An estimated 34.7 million people are expected to embark on cruise trips in 2024, according to the Cruise Lines International Association (CLIA). However, travelers should be cautious, as unexpected medical bills can arise if they are not adequately prepared.
For those planning a cruise, it is essential to thoroughly review the terms of the cruise line, particularly regarding medical care.
Vincent Wasney’s experience emphasizes the importance of understanding these terms. Wasney, who was uninsured at the time, went on a cruise in December 2022. After experiencing several seizures, he needed to be evacuated for medical care on land. Before leaving the ship, Wasney was presented with a $2,500 bill for medical services received onboard.
Wasney was on a Royal Caribbean cruise, which requires guests to pay all onboard costs before disembarking. Even insured passengers can face substantial medical bills, as most cruise ships do not accept health insurance.
Medical Issues on Cruise Ships
Cruise ship medical staff handle a variety of health concerns similar to those in emergency departments and urgent care centers on land, said Joe Scott, chair of the cruise ship medicine section of the American College of Emergency Physicians (ACEP). Common issues include chest pain, abdominal pain, fever, injuries, and mental health problems.
The U.S. Centers for Disease Control and Prevention (CDC) notes that ship environments can facilitate the spread of person-to-person, foodborne, and waterborne diseases. The CDC reports that roughly half of passengers seeking medical care on cruise ships are over 65 years old.
Medical Facilities on Cruise Ships
All CLIA-member oceangoing cruises must adhere to medical facility guidelines set by ACEP, said CLIA vice president of communications and public affairs, Sally Andrews. These ships must have at least one qualified medical professional available 24/7 and be equipped with an examination room, an intensive care room, and equipment for lab tests, vital sign monitoring, and medication administration.
Approximately 95% of medical conditions reported on ships are managed onboard, according to the CDC.
Health Insurance on Cruise Ships
Most cruise ships do not accept health insurance due to the diverse international backgrounds of guests and the varying policies for international coverage. Guests are typically encouraged to seek reimbursement from their insurance plans upon returning home.
What to Look for in Travel Insurance
To protect against medical expenses, travelers should purchase travel insurance that covers medical emergencies. These premiums can cost up to a few hundred dollars but can save thousands in case of an emergency.
Travelers should ensure that their insurance plans cover existing medical conditions and the destinations they will visit. Adequate medical evacuation coverage is also crucial, especially since cruises often visit remote locations. Air medical evacuations from areas like the Caribbean to the U.S. mainland can cost around $20,000, while similar evacuations from locations like Alaska, the South Pacific, and Australia can exceed $100,000.
Preventative Measures
According to Scott, passengers should take preventative steps such as bringing extra medication, maintaining a list of prescriptions, medical issues, and doctors’ contact information. It is also important to frequently wash hands, stay hydrated, and know physical limits.
Scott advises reconsidering physically demanding activities if unaccustomed to them, highlighting that medical concerns onshore will persist while on a cruise.