or reduced for members.

Also, for everything, check for AAA discounts (if they are members) and senior citizen discounts.

After booking, call the airlines / airports to see if they offer any services to help seniors get around, find connecting flights, etc.

Follow up.

There were some really great pointers presented here, and I made a list of them for these neighbors. They already have an appointment with AAA Travel on Monday morning. It's a relief to put them in safe hands, as they are very nice people, and I would hate this trip to be unpleasant for them. (They plan on going in September.)

Thank you again.

Please don’t let them forget to look at medical insurance for their trip, chances are they do not have international coverage through Medicare, and sometimes pre-existing conditions are not covered unless purchased shortly after making the initial trip arrangements.,

Buying a refundable ticket and buying travel insurance are really quite separate decisions. Whenever I look at the brochures that accompany travel insurance policies the biggest financial component is always the coverage of the cost of healthcare overseas. Coverage of cancellation costs is also usually in there, but the health care aspect is more important. However I have also been told that travel insurance can be very expensive for the elderly.

At their age, they should look at evacuation insurance, in addition to health care coverage.

Lots of good advice here on this thread, one thing I'd like to add though concerning insurance would be their age. Many insurers won't cover people over a certain age, so it would be best to consult a professional on this before securing coverage.