When Cruise Passenger reported on the $21,000 Covid bill Brian Shaw received while on an American ship, it quickly became clear that the way lines dealt with sick passengers was a big source of concern.

Some 80,000 read our story. And dozens poured out their own stories of how they were treated if they fell ill on the seas.

Many comments were filled with praise for the way both companies and crews took care of them. Others experienced big bill shocks and patchy care.

What was clear was that there are inconsistencies and a bit of potluck. Some lines put their passengers first. Others, perhaps not so much.

Covid and the pandemic put the entire travel industry under huge pressure. Both financially and in terms of crew and staff. And the insurance industry was also hit with dilemmas it had not been prepared for.

And a Covid bill at sea is never going to be cheap. While most lines now have very good facilities and skilled staff, it is a complex and expensive service.

Today, however, a clear and consistent policy and transparent charges are needed to help ease the worry and anger some passengers still feel about the way they were treated.

While Mr. Shaw was covered under his travel insurance, he still had to stare down the barrel of a $21,000 bill.

A big Covid bill but big praise

Bruce Hurrell from Mildura who is in his seventies says he received an even bigger bill. After three days of treatment for Covid and pneumonia on Norwegian Encore and onshore in Panama, he and his wife received a $47,000 bill.

The Hurrell’s treatment included three days on IV drips and 24 hours of ICU treatment. On his itemized cost breakdown the 24 hours of ICU treatment came out to about $21,000 each. And, the IV drip about $2000 each. 

That said, Mr. Hurrel said the medical services were exceptional.

“Treatment and attention onboard was exceptional. Once I was hospitalised in Panama, NCL was in regular contact with me from Miami. They checked on my progress and well-being. In addition, a local NCL doctor visited me daily to assess my health and well-being.”

Mr. Hurrell, who has sailed Norwegian nine times, added the experience hasn’t turned him off cruising. He has more NCL cruises booked. 

$20,000 off Australian waters 

Cruise Passenger reader Peter S and his wife developed acute bronchitis during a repositioning cruise. While their insurance covered them in the end, they had to pay a $20,000 Covid bill, up-front for medical costs. 

However, the cruiser said he understood how it works and thanked  NCL and the Norwegian Star for the treatment.

“Our own Covid bill of $20,000 seemed to be about the same as we would expect to pay for several days of unassisted pay-as-you-go medical care.

“They have to focus on best quality treatment instead of trying to keep the billing down. They would be sued for zillions by the deceased’s family if things ever went worse due to cutting corners.”

Delightful Princess

Many passengers particularly singled out Princess Cruises for exceptional treatment.

Diane Takacs wrote: “One year ago I contracted Covid whilst on a Princess cruise and they were wonderful to me.

“I just had to pick up the phone to order food and drinks and everything arrived relatively quickly and hot. We were given WiFi as well. Because I was positive about when I returned home, my friend could not come to Brisbane to collect me. Princess organised a taxi for me to my home on the Gold Coast.

“I also received credits for the nights I was in isolation. One day, they sent a gift from the Port we had visited when we had Covid.”

Vicki Ritchie had a similar positive experience with Princess.

“Not only were we upgraded to a balcony cabin, we could order anything from the specialist menu including wine. In addition, we got a credit, which we’ve since used on another Princess cruise.

“Given their amazing choice of movies you can watch at any time, cabin upgrade, room service, and the choice of food, the extra credit on our account, Princess was more than fair!”

Judy Crane had the same glowing review of Princess.

“We can’t fault Princess Cruises. After contracting Covid on our cruise in February this year. We received daily antiviral tablets and medical staff checked on us each day.

We could order any food or drinks at any time day or night all delivered to our cabin. Also, we were given $250 each as a pro-rata refund for lost days.”

Special with Celebrity Cruises

Celebrity Cruises’ treatment of Ron Stretson and his wife on a 17-night Hawaii cruise was also reportedly wonderful.

“Celebrity Cruises were just fantastic when my wife and I caught Covid on a 17-night cruise from Sydney to Hawaii. They treated us like VIPs. We had a Covid concierge who was amazing. Great food and lots of water. 

“We had no Covid bill for medical expenses. And they refunded us for the days we were in isolation. A credit to their handling of this pandemic.”

Kachini Gilcroft felt the same five-star treatment from Celebrity.

“Celebrity gave us free antivirals and excellent food for the five days I was confined. They moved me to the cabin next door. My travel buddy was ill three days before me, and then had to leave the ship with heart problems. 

“I was so well looked. If I’m going to get Covid this is the best place to be! They also refunded fares pro rata. I can recommend Celebrity Cruises.”

So what should you do? What the experts say 

Certified CLIA cruise agent and owner of Deluxe Cruise & Travel Sharon Summerhayes says these stories aren’t uncommon. Especially where Covid treatment is concerned.

Ms Summerhayes has even seen a spectacular $1 million bill for six nights of ICU for a six-month-old baby in Hawaii. A stern reminder there are no limits to how high that bill can rack up. 

Ms Summerhayes warns that cruise lines will try and make you pay the Covid bill upfront. However large it may be. 

“They do try their absolute best to get you to pay. They’re gonna try everything they can to get it out of you.

“The best thing would be to contact your insurance company straight away. You need to speak to your insurance company and get them to confer directly with the ship. 

Ms Summerhayes also says that in the fine print of your cruise contract. “It gives them permission to try and charge the credit card you have on file. Even if you haven’t authorised it.”

