Perhaps you are one of the 7.5 million people in North America who are planning a cruise this year. You've compared cruise lines, pored over the brochures, trimmed your diet in anticipation of the sumptuous cruise feasts, and even bought new vacation clothes. But have you called your doctor? Or your health insurance provider?

Although illness may not be on your vacation agenda, it's wise to do some medical planning. Onboard medical facilities are no substitute for a hospital. And if you get sick while sailing the Caribbean waters, be prepared to shell out your own money; most insurance policies and Medicare do not cover cruise ship medical treatment.

What to Expect From Onboard Medical Facilities

Because cruise ships originate from many countries and travel internationally, there are no common standards defining minimum credentials for doctors or equipment on cruise ships. In 1995, the American College of Emergency Physicians (ACEP) developed recommendations for onboard medical facilities, and these recommendations were voluntarily adopted by the International Council of Cruise Lines (ICCL). Today, ICCL member cruise lines voluntarily comply with these guidelines, which also include equipment standards.

"Reasonable" Emergency Medical Care

The goal of medical personnel aboard cruise ships is to provide "reasonable" emergency medical care, which means stabilizing the ill or injured traveler until definitive treatment is available on shore.

At minimum, most ship infirmaries will contain:

  • One or more doctors and nurses
  • Oxygen
  • Cardiac defibrillators
  • External pacemakers
  • EKG and x-ray machines
  • Stretchers and wheelchairs
  • Immobilization equipment for back and neck injuries
  • Sutures
  • Medications
  • Bandages

As cruise lines continue to grow and medical technology improves, some ships are becoming equipped with telemedicine capabilities. The Princess cruise line, for example, has affiliated with Cedar-Sinai Medical Center in Los Angeles to consult with doctors and surgeons, using fax and even video to diagnose and treat onboard patients.

Sanitation

Whenever large numbers of people congregate in a confined area, disease outbreaks from an infected person or a tainted food supply become a real threat. The Vessel Sanitation Program run by the U.S. Centers for Disease Control and Prevention (CDC) inspects all ships that carry more than 13 passengers, visit a U.S. port or territory, and sail an international itinerary. Inspections are done twice yearly, are unannounced, and take six to eight hours to complete.

The inspections focus on:

  • Water supply
  • Food preparation
  • Filtration of spas and pools
  • Employee hygiene
  • General cleanliness of the ship
  • Training in environmental and public health practices

Each ship starts with a score of 100, and points are deducted for infractions. A score of 86 and higher is acceptable; any ship receiving a score of 85 or lower will be re-inspected within 30 days. All scores are updated every two weeks in the CDC's Green Sheet . It is a good idea to review these scores before making your choice of cruise lines.

Medical Care Cruises

People with medical restrictions may face considerable difficulties during long journeys on land or sea. Fortunately, there are agencies that specialize in making arrangements for people who have important medical considerations. Over 13 years ago, Ira Goldberg, director of Medical Travel Inc., realized that people with medical restrictions were just as interested in cruise vacations, but would need help navigating the myriad obstacles.

Today, this agency provides full travel service for people with ongoing medical needs and disabilities such as:

  • Dialysis
  • Heart problems
  • Oxygen dependency
  • Hearing, speech, or vision impairments
  • Arthritis

For people requiring medical care during their cruise, Medical Travel, Inc. arranges for them to be accompanied by appropriate health care professionals, such as physicians, nurses and therapists.

Before You Go...

Check CDC sanitation scores
Before you book your trip, review the CDC sanitation scores of the cruise line you are considering.

See your doctor
Have a check-up 6-8 weeks before your trip, and ask your doctor about any recommended precautions.

Check insurance coverage
Check with your health insurance provider regarding coverage. If you won't be covered while onboard, consider buying supplemental health insurance.

Notify the cruise line
You are responsible for notifying the cruise line of any pre-existing medical conditions, including pregnancy.

Pick your cruise line and ship carefully

  • Stick with cruise lines that are ICCL members.
  • Ask the age of your ship, and the cruise line's country of origin. The newest ships usually have the best medical facilities; North American and European ships are the most likely to have English-speaking medical personnel.

Travel insurance
Consider purchasing travel insurance , which provides support and some reimbursement for medical emergencies.

Bring medical records and supplies
Bring the following on your trip:

  • Copies of medical records listing your current medications and their dosages, blood type, allergies, and immunizations
  • Extra prescription and over-the-counter medications
  • Contact information for your home doctor and next of kin