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What occurs when you get sick on a cruise?


The last thing you want to think about before packing your bags and sailing away on your dream cruise vacation is what would happen if you got sick while on board the ship.

But unfortunately, people do get sick while on vacation. They can also injure themselves or become ill enough that they need to return home.

That’s why it’s prudent to invest in a cruise travel insurance policy and be prepared for the unexpected. It’s also a good idea to know what onboard medical care your ship can and cannot provide in an emergency. It’s especially important if you’re traveling in far-flung locales that may not have adequate medical facilities – when you can even go ashore.

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TPG reached out to several cruise lines, from mass-market companies to smaller luxury ships and expedition lines, but few wanted to comment directly on this topic in response to our questions. Some declined, while others referred us to their websites, where you can find basic information under the FAQs sections on what their ships typically offer regarding medical assistance.

If you want to know the specifics about getting a COVID-19 test on board or what would happen if you broke an arm or needed to be airlifted to a medical facility while cruising, we have direct answers from three cruise lines – MSC Cruises, Holland America Line and Azamara. We’ve also compiled general information from several lines with detailed information on their websites.

Here’s what you need to know before you go, so you can feel confident that you’ll have competent and comprehensive medical care if you fall ill while cruising on the high seas.

Do cruise ships have medical centers, and who works in them?

All ocean-going ships have medical centers staffed with trained professionals, so medical care is accessible when you’re on board the ship. The facilities and what they offer will vary, depending on the size of the ship and the number of passengers and crew.

For example, according to Royal Caribbean‘s website, their medical centers are staffed with two or three licensed physicians and three to five licensed nurses 24 hours a day. The staff may be international or U.S.-based. The website also states, “All Royal Caribbean Group (Royal Caribbean, Celebrity and Silversea) ships are built, staffed, stocked and equipped to meet or exceed guidelines established by the American College of Emergency Physicians Cruise Ship & Maritime Medicine Section.”

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A clinical staff from multiple nationalities works in MSC Cruises’ facilities. The medical professionals also adhere to the standards prescribed by the American College of Emergency Physicians – Cruise Ship Medicine Section Guidelines.

A hospital-like treatment room in a medical center on board a Princess Cruises ship. PRINCESS CRUISES

Holland America’s medical centers are staffed with a team of experienced physicians and nurses that can manage a broad range of conditions. The onboard facilities are fully equipped with testing and treatment capabilities, and the team has a close working relationship with the Centers for Disease Control and Prevention (CDC), the U.K.’s National Health Service, regional and local public health agencies and the University of Texas Medical Branch. These associations benefit both the guests and their employees.

Azamara’s spokesperson tells us that the medical facility on board its four boutique ships offers “enhanced equipment, isolation staterooms that provide comfortable and complimentary care, onboard testing capabilities and telehealth medical support. Guests who fall ill will meet with the medical team, which is typically at least one registered physician and one nurse, who will then develop a multi-level response plan.”

Viking‘s website also states that its ocean and expedition vessels have upgraded state-of-the-art medical facilities with specialized equipment.

It’s best to contact the company directly if you’re traveling with a smaller cruise or expedition line and want information on specific capabilities and the medical services they offer should you become ill or injured. Many smaller ships sail close to shore, so additional medical facilities will be available in port. However, this won’t be an option when sailing expeditions to remote destinations like Antarctica or the Arctic.

Related: How to avoid seasickness on your next cruise

Do I need an appointment to see a doctor on board?

You should visit the medical center if you have a persistent sore throat, headache, fever, body aches or an upset stomach that could be the flu or a contagious virus, such as COVID-19 or norovirus. If you’ve tripped or fallen and have a swollen ankle or hand, you should also seek medical care.

According to a representative for MSC Cruises, you don’t need an appointment to go to the onboard medical centers. Walk-ins are welcome 24/7, but you can also make an appointment.

MSC’s spokesperson recommends seeing someone if you’re not feeling well, and they tell us their staff can handle a “spectrum of medical situations ranging from routine general practice cases and medical emergencies to those requiring intensive care.”

Holland America guests can dial the emergency number on their cabin phone 24 hours a day for medical assistance.

Azamara’s medical centers are open twice a day for walk-ins. If you need to see someone during off hours, guest services can call an on-duty nurse.

