Hospitals while on cruise

[Coopie]

I am a fairly seasoned cruiser but not so much with the hospital situation. We will be sailing the eastern c (St Thomas, St Marteen (spell), etc. I am curious about the hospitals should you need one off the ship. We have a family member who wants to go but who isn't in the best of health. I have heard terrible things about the one in Nassau but nothing about other islands. We are well aware of the care on board. Had to use it one time ourselves and was extremely pleased with the care on board. Just want to check out the hospital situation before this person makes a final decision as to accompany us.

 

Any help would be greatly appreciated.

[spookwife]

far too vague a question. what are their issues? what would necessitate hospitalization and what level of care would be required? can they even get the necessary travel insurance that would cover being hospitalized in a foreign country plus expenses while there and travel back to the US?

[NMLady]

I am a fairly seasoned cruiser but not so much with the hospital situation. We will be sailing the eastern c (St Thomas, St Marteen (spell), etc. I am curious about the hospitals should you need one off the ship. We have a family member who wants to go but who isn't in the best of health. I have heard terrible things about the one in Nassau but nothing about other islands. We are well aware of the care on board. Had to use it one time ourselves and was extremely pleased with the care on board. Just want to check out the hospital situation before this person makes a final decision as to accompany us.

 

Any help would be greatly appreciated.

 

If they do decide to go they'll need to pay for third party insurance within 7-10 days of booking in order for pre-existing condition to be covered. Even then, they need to read the policy for coverage terms. And definitely need "choose your own hospital" coverage. Not all policies provide that. Most are to nearest hospital.

If they are that worried about hospital, should probably not cruise.

[BlueRiband]

I'd have to agree with NMLady. If your relative's health is fragile enough that it's a real possibility that they may need to be hospitalized a cruise is not a good vacation choice for them. And a ship medical center is very limited. At best a patient will be stabilized and made comfortable before being transferred ashore and it will be the closest one in port. (And nobody will be flying back home to the States without a passport.)

[CruiserBruce]

And, if you feel you will require first world medical care...that will eliminate a lot of places you could cruise. Most of the Caribbean, for example.

[rccampbell]

And not to sound completely insensitive, if the person would need hospitalization or air-vac, coast guard, etc....this could hold up the ship and its passengers possibly causing the requirement to turn the ship around to go back to a port or not being able to make a port of call.

I personally would not like to be the person who knew I might need medical care but because of my desire to cruise messed up an entire ship load of cruisers from fully enjoying their vacation that they paid for too.

I also would prefer my own doctors, hospital etc if I was that fragile.

Perhaps a day cruise is the way to go as a thought.

[Coopie]

Thanks for the replys,,, I have to say I agree. Perhaps we will plan a land vacation prior/after cruise and have them join us on that.

[Essiesmom]

And even with travel insurance, they would need a credit card with a large credit line. Out of country hospitals are 'cash only', they don't take the insurance, You have to file a claim to be reimbursed when back home. And Medicare/medicaid does not cover out of country. EM

[cb at sea]

There is no way I'd travel while in "fragile" health...not would I want to assume responsibility for a family member who is considering it! It could be a difficult time, should a health issue arise.

[CPT Trips]

And even with travel insurance, they would need a credit card with a large credit line. Out of country hospitals are 'cash only', they don't take the insurance, You have to file a claim to be reimbursed when back home. And Medicare/medicaid does not cover out of country. EM

 

A "Medicare Replacement" policy may cover out of country medical expenses; I know mine does. We do get trip insurance for cancellation and the other expenses that may accompany a hospitalization/medical emergency.

[whogo]

Is the family member in question able to make the decision himself? Personally, there may come a time in my life when I would be happy to risk inferior health care while traveling abroad than be stuck at home because I'd be close to better health care.

 

From the US Department of State:

"Access to quality medical care is limited in Sint Maarten. Facilities may not meet U.S. standards. There is one hospital on the Dutch Side, St. Maarten Medical Center (SMMC), which offers 24-hour emergency services. The hospital has tiered health care with accommodations varying according to ability to pay.

Not all medical specialties are available in Sint Maarten. Critically ill patients requiring services not offered at SMMC are transferred to neighboring countries. Airlift is available to Puerto Rico and the continental United States in case of extreme medical emergency. We strongly recommend supplemental insurance to cover medical evacuation."

[Shorex]

Like many others who cruise and travel to countries around the world, we have a membership in MedjetAssist. If hospitalized anywhere in the world, Medjet will evacuate us to the hospital of our choice in the US. They give a discount to AARP members up to age of 75.

 

MedjetHorizon is a higher level of membership that will advance up to $50,000 cash to pay medical expenses incurred away from home including ground ambulance and specialty hospital transport.

