Her $5,500 infirmary bill was higher than the cruise itself: How she got it covered

Travel insurance is a must for cruises, as medical bills can be high.
Even a low level of travel insurance can cover medical bills from your ship.
If you opt for a comprehensive trip policy, you’ll be fully covered for trip cancellation plus medical expenses.

After taking a Caribbean cruise with her mother last year, Megan Ayscue didn’t think she’d end up with a medical bill that would cost more than the cruise itself.

The North Carolina-based traveler and her mother boarded the Norwegian Pearl in November to visit the Dominican Republic, Curaçao and other island destinations. The two were enjoying the trip until Ayscue went snorkeling in the Dominican Republic a few days in and got water stuck in her ear.

At first, she went to an infirmary in St. Thomas in the U.S. Virgin Islands, but the problem wasn’t resolved. Thankfully, her medical insurance covered the visit. Back on board, Ayscue went to the ship’s infirmary, where she was given oral antibiotics, Tylenol and ear drops. Her ear still hurt, so she went back to the infirmary the next day while the ship was at sea and was diagnosed with a bacterial infection that was spreading to her face.

What happens if you get sick or injured (or bitten by a monkey) on a cruise ship

“My ear had completely swelled shut. I could not hear out of my left ear. It was so painful, and I couldn’t feel the side of my face,” she said. The infection had spread into her lymph nodes, numbing the left side of her face.

Ayscue received an IV infusion of steroids, anti-inflammatory medicine, antibiotics and anti-nausea medicine. The doctors told her to return the next day for another infusion. Ayscue said her experience with the onboard infirmary was positive and healed her infection, but she left with a bill of $5,528.29. Since Ayscue didn’t have the money at the time, her mother put it on her credit card.

Back home, Ayscue waited six months to hear that her insurer denied covering her medical expenses from the cruise. Her parents had to shift money around to cover Ayscue’s medical bill, and because her mother had booked the cruise on the same credit card, struggled to make her monthly payments.

Norwegian Cruise Line told USA TODAY that “we strongly encourage guests to file a claim with their health insurance provider post-cruise.”

There was, however, one saving grace. Thankfully, the family had purchased travel insurance for the cruise because Ayscue’s mother had experienced a heart attack a few years ago. That insurance, which cost about $300, ended up covering every cent of the medical bill.

“It ended up basically saving me and my parents from a financial cliff,” she said.

Unfortunately, Ayscue’s experience is not unusual, and a hefty medical bill on cruise ships can be expected, even for typical medical problems that warrant a little medical attention, such as seasickness or infections.

“It’s unfortunately extremely uncommon,” said Jenna Hummer, public relations director at travel insurance platform Squaremouth. “Our highest recommendation for medical coverage is always for cruises.”

Here’s everything you need to know about travel insurance and cruising.

Why do I need travel insurance for my cruise?

For starters, cruise ships are nearly always out-of-network from your typical medical insurance. “It’s not like you’ll have a co-pay, no, you’ll probably have to pay out-of-network costs and have an astronomically high bill if you break your ankle,” Hummer said.

“The thing about cruising is if you get sick on the boat, you obviously have limited resources, so those resources cost more. It’s like dining on top of a mountain or an island − it’s just harder to get supplies, so it can cost more.”

Even a low level of travel insurance can cover medical bills from your ship, but it also goes far beyond that − for example, if you need medical care in a foreign country or to return home early. Even if you port in a U.S. territory and go to a hospital there, it’s likely that visit will be out-of-network for your insurance as well.

Travelers prone to getting seasick or planning on a “high-risk activity” like jet skiing or scuba diving should also consider travel insurance for that extra protection if things go south.

What does travel insurance cover on a cruise?

It depends on what option you purchase. Emergency medical travel insurance will be your cheapest option at around $50. That is, unless you’re considered to be at a higher risk of needing medical care − for example, if you’re 65 years and older, or going to a destination that’s considered high-risk or harbors communicable diseases.

“By purchasing a travel insurance policy with emergency medical and emergency medical transportation benefits, cruisers can be reimbursed for the cost of emergency medical care up to their policy limit, whether they’re seeking care directly on the cruise ship or at their port of call,” said Daniel Durazo, director of external communications at Allianz Partners USA, which allows people to compare travel insurances.

If you opt for a comprehensive trip policy – which does cost more, 5% to 10% of your trip – you’ll be fully covered for trip cancellation plus medical expenses. “You’ll have 100% of your trip costs covered, but you’ll have options for how much medical coverage you want, like $10,000 or up to $1 million for medical evacuation coverage,” Hummer said. (A medical evacuation can cost tens of thousands of dollars.)

“It’s not a lot of money to insure yourself from a medical perspective,” she said.

“It’s better we spent those $300 for peace of mind and then it actually came in handy,” Ayscue said.

But if you’re intoxicated while visiting the infirmary, it’s possible your claim for travel insurance will be denied, Hummer added. So be careful with drinking. Pregnancy complications are also not typically included, although if you feel seasickness and are also pregnant, that will be covered.

For what it’s worth, travel insurance that’s more expensive doesn’t necessarily mean it’s better or covers more, so shop around and compare what’s included, Hummer said.

Can I buy travel insurance through my cruise line?

Technically you can, as most cruise lines offer some type of insurance, but it won’t be the best coverage. “Usually, they have very specific exclusions to keep an eye out for, like, they’ll only refund you a small portion of your trip if you get sick and there’s a very small timeline,” Hummer said. Basically, if you want to buy your cruise line’s insurance, read the fine print carefully.

When should I get travel insurance for my cruise?

For the most part, the earlier you get travel insurance, the more coverage you get. However, factors such as where you depart and the time of year also play a role.

“If you’re flying into Miami to board a cruise ship and it’s the middle of hurricane season, buy your travel insurance today,” Hummer said. “Alaska probably hasn’t seen a hurricane in forever, so it’s probably OK (to wait.)”

Buying travel insurance the day before your trip doesn’t necessarily affect the cost of insurance as it does the cost of flights, just what’s covered. If a storm is predicted before you purchase insurance, then that probably won’t be covered by the time you do.

“Buying travel insurance as soon as you book your cruise is a smart move,” Durazo said.