As a general rule, around the world, no Coast Guard (USA or other countries) will charge to evacuate you off a cruise ship. We are not aware of any cruise medical evacuation done by anyone other than a Coast Guard organization or the military (who also does not charge). On our many cruises (more then 3 years on cruise ships as a passenger) we have seen several ship helicopter evacs and they were all done by Coast Guards....with the exception of a US Navy (the SEAL aviation unit from San Diego