What to expect if you have to visit the medical facilities onboard a cruise

Things sometimes go wrong on cruises. Even a minor medical incident can undo all your careful planning. What happens when you're in the middle of the ocean or in a foreign country where your cruise ship is docked and you find yourself in need of a doctor? It's happened to me twice, and I have to confess, there were things about the experiences that surprised me both times.

My first encounter with the medical facilities on a cruise ship involved heat exhaustion and dehydration while tendering back to one of Windstar's sailing yachts. I almost made it back on board but collapsed into my husband's arms as we started up the gangway stairs. What I awoke to was surprise number one.

The captain may be involved in your medical situation

Cruise ship captains are the final decision-makers onboard any ship and must be apprised of things like outbreaks of illness, guests injured in port and minor injuries that could escalate. In my case, the captain's face was the first one I saw when I opened my eyes. Hubs said she ran down the gangway pushing everyone out of her way to reach me and assess my condition herself, quickly taking control of the situation.

You could be kicked off the ship for not being healthy

The captain has the ultimate say in whether an injured or sick guest can even continue the cruise. Luckily for me, once inside the ship's medical facility, the onboard doctor determined I was simply overheated. With some Gatorade and a bit of monitoring, I was cleared to continue the cruise. If either the physician or the captain had been worried that my fainting incident was a sign of something more serious, I might have faced being left behind in St. Lucia to seek medical treatment there.

Cruise ship crew members may use the medical facilities more than guests

On a recent transatlantic cruise on Carnival Legend, I visited the medical facilities for a minor illness and found it to be a bustling place, much like a primary care clinic on land. I was surprised to see that while I waited to talk to the doctor, several crew members came through the doors. Most were there to pick up prescription medications. I overheard one checking in for a routine physical and one was there for a vaccination. It's one of those scenarios you don't think about when you cruise, but this is essentially crew members' regular doctor's office.

There are facilities for guests (or crew members) to be monitored overnight

Carnival Legend's medical facility included a central nurse's station, several exam rooms, two offices, a mortuary and a fully equipped hospital room where a patient was under round-the-clock care until we docked in Tampa for disembarkation. Her family members came and went, visiting like they would at any hospital. One even brought her a milkshake. It's good to know ships have hospital-like accommodations, but keep in mind, these are limited, so if you do get seriously ill or injured, you will likely want to seek out medical attention on land.

About that mortuary…

I knew cruise ships had morgues, but I had never actually seen one until I saw Carnival Legend's. The stainless-steel door in the corner of the exam room where the nurse took my vitals was clearly labeled "mortuary," even with the expected temperature range shown on the door. Unfortunately, it was my understanding that the mortuary was indeed occupied as we neared the end of our 15-night cruise. And that, too, is not as rare as you might think. It's estimated there are about 200 deaths on cruise ships per year — perhaps not surprising given more than 30 million people cruise per year and their average age is just shy of 50 (though it was higher before the pandemic). Hopefully your only morgue sighting will be like mine — unrelated to your own health!

Many medications are available onboard

On the Carnival ship, if the doctor orders a prescription for you, one of the nurses at the nurse's station steps into a locked pharmacy area and dispenses your medication. There is also a large rack of common over-the-counter medications available. I've been on ships where motion sickness medication and Tylenol are dispensed free of charge, either at guest services or just outside the door of the medical clinic. One guest who came into the medical center while I was in the waiting area asked for something for a cold. They were surprised to learn that a decongestant was not free of charge, nor was a chat with the doctor, which brings us to our next surprise.

Most onboard medical assistance comes at a price

On Carnival, when I first checked in, one of the forms I signed was an authorization to charge my stateroom account. At the end of the visit, I was presented with an invoice for $214.80. The total included $170 for professional services and $44.80 for ten antibiotic tablets.

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On the Windstar ship my exam was far less involved, resulting in a bill of around $100. Both bills were eligible to be paid under the medical part of a travel insurance policy, but it required my filing the claim after paying the bill myself. All of this to say, a cruise line likely will not accept payment directly from any kind of insurance. You pay with your onboard account, then use the invoice and record of the visit to file a claim yourself. Windstar provided the bill and detailed record of the event at the end of the cruise. On Carnival, I was told to stop back by in a couple of hours, and they would have the visit record to go with the invoice printed for me.

Bottom line

Medical help for illness or injury is available on board cruise ships of all sizes.

Facilities and crew are set up to manage even life-threatening emergencies, at least until you are stabilized and able to disembark into more capable hands.

I've been on multiple cruises where passengers were disembarked into ambulances in ports of call, one where a medical team came onboard via a Coast Guard boat and two that required helicopter evacuations. The best advice I have is to be prepared with your own first aid kit for minor problems, but to have a plan B that consists of enough credit to pay medical bills up front, either onboard or in port — and back that up with a cruise travel insurance policy that has supplemental medical coverage.

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