On a Carnival Cruise Line ship, medical staff is on call 24 hours a day for emergencies. On sea days, you can visit the medical center between 9 a.m. and noon and again between 3 and 6 p.m. On port days, the facility is open from 8 to 10 a.m. and from 4 to 6 p.m.

According to its website, Princess Cruises‘ ships also have medical centers staffed by full-time registered physicians and nurses. The facilities are open twice daily, and they provide 24-hour emergency care.

Can you get a COVID-19, flu or strep test on the ship?

Most cruise lines, including those mentioned above, can perform various tests, as needed, as part of the medical services offered. These include testing for COVID-19, flu, strep or other suspected illnesses.

Some lines, like Azamara, offer COVID-19 testing without a medical consultation, while others, such as MSC Cruises and Holland America, do not offer walk-in testing. Guests must see a physician first to determine if testing is necessary.

Related: Why I feel safer now on a cruise ship than in my home town

“The onboard physician may recommend a test for COVID-19 if one’s symptoms suggest the possibility of a Covid infection,” shares a Holland America spokesperson in an email. “We encourage our guests to purchase their self-tests before traveling and bring them aboard. In that way, if they have any concerns, they may test themselves and protect their family, fellow guests and our crew. Of course, we do request they notify the medical staff if they test positive.”

Can I get medications on board the ship?

It’s better to pack any medications you’ll need during your cruise. PYROSKY/GETTY IMAGES

If you forgot to pack basic over-the-counter medications, such as aspirin, ibuprofen, allergy medications or antacids, these items are typically available in one of the shops on the ship or at the medical center. You should also be able to find them at a pharmacy in port when you go ashore.

If you’ve forgotten prescription medications and need a prescription filled, you’ll have to visit the medical center to see a nurse or a physician. A cruise ship can’t stock all possible medications, so you might need to accept an alternative.

Cruise lines aren’t going to release their formularies, but they probably have prescription medications for the most common ailments such as high blood pressure, cholesterol, diabetes and thyroid disease. They also stock antibiotics for infections.

If you have another medical condition, you may not find the appropriate medicines to treat it on board. On its website, Carnival advises that its ships may not have certain medications and vitamins available. If you forgot your medications and they’re not stocked on your ship, you must visit a medical facility ashore.

MSC Cruises urges passengers to bring any required medications for their journey from home. If they forget or need something, over-the-counter medications are available in the retail spaces. Guests will find some medicines at the reception desk for minor ailments like motion sickness. They can visit the medical center for other requests, such as basic prescription medications inadvertently left at home.

Related: 27 cruise ship embarkation day do’s and don’ts

In addition to over-the-counter medications available at the retail shops, such as pain medications for headaches, cough drops or upset stomachs, doctors at Holland America’s medical centers can prescribe and dispense basic medications you may have forgotten. They also have medication to treat severe illnesses until a guest is better or until they can be brought ashore for treatment.

Some over-the-counter medications, including antacids and ibuprofen, are available to guests at the medical center on Azamara’s ships. If a guest needs a prescription medication, it can be prescribed after a consultation.

Carnival sells over-the-counter medications for colds, coughs and upset stomachs at the medical center, or in some cases, at the retail shops. Its ships also have motion sickness pills available (for a fee) through room service, guest services or the medical center. In extreme cases, they can administer a shot for motion sickness.

The line also offers complimentary medi-coolers to store prescription items that must be kept at a specific temperature. They are available in limited quantities with a $75 deposit. You can request one once you’re on board the ship.

What if I fall and break a bone or need stitches?

The trained staff at the ship’s medical center can handle injuries, such as broken bones or deep cuts that require stitches. If the injury is more severe, the medical team can stabilize a guest until the ship reaches the port and the patient can be transferred off the ship.

MSC Cruises’ onboard medical centers can handle a spectrum of medical situations, including the initial management of fractures and suturing of lacerations, a spokesperson explained.

Holland America’s medical centers are also well-equipped to care for guests that need immediate medical attention, much like an urgent care center at home. Their ships have X-ray machines, and the medical teams are trained to operate radiology and lab equipment.