 

Medjet combined with the highest level of primary medical insurance in a travel insurance policy gives us confidence that we have protected ourselves as much as possible when traveling abroad. Granted this level of protection is not necessary for the traditional Caribbean cruiser, but for some it is a wise choice.

[NMLady]

And even with travel insurance, they would need a credit card with a large credit line. Out of country hospitals are 'cash only', they don't take the insurance, You have to file a claim to be reimbursed when back home. And Medicare/medicaid does not cover out of country. EM

 

Many better insurance policies do make direct arrangements with hospital and pay them up front.

Those policies do not require reimbursement.

[easyboy]

Like many others who cruise and travel to countries around the world, we have a membership in MedjetAssist. If hospitalized anywhere in the world, Medjet will evacuate us to the hospital of our choice in the US. They give a discount to AARP members up to age of 75.

 

MedjetHorizon is a higher level of membership that will advance up to $50,000 cash to pay medical expenses incurred away from home including ground ambulance and specialty hospital transport.

 

Medjet combined with the highest level of primary medical insurance in a travel insurance policy gives us confidence that we have protected ourselves as much as possible when traveling abroad. Granted this level of protection is not necessary for the traditional Caribbean cruiser, but for some it is a wise choice.

Absolutely agree. We also use Medjet Assist to supplement our 3rd party travel insurance. If hospitalized due to a medical emergency, we prefer to be treated by a physician, and at a location, of our choice, and be with family members.

[CanadaDeb]

There are a few companies that will have a short 'stable prior to departure' clause to cover pre existing, all depending on age...I'm in my 40s and book with a company that have a 7 day prior clause. Another option is to book an evac insurance...some offer a lump sum insurance. If something happens, the hospital at destination gets the patient stable and then the evac flies them to the home hospital of their choice. As someone with a chronic illness, I book this as well and feel I have a safety net in place. Good luck!

[SuiteTraveler]

The hospitals in the Caribbean are a real mixed bag with some being better than what is in the US and some being absolutely awful but the advice here is good:

 

http://blog.tripadvisor.com/2015/06/06/how-to-get-good-emergency-medical-care-in-the-caribbean/

[Underwatr]

DW spent a few days in a small private hospital in Castries, St. Lucia. The chief of the hospital was her attending physician (you don't often get that at home).

 

Our own experience was that the doctors are well trained and the hospitals are well equipped for diagnosis (such as CT and CAT scanners) but the nursing care and equipment in the patient rooms may not be of the standard you'd expect. Things like a tank of oxygen at each bed rather than banked oxygen distributed throughout the hospital.

 

We had to pay for everything on a credit card (in the ER, payment was taken before being seen and before each diagnostic test like a CT scan) and submit for reimbursement after getting home. Her Medicare supplement insurance covers urgent care outside the US and we had comprehensive travel insurance so eventually we were made whole but having a credit card with a limit of a few thousand dollars to pay the bill and access to a cash reserve to pay the subsequent credit card bill helped greatly.

 

Don't forget evacuation coverage. The travel insurance company sent a nurse from Miami to St. Lucia to accompany my wife until we both got home. My stay in St. Lucia and my ticket home were paid from our trip interruption insurance. Her evacuation was paid directly by the policy but my expenses had to be paid upfront then reimbursed. It's all in how the policy is written.

 

There are a handful of travel insurers that have a preexisting conditions waiver if you buy the policy before final payment date. Their price is comparable to other policies that only cover preexisting conditions if you buy shortly after the initial payment.

[Geckotraveler]

In the 90's I lived in St Thomas and worked for a private physician. Just before leaving the island I got sick and it required hospitalization. The physician I worked for was off island and not able to assist me. To this day I believe the only reason I lived through that experience was because of my limited medical knowledge and friends who were nurses. Not only were basic linens in short supply (nonexistent) but so were medications. My friends needed to go to an outside pharmacy to purchase the medications I needed.

 

I admit things may have changed drastically since that time but I would not take the chance until I thoroughly investigated the current situation.

 

Ships may not deem it necessary to stop at an island or turn around for one ill passenger. All those port fees and taxes we pay and not waived for medical reasons. It would be more likely that a helicopter would be summoned (at your expense) then your traveling companions would need to find their way to the evacuated passenger. Travel insurance is also a great reason for these unexpected reasons.

 

At the time I had insurance to cover medical evacuation off island, but the doctors would not release me. In order to be evacuated you have to be cleared medically.

 

This may seem impossible for a US owned territory, but if you are familiar with how the government works in these places, you will know it is very possible.

[mafig]

My m-i-l was in a hospital in Puerto Rico and there was virtually no nursing care. Family/friends are expected to tend to the patient's needs during the day and night.