Contemporary travelers are increasingly health conscious but often fail to consider medical care when planning a vacation. They should be asking questions. How well prepared are cruise ships when medical emergencies arise? Is superior medical care offered only on 6-star cruise ships? Will private insurance/medicare cover medical expenses incurred on a cruise ship? Read on for the answers.
We made some personal discoveries on the Crystal Harmony, a 6-star luxury ship, as Toni noisily coughed her way to the infirmary. We were impressed seeing five beds with an intensive care area, sophisticated x-ray equipment, surgery and laboratory facilities. The ship's doctor, movie-star-handsome, Keith Gretemeier, diagnosed and treated bronchitis professionally. Trained in the United States, Germany, and England, his medical credentials and fluency in six languages won him the job in 1992. He is Board Certified as a family care and emergency physician capable of treating the most serious illness, injury or emergency, including cardiac strokes.
Our shipboard account was billed for the visit and medication dispensed. We forwarded the bill and medical report to Medicare for reimbursement, only to be informed that Medicare does not cover passengers on cruise ships not registered in the United States or sailing in American waters. Most senior cruisers may not be aware that since the majority of cruise ships are registered in other countries they are not covered by Medicare. Secondary coverage, Blue Cross/Blue Shield, instructed us to file an overseas claim with a special division: Care First Blue Cross Blue Shield, 550 12th St. SW, Washington DC 20065.
Celebrity Cruises' policy doesn't permit publication of doctors' names or photos, but we were permitted to interview a young physician who had served for a year on the upscale Celebrity Mercury. Two physicians and three nurses contract for six month intervals in a first-class treatment facility. It "lacks nothing" according to the doctor. "I get everything I need" from the company whose policy is to visit only ports with adequate medical facilities. He said that on Celebrity ships all doctors and nurses must be qualified in advanced cardiac life support and have American medical experience. They are available 24 hours for emergencies. As we were leaving, a woman in a wheelchair arrived and was quickly diagnosed with a fracture. Fortunately, she was on a cruise ship that provides outstanding medical attention.
Two views of the Infirmary aboard Mercury
Although, originally from Colombia, this Celebrity Cruises' doctor spoke perfect English as well as three other languages. The cruise industry has been criticized in print recently for hiring physicians who don't speak English and are not well-trained.
Other Cruise Lines
While we were sailing on an economy cruise to Mexico, passengers who carelessly ate and drank while touring Chichen Itza and Cozumel were stricken with the dreaded "Montezuma's revenge" gastrointestinal disturbance. The doctor, sailing his first voyage on Commodore's Enchanted Capri and unfamiliar with his medical surroundings, was swamped with ill passengers. The nurse was experienced, but the situation wasn't ideal.
Two women cruising with us who suffered injuries on Premier Cruises' SeaBreeze and American Hawaii Cruises Independence raved about their care. The hostess on the SeaBreeze, an older budget ship, told us that international doctors sign on for six month tours and alternate among the line's seven ships. The physicians work with two nurses and are professional cruise doctors. The doctor who sailed with us on American Hawaii's Independence had worked twenty-one tours on that ship, as well as tours on other cruise ships.
Margaret Taylor, a lovely English lady, sailing with us on the Seabourn Sun related suffering a serious thrombosis during the cruise. The ship's doctors and nurses made several visits to her stateroom providing excellent care.
Mickey Arison, head of the Carnival Cruise Line empire, says 60% of their doctors are American, the rest are Canadian and British and stringent guidelines for employment are enforced.
Disney Cruises employs U.S., Canadian, British, and Scandinavian physicians to treat their passengers, a lot of whom are youngsters. Seasickness and sunburn are frequent passenger complaints.
On Royal Caribbean's Splendour of the Seas, a tablemate of ours sported a green complexion that screamed "seasick" and clashed with her outfit. After an injection by the ship's doctor and medication, she enjoyed the balance of the cruise.
The Delta Queen Steamboat Company's paddlewheelers, Mississippi Queen and Delta Queen, which sail American rivers, do not carry a doctor. The hotel manager assured us that they cruise so close to shore the captain simply pulls over, and debarks the passenger, accompanied by a ship's representative, to the nearest medical facility.
Taking advantage of new technology, Princess Cruises' Grand Princess and Sun, Dawn, Sea & Ocean Princess series have satellite hook-ups to Cedars Sinai, a major Los Angeles medical center, for medical consultations. Eventually, Princess Cruises plans to implement ultrasound technology for the fleet. Renaissance Cruises is installing a linking system to Johns Hopkins on its new ships. Other cruise lines are employing a "wait and see" stance regarding the new innovations.
Erik Elvejord, head of public relations for Holland America Line states that Holland America and Windstar doctors are all U.S./Canada trauma-certified doctors. On average they work 3 to 4 weeks at a time because many are practicing doctors in emergency rooms. The dentists aboard do shorter tours, but in a less critical position. Dentists are a rarity on cruise ships, but Holland America has one to care for crew and the occasional passenger emergency.
Passengers should carry required prescription drugs and copies of their prescriptions on their person, not in luggage. Carrying vital X-rays, medical information, a list of personal doctors and dentists, family members, and their phone numbers, e-mail, or fax numbers is advisable. Bring insurance information in the event a company must be called to authorize surgery or special treatment.
ALL PASSENGERS WHO DESIRE NOT TO BE RESUSCIATED IN CASE OF A LIFE-THREATENING ILLNESS OR INJURY SHOULD CARRY A DURABLE POWER OF ATTORNEY STATING THAT FACT. Absent such a legal document, physicians and emergency technicians are usually required by law to use any and all means to sustain life.
We highly recommend that anyone planning a cruise investigate supplemental medical insurance and trip-interruption insurance. The unexpected expense of a ship's infirmary can put a big dent in the vacation budget, not to mention the cost of medical evacuation being responsible for putting many a cruiser into bankruptcy.
Medical caretakers are independent contractors, so cruise lines are NOT liable for their actions. There is no uniform international oversight of medical standards. Ships are governed by the laws of the countries whose flags they carry. If concerned, cruisers should ask questions of their travel cruise specialists or the cruise line directly. As the spotlight is focused more and more on the industry's passenger medical care, every cruise line will most likely be required to provide 6-star medical personnel, equipment, and treatment to their guests.
Photos courtesy of Jack White.
Jack and Toni White of Rancho Mirage, California have, for many years, been freelance travel writers specializing in cruise travel. Their articles have appeared in newspapers throughout the United States and Canada, including the Chicago Tribune, Dallas Morning News, and Vancouver Sun. Prestigious Palm Springs Life magazine published their article on filming the movie "Out to Sea" on the Holland America Line Westerdam. They also write regularly for Mature Living and Plus, formerly Senior Life.
Jack graduated from USC as an architect. His background in architecture allows him to review, write, and produce photographs from a unique perspective. Toni attended UCLA after graduating from Hollywood High School where she had been the Feature Editor of the Hollywood High School News, where one of the writers was comedienne Carole Burnett. Toni lived abroad for many years in South America and in the UK and has a familiarity with different cultures that influences her writing. The Whites love to travel and especially want to share their passion for cruising with you.
Toni & Jack White may be reached at: JACNTONI@aol.com.
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