Azamara can also handle these types of injuries, says a spokesperson for the line. In the case of a broken bone or orthopedic injury, the onboard provider will also recommend that the guest follows up with an orthopedic referral at the next available port.

“While Azamara’s onboard staff is available to help with any medical issues that arise, the medical facilities are not intended as clinics for guests,” a spokesperson says. “Azamara is not responsible for the diagnosis, treatment or services furnished by shipboard medical personnel, who are independent contractors.”

What if I’m really sick and need a specialist or hospital?

For life-threatening emergencies, a medical helicopter may evacuate a patient from a cruise ship. IMAGINEWITHME/GETTY IMAGES

The medical staff on oceangoing vessels are trained to handle emergency situations such as a heart attack or stroke and they have defibrillators and other life-saving equipment on board in case of such emergencies.

MSC Cruises’ vessels are equipped with intensive care facilities where guests can be stabilized and cared for until the passenger can be transferred to a hospital. If the ship is at sea, the ship’s captain and medical staff will need to decide how the passenger will be evacuated. Options may include a diversion of the ship to the nearest port, a boat transfer or, if necessary, a helicopter evacuation.

“The decision is influenced by a variety of external factors, like weather, distance to land and resource availability,” an MSC Cruises spokesperson told TPG. “The decision is also made by consulting with local shoreside maritime authorities.”

Related: How to avoid getting sick on a cruise

Holland America also has established and well-practiced medical protocols surrounding treating seriously ill passengers. “In situations that require referral to shoreside hospitals, the shipboard treating doctors evaluate suitable options by medevac,” a company spokesperson said.

The line works with local emergency services to arrange for the patient to be picked up and transferred to a designated shoreside medical facility when necessary. The care team will also continue to assist and support the disembarked guest and their traveling companions.

Azamara will also assist in bringing guests that need additional care to a hospital as quickly as possible. The onboard team will request an airlift if necessary (depending on the location). Since the line’s itineraries include more time in port, ships are typically close to land. Azamara will also follow up with the guest to ensure they receive the necessary care.

Royal Caribbean Group’s physicians and nurses are required to maintain Advanced Cardiac Life Support (ACLS) training. “In responding to medical emergencies, our goal is to first stabilize emergency patients and, when necessary, evacuate the patient to an appropriately equipped and staffed shoreside medical facility,” its website says.

Will insurance cover me if I get sick on a cruise?

You’ll be charged a fee for service if you need to visit a physician or nurse during your cruise. Cruise ships don’t file insurance claims, so you’ll have to do that directly with your insurance company once you’re home. Princess’ website clearly states that charges for medical services will be added to your shipboard account and that guests will receive an itemized bill to send to their insurance company.

This is one of the reasons to invest in travel insurance when you travel. Your regular health insurance policy may or may not cover you when you’re traveling outside the country — or will only cover some but not all of your expenses. Some insurance plans, like Medicare, won’t cover you outside the U.S. except for a few specific emergency circumstances. A travel insurance policy with good medical coverage can make up the difference or reimburse you for medical bills your regular insurance won’t.

Related: The 5 best cruise travel insurance plans

Bottom line

It’s advisable to bring emergency supplies with you when you cruise because you never know what might happen. You’ll want to pack essential over-the-counter medications, such as ibuprofen, aspirin, antacids and allergy medications. If you think you may need any of these medicines during your vacation, you’ll want to have them on hand, so you won’t need to pay high prices on the ship or schedule a consultation with a doctor in order to get them.

You might also want to bring a COVID-19 test with you or any braces or assistive devices you occasionally use. It will be much cheaper to bring them from home than to purchase them on board.

Also, consider purchasing a travel insurance policy to cover the cost of medical care that your regular health policy won’t reimburse you for when traveling, especially when you’re out of the country. Depending on the policy, you can also recover some of the expense of the trip if you have to return home early.

It’s important to know that if you fall ill or become injured during your vacation, you can get medical care on board the ship for many situations – or at least be stabilized until the medical team and crew can transfer you ashore to a hospital or emergency facility.

It’s best to check with each cruise line before traveling to understand their policies, especially if you have a preexisting condition that could flare up while on the cruise. Be sure to ask what medical care is available specifically on the ship you’ll be sailing on, as older and smaller vessels may have different facilities and capabilities than the newer and larger ships.

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