Try and negotiate

If the Covid bill treatment is overly crippling for your finances, hold firm and negotiate with the cruise line. Make sure that they have all your insurance details and you’ve contacted your insurer.

For when you’re leaving the medical centre, Ms Summerhayes says they should provide you with everything, but double check.

“They should provide you with everything anyway, but always ask for a full report, because you’ll need to send that to the insurance company. Also make sure you grab an itemised bill, because you’ll need that as well.

“Make sure you don’t leave the ship without any documents you need, as it’s much more difficult to grab them afterwards.”

As an extra tip, Ms Summerhayes says it can even pay to be a bit careful about what you tell the doctors onboard.

“Even a passing comment like ‘Oh I usually get sick when I go away’, could be used by your insurer to infer that you have a pre-existing condition. Make sure what you say is only on a need to know basis and isn’t giving an insurer a path to blocking your claim.”

Of course if you have pre-existing conditions you should tell your doctor, but these should have been already mentioned to your insurance when signing up.

Every cruise ship has first class medical facilities

All large cruise ships are equipped with first-class medical facilities which are run by trained medical professionals. For example, a Royal Caribbean ship will have two to three licensed doctors and three to five licensed nurses on-call 24 hours a day. 

All major ships sailing in Australia have comprehensive medical facilities onboard. But cruise medical centres aren’t hospitals and if a patient’s condition escalates to a certain extent they will need to be transferred to a hospital. However, modern cruise ships do have the facilities to safely manage the majority of conditions and injuries. 

If you have a pre-existing condition, cruise wisely 

If you have any pre-existing conditions or other reasons to be health conscious, it’s good to be wary if you are planning on expedition cruising or any other type of small-ship cruising. These smaller ships may not have the extensive medical facilities of larger ships and it can be good to check in with the cruise line about what kind of care they can offer. 

Furthermore, these ships often travel to more remote areas which make medical transfers much more difficult, so if you are at a high risk of something serious, it may be best to avoid them.

You don’t need an appointment

If you come down with something or hurt yourself on a cruise, head straight to the medical centre, you don’t need an appointment. If you do have a more minor issue that can wait, you can generally make an appointment to cut down on your waiting time. 

Generally, cruise ship medical centres are available for walk-ins 24/. So don’t hesitate to visit the medical centre.

You can also dial emergency numbers from your room phone if you are unable to get yourself to the medical centre. Furthermore, if the medical centre is closed, there will always be a number you can call for emergency treatment.

Can you get a Covid test for free?

Whether you can Covid test for free will vary greatly depending on where you’re sailing and who you’re sailing with. The simplest advice is to take a few RATs onboard with you and save yourself the hassle.

If you’re sailing in Europe or America you may have a more difficult time getting tested and may need to be assessed first. In these regions most ships no longer are sailing with strict protocols so you will need to be exhibiting symptoms or have come in contact with someone who is, to be tested. 

On Australian ships it will vary line-to-line, but as Covid protocols remain in place. But if you have reason to believe you may have Covid you should be able to get your hands on a test. However, if you have to be assessed before testing, whether in Australia or other parts of the world, this will generally come with a bill for a doctor’s consultation. 

What happens if you get Covid?

If you do test positive for Covid, in Australia it is mandatory to isolate for five full days. The doctors will make an assessment on the kind of treatment you need, which could simply be rest and painkillers, or in more serious cases may be antiviral medications or an IV drip. 

Many customers of cruise lines like Princess and Celebrity have received free antiviral medication, however, more serious medical services or basic medical services with other lines will generally incur a charge. 

Does your insurance cover cruise medical costs?

Travel insurance can cover cruise medical costs, however, the crucial information is that it doesn’t always. The majority of insurance providers will make you buy an extra ‘cruise pack’ if you also want to be covered for medical expenses when on your cruise. 

As long as you disclose all pre-existing conditions, and haven’t engaged in reckless behaviour, cruise medical cover is generally unlimited and you’ll qualify for coverage no matter the bill.

Currently, most cruise packs cover Covid-related medical expenses onboard cruise ships, but it’s very important to read the fine print and make sure this is the case for yours as well. 

What medications do ships have onboard?

Large ships will always have pharmacies or shops onboard where you can buy all standard over-the-counter medications. However, if you are cruising overseas you might want to double-check that the medication is also over-the-counter there and doesn’t require a prescription. Furthermore, if possible it’s best to bring your own medications with you as they will always be more expensive on a ship.

In terms of prescription medications, you can generally expect larger ships to have prescription medications for common conditions such as infections, high blood pressure, diabetes, cholesterol, and so on. 

You can’t expect ships to have everything stocked so it may be best to bring extra prescription medications or have a member of your travel party visit a medical facility at a port. In saying this, it’s always worth checking what the ships have in stock before panicking or planning a port visit. 

What happens in case of an emergency?

Cruise ship medical centres aren’t hospitals. And if conditions become life-threatening or overly serious, a transfer to a better-equipped medical facility will be necessary. In the majority of cases, this will involve the cruise ship transferring you to the next port, but in serious emergencies, helicopter evacuation may be necessary. 

If this is the case, serious consultations will be made with shoreside medical authorities about safety and you can assure the utmost care will be taken.

Cruise lines generally have existing relationships with local emergency services at ports so you can get the care you need as quickly as possible.

In Australia, stories of emergency evacuation are rare but do happen and cruise ships are well-equipped to handle them.