Having A Medical Emergency On A Cruise
Note: The following is based on our recent experience with a serious medical emergency while on a cruise ship along with conversations with other cruisers that also had major medical emergencies.
First, there are medical emergencies and then there are serious medical emergencies. The every day ones like a case of the flu, a sprained ankle or a minor cut will find most ship clinics and staff well prepared to deal with, but a stroke or a heart attack, is a completely different emergency.
In the case of a serious medical emergency rest assured that your cruise ship will not abandon you, but they will also want to get you transferred to an appropriate medical facility ASAP. We have been on cruises where an evacuation helicopter was brought in, another where a launch came out from the Canary Islands to pick up a family as the ship passed by and on another cruise in high seas the ship turned toward the nearest port and greatly increased speed to get a passenger having a heart attack to a hospital (a really rough ride). On one Alaska cruise, a family had a child with an appendix issue who was disembarked in a remote area for a helicopter to take them to a hospital. In that case, several days later, the family actually rejoined the cruise.
The first and obvious reason for a cruise ship to disembark a person (usually along with family members or traveling companions) is they are seriously ill and they need care that the ship is not generally equipped to provide. Additionally, there is also an understanding in the industry, that a seriously ill person on board a cruise ship is potentially a major liability. The faster they can transfer a seriously ill person to another institutions responsibility, the less legal risk. Don’t take that as a criticism but simply a recognition of the litigious world of today.
So what does this mean to you, the cruise passenger? Well first, if you are seriously ill and the ship is aware of it, you can expect to be disembarked as quickly as possible. That may mean calling for a helicopter evacuation, or if you are in a port, they will call for an ambulance. Usually your bags will be packed by crew members, your onboard account will be closed, guest relations will likely ask for additional contact information and phone numbers for you and family members and they will ask for your travel insurance information. They will probably bill your credit card on file. They could also bill your travel insurance for the clinic tests, drugs and time in their clinic but that is less likely. If you’re in a port you’ll quickly be in an ambulance along with your bags and companions heading for the nearest hospital emergency room.
If you are out at sea, a number of evacuation options are available and they will be quick to activate the one with the shortest delay time.
In a serious emergency it is difficult, as a passenger, to know what steps you should be considering but in a number of instance we’ve been told about the evacuee’s luggage being left behind on the ship causing unforeseen complications. In one case, that included money and passports being left behind. The only advice we can offer to avoid something like that is to be proactive and insist on knowing what the ship is doing regarding luggage, passports and even billing actions. If at all possible, the non patient in the situation should insist on having a guest relations person come to you.
Before you cruise, this is something that should be part of your cruise planning and needs some serious consideration. Plan to keep important documents, passports, credit cards and insurance information all in one place and at least an overnight bag with basic toiletries and clothes ready to go.
What Happens Next?
The following may not be universal, but is highly likely to be a potentional scenario.
Regardless, if you’re at sea or your ship is sailing soon or even if it has another day in port, as soon as the ship can arrange it you are no longer their passengers. Technically they will not even allow you or a member of your travel party back on the ship*1 once officially disembarked. Any future contact will most likely be from the cruise company’s home office or their agent in a nearby port. In our case, it was an agent in the African departure country. As you and members of your traveling party are being transferred off the ship someone will probably need to deal with “guest relations” before you disembark clearing your onboard account. Allowing for follow up communications with your party or emergency contacts is the principle reason guest relations will need to meet with someone in your party. They will want to clear your account and confirm additional contact information as you depart.
The least you can hope for and should expect is help with getting the sick or injured person to medical facilities and arranging accommodations for companions in the hospital port along with transportation around the evacuation city*. In our case, an agent contacted us at the hospital to let us know he had made reservations at a local hotel and had arranged for a car service. Again in our case the agent was in a city hundreds of miles away and we would have to contact the agent to schedule getting car service for pick ups. During those first few days the agent would email and inquire about the patient’s condition and if we needed anything else*2, though I am not sure what anything else would have entailed.
At this point, thanks to the local doctors and the hospital, the patient is still alive and with a pathway for treatment and hopefully recovery. Here’s the possible bad news; without your own financial resources and hopefully travel insurance3, the cruise ship and its parent company have completed what they considered their obligation and, with a final contact to check on how the patient is, they’re going to be moving on. In our case, we were presented with a final bill for the local hotel and the car service, payable by credit card upon presentation4.
Going Without Travel Insurance Is Just Fool Hardy And Reckless *4
If you are an American (as well as many other countries) and you have private health insurance and/or national health (MediCare), you need to understand that your health insurance coverage ended the minute you left your country and entered into international space or in the case of cruise ships, international waters. Without travel medical insurance (or a rider to your health insurance for travel, you’re on your own with absolutely no insurance at all.
You can arrange to buy international travel insurance through a number of options and the easy one is to add it to your cruise package from the cruise company. Whatever you do, do not just accept this option without understanding what it covers and the actual costs that you could incur. Some cover only a specific amount of medical costs but do not offer emergency evacuation, while others offer only a percentage of actual costs. Some may require you to initially pay out of pocket and file for reimbursement with the insurance company (a typical cruise policy*5). For MediCare Americans you also need to understand that your health coverage stopped the instant you left American soil, but your health supplement may offer some travel medical coverage (you’ll need to check with them). Our strong recommendation is that you need to know specifically what is covered and the cost limitations and do comparison shopping for additional needed health insurance before you travel!.
Regardless, if you are cruising or touring over land, we strongly recommend having travel insurance. We’ve always thought that emergency evacuation and repatriation insurance is another important element and after our last emergency we feel even stronger about it*6.
Notes:
*1 Cruise ships are extremely cautious about who comes onboard and why. In our recent medical emergency my wife thought she had stashed some items out of the way in our stateroom and she wanted me to return to the ship and check. After just two hours the ship was reluctant to let me back onboard. Eventually they had to issue me a special ID just to come aboard and ship’s security had to accompany me back to the stateroom and off the ship.
*2 After an emergency disembarking from the cruise ship an agent made reservations for the companion (me) at a local hotel and arranged for a car service. After a couple of days I was presented with a bill by my driver payable on presentation for the hotel and car service. After that, the agent continued to inquire for over a week for what seemed to be information allowing him close the account. but offered no additional assistance. In hindsight, we would have been much better off contacting the travel insurance company for assistance as those were actually covered expenses. The lesson here is if you have travel insurance contact them ASAP.
*3 Requiring us to pay for hotel and car service was a bit of a surprise that could have been avoided if we worked with insurance. I have also been trying to get a copy of the statement from the cruise agent that I could submit to insurance for reimbursement but so far have had no luck.
*4 Do NOT neglect or skimp on travel insurance. Buying insurance with a cruise or land tour may be easy and fine, but it’s important to know exactly what you’re getting for your money. In our case I’m not sure what a MediVac jet with a doctor and a paramedic costs and add to that the expense of a nurse traveling 9,000 miles to get to us, two long distance flights for us to get home along with the nurse all in business class, but my guess is it wasn’t cheap!
*5 Cruise and travel companies offer travel insurance but they are not the insurance company. Cruise ships will usually expect you to pay for medical services and you will have to file with the insurance provider. FYI – Be sure and get receipts and copies of reports generated by the cruise ship so you can submit a claim.
*6 Evacuation insurance can be part of a travel policy but you need to make sure. We had a policy with EA+ that covered evacuation for both of us for less than US$200 a year.
Click below to visit these popular travel sections from The Intentional Travelers…
Please join us and subscribe to The Intentional Travelers. Simply enter your email address below to receive notices of new posts right to your inbox. Unsubscribe at any time…
