What happens if you need to be medically evacuated from a cruise

The U.S. Coast Guard airlifted four passengers from three different cruise ships off the coast of California over the weekend using helicopters. The aircrews evacuated the Carnival Cruise Line and Princess Cruises passengers over a 24-hour period that started Friday night because the travelers suffered from various ailments.

According to a Coast Guard news release, the passengers were all women. They included a 47-year-old who reportedly had a “progressive acute illness” aboard the Carnival Panorama ship; a 74-year-old who reportedly was having “stroke-like symptoms" on Majestic Princess; and another Majestic Princess passenger, 77, who reportedly experienced kidney failure. The fourth traveler, 84, was sailing on the Carnival Spirit and reportedly had symptoms related to a stroke.

Carnival spokesperson Matt Lupoli said he could not confirm any medical information and did not have any more to share. Princess did not immediately respond to USA TODAY's request for comment.

While major cruise lines' ships are equipped with medical facilities, there are limits to the health care they can offer on board.

Here’s what travelers need to know about coping with a health crisis while cruising:

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What happens if you get sick on a cruise ship?

Cruise ship medical facilities can treat a wide range of ailments, from earaches to heart attacks.

Dr. Joe Scott, senior director of fleet medical operations at cruise line operator Carnival Corp., told USA TODAY in February that its ships' facilities are generally set up like a typical emergency department. Scott oversees day-to-day operations for the company's North American brands, including Carnival, Princess and Holland America Line.

The facilities are staffed by doctors and nurses, and the company's bigger ships may also have medical administrators, paramedics and health care assistants. When a guest gets sick, Scott said, "There really isn't (anything) we can't treat, at least for the first few hours.”

Doctors on board can prescribe medications to be dispensed and taken while on the ship, and treat serious medical issues until passengers improve or as a stopgap measure until a passenger can be brought ashore, depending on the situation. For example, in the case of a heart attack, they can give patients thrombolytics – or "clot-busting drugs" – on board until they can get them to a cardiac catheterization lab, which the vessels do not have.

What is a medical evacuation on a cruise?

The way cruise ships get sick or injured passengers to shore depends largely on "the weather, the location and the assets available," Scott said.

If the ship is nearing a stop, they may wait until they get to a port. If not, they consider what is close by, or if the U.S. Coast Guard (or equivalent officials in other countries) are available to them, who can provide an evacuation by helicopter, or by boat if they are closer to shore.

Scott said they remove sick or injured passengers at ports most of the time, which is the "safest way to do it." Even if there aren’t medical facilities near a port, there may be an airstrip, which would allow the team to schedule a medevac aircraft to come meet the ship, according to Scott.

Do you have to pay for medical care on a cruise ship?

Many health insurance plans do not cover medical costs travelers incur at sea or in foreign countries, Scott said. Carnival Corp. requires passengers to pay for those services, and they can then submit the receipts to their insurance company.

He said he is "not aware" of any cruise line that accepts insurance in its medical facilities and highly recommended passengers purchase travel insurance, which he said is more likely to cover those bills.

Comprehensive travel insurance plans that cover the cost of travel as well as a variety of unforeseen circumstances can generally cost between 4% and 10% of the overall trip cost, according to Meghan Walch, Director of Product at InsureMyTrip.

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How much does it cost to be medically evacuated from a cruise ship?

Evacuations from a cruise ship are typically covered by the Coast Guard or similar entity, Walch said.

"Evacuation arranged and covered by the travel insurance typically comes into play once you are already hospitalized and need to be moved in order to get more appropriate care," she said in an email.

Scott said a medical evacuation can cost tens of thousands of dollars, though the amount varies depending on the circumstances and where travelers are at the time.

Walch said travelers should read the details of a policy to find out what is and isn't covered.

"If an incident does occur where medical attention or an evacuation is needed, the traveler would want to get in touch with the emergency assistance provider associated with their policy," she said. That way, "the necessary care can be arranged once at port. ... Failure to notify the assistance provider could affect what is covered."

Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. You can reach him at ndiller@usatoday.com.

This article originally appeared on USA TODAY: Medical evacuations on cruises: What to know