What happens if I get sick on the ship?

Most ships have onboard medical facilities. Thus, when someone becomes ill or gets hurt there are facilities aboard where they can seek treatment. This is usually an area well marked on maps of the ship’s layout.  Also, a quick call to guest services or in some cases 911 will get you help or directions to the ship’s medical facilities.

Norovirus, a collection of stomach flu type virus illnesses, is one things that sends many folks to the medical facilities. Most cruise lines will evaluate and treat those with norovirus at no charge to the passenger because they tend to spread among passengers when the ill are not quickly and properly treated.

Although ships have medical facilities, it is not an open invitation for the sick and severely injured to travel by ship expecting treatment while at sea. In that kind of situation advanced communication with the cruise line and ship is needed to ensure the care needed while on the cruise will be readily available. Also, if you get injured while on shore on a shore excursion, it depends where you are traveling if you will be better seeking care in the port or back on the ship. Again, it boils down to the ship is not running a full specialty clinic or emergency room but instead hosts a clinic prepared to help in emergencies and treat most basic issues that your primary care doctor would see.

The ship and cruise line typically has arrangements with one of the telemedicine providers back in the USA, much like airlines have, where they can get advanced treatment information as needed. This may include assistance arranging medical evacuation from the ship where needed. In these cases the evacuation may be by air or thru an unscheduled port stop depending on many different factors.  These factors include the needed care and what will get the needed care most quickly for the sick or injured crew member or passenger.

What to do is you get sick on the ship; first if it is something beyond what you can treat with the over the counter medicine you bring with you, go to the clinic during normal hours (it is less expensive than an after-hours visit) and get evaluated. Just because you are sick doesn’t mean you will be treated differently by the crews. Then take the treatment and get well so you can enjoy the rest of your cruise.

If you get hurt and need help getting to the clinic let the nearest crew member know or call 911 on a ships phone. This will begin an emergency response to the scene of your injury allowing the crew to assist you to the clinic for evaluation and management of the injury. Again, the ship may consult shore side physicians for advanced advice and assistance facilitating advanced care as needed.  If the physicians agree an immediate evacuation is needed the Captain of the ship gets involved as a nearest port will be determined and possibly if near US waters a call to the United States Coast Guard will be called into action. There are even cases where the US Navy has assisted getting passengers off the ship to definitive care. Air evacuation is of course a last resort situation.  At least in the US there is no charge by the US Coast Guard or Navy for their assistance, although in foreign countries it is possible a charge will apply.

Buying a travel insurance policy is very important when traveling on foreign trips. They may provide primary coverage for medical care on the ship in addition to helping cover the cost of medical evacuations as needed which can be really important. If you are taken off the ship in a foreign port and have to be evacuated back to the United States it can be a very costly endeavor, thus the insurance is critical.

If needed on most ships you can get medical care for illness and accidental injuries.

How is immigration handled in each port?

The immigration of passengers into each port of call and the final destination port are of concern to some cruisers. Typically it is a process which takes place behind the scenes. The ship typically has hours between ports in which the guest services crew is able to send advance arrival lists to the immigration authorities in each port well in advance of arrival.  This allows upon arrival a very fast clearance of the ship’s passengers to go ashore.

In some foreign ports (non-USA that is) each passenger will be provided with and must retain a landing card which is their tourist visa. These are most typically collected upon arrival back to the ship allowing a very quick count of # of visas distributed and returned to see if anyone is trying to overstay their visit. Of course anyone having an emergency while ashore is handled somewhat as an exception.  These ports tend to be in areas of the world where cruising is more of a new phenomenon and are infrequent.

Immigration issues are also one of those things that differ depending on where the passenger is from, as those from the USA face one set of immigration rules while those from other countries have totally different immigration rules. These rules vary on who must have an immigration/visitor visa when they visit a particular country. Also, it may be that some countries require a lot more work to get a visitor visa than is required of countries. Those with USA passports typically have among the easiest time getting VISAs issues ad needed for stops nearly anywhere in the world. There are a few places you can/should not travel on a USA passport though, and cruises don’t typically go there.

In most ports the passenger will never even know how their immigration takes place. In the Caribbean an official will come aboard the ship and look over some overall ship records and clear the ship or single out specific passengers. As I said before typically with advanced notice of who is arriving, any specific issues can be addressed fairly privately and without any real issues allowing folks to dash for their shore excursions. This is one thing that makes sailing the Caribbean so nice for many persons. In fact in some places arriving with just the minimum paperwork to sail a closed loop cruise from the USA will not even be enough to get you into the port should you arrive any way other than by cruise ship.

On Caribbean sailings typically travelers, with few exceptions, will retain their own passports. In some cases certain foreign passengers must surrender them to officials when traveling to certain ports. Generally though cruising the Caribbean is so well set up that it flows seamlessly for the passengers. Sail out of Europe, the Middle East, Asia, and other places around the worlds and often you will be handing over your passport to the ship’s authorities for handling in each port. This helps make the immigration process flow much better than if each person had to queue up and go thru immigration on their own.

What is important to know though is what the immigration rules are for your arrival into each country you visit. Don’t assume that the cruise line will ensure you have them ahead of time, you must be sure you have all of the proper documents for your trip. Also, if you book well in advance be sure to double check the documents requirements shortly before the cruise to again make sure you have all of the proper documents.  Your travel agent can help you with this as well.

Can I get on and off the ship at alternate ports?

For those who want to cruise but think they can’t get to the departure port or who need to get off early, the question often comes up can I get on late or off early. There is however no simple answer to this question. It tends to vary based on what ports are involved, most specifically the departure and arrival ports for the ship. (The two ports being, where the cruise officially begins and ends.)

Ships sailing out of embarkation ports in the USA have special rules to follow. There are laws on the books which prohibit foreign flagged ships from taking passengers from one US port to another port for hire.  To add some clarity, taking passengers who remain on the ship is permissible, thus we have all the Alaskan Cruises.   What is not allowed is sailing passengers for pay from Anchorage to Seattle which is why you see the ships embarking and disembarking in Vancouver on the Southern end.

Round trip cruises out of and back to the same US port are permissible so long as if they stop at a port, a foreign port is included in the mix. Thus the round trip Alaskan cruises out of Seattle stop somewhere in Canada.  US flagged ships such as those owned by American Safari Cruises can depart and go to any US port they want without the same restrictions. NCL’s Hawaii based cruise ship is essentially the same situation where they have a US flagged ship serving the destination.

Since most of the cruise ships are foreign flagged (that is a whole different blog post) I will focus the answer there.  Most cruise ships with advanced notice of the special need for downstream boarding or early disembarkation are able to work it out. The key is that you are boarding in a US port and getting off in a foreign port or vice versa.  There are other cases and countries where you can’t get on or off at alternate ports like with the US. 

You will find many one way sailings between foreign ports and even transits of the Panama Canal. Notice though that the Panama Canal transits almost always you stop in Aruba which is one of the nearby distant foreign ports where ships can stop that allow then for one way transports between US ports by foreign flagged ports.

If you miss your ship catching up later is usually possible except on most Alaskan cruises sailing round trip from Seattle.  However, missing your ship and playing catch up can be a costly affair, hence the need for travel insurance.   Getting off early usually can be arranged. You just have to work it out ahead of time and make sure it is not in another US port than where you boarded.  Of course if it is a medical emergency there are provisions for paying a fine if it were enforced in the time of a medical emergency.