Jul 15, 2025
If you're planning to book a cruise vacation, you probably aren’t thinking about what would happen if you had a medical emergency at sea, but maybe you should.
Mohammad Hamza from North Olmsted, Ohio, learned this lesson in the most devastating way possible when his wife, Julia, died after suffering heart attacks during their Royal Caribbean cruise to the Bahamas.
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The couple had boarded the vessel for what should have been a relaxing getaway. However, on the second day of their trip, Julia began feeling nauseous and dizzy before collapsing on the floor. It was her first-ever heart attack.
“The doctor immediately said she’s going to have another episode of cardiac arrest. She needs to be transported now,” Hamza shared with News 5 Cleveland.
What happened next highlights a serious concern that many cruise passengers may not consider until it's too late.
Immediate assistance costs $15,000
When Julia needed urgent medical assistance, Hamza claims he was asked to produce $15,000 — in cash.
This, as you might imagine, left Hamza incredulous as he couldn't understand why anyone on the ship would carry that amount of cash on them. After finally arranging payment with his credit card, Hamza said his wife’s evacuation was then repeatedly delayed.
“Now, where’s the jet?" Hamza asked the medical team on the ship. "Coming in a half hour, coming in two hours, coming in three hours" is what he was reportedly told. Meanwhile, hours went by, and it was during this critical waiting period when Julia suffered a second heart attack.
"She wanted to say something," Hamza recalled. "I told her to squeeze my hand. She squeezed my hand."
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According to Hamza, his wife experienced a third heart attack that proved to be fatal while on the transport boat headed for the medical jet. And while Royal Caribbean declined to speak with News 5 Cleveland, the company did provide a statement:
"The safety and well-being of our guests is always a top priority. In Mrs. Hamza's situation, the shipboard medical team responded quickly to her medical needs and worked continuously to stabilize her condition in preparation for her transport to a shoreside hospital. Our thoughts continue to be with Mr. Hamza during this difficult time."
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How medical care works on international waters
Jamie Barnett, president of the International Cruise Victims Association, wasn't exactly surprised by Hamza's story.
"I thought, oh, no. Here's another one," said Barnett, whose daughter needed emergency assistance during a cruise in 2005. A defibrillator reportedly took 30 minutes to arrive, and that delay had cost Barnett’s daughter her life.
What a lot of travelers may not be aware of is that major cruise lines sail under the flags of different countries, known as "flags of convenience," which means American medical standards don't often apply to international cruise ships.
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Emergency care in the U.S. is governed by the Emergency Medical Treatment and Labor Act, which requires hospitals to provide emergency care regardless of the patient’s ability to pay. However, this law does not apply in other countries or on international waters, where cruise ships operate.
"And that's one of the first and foremost things that I wish people knew," Barnett said.
This jurisdictional issue creates a situation where American cruise passengers may not receive the same level of medical care they expect at home. And that, unfortunately, is something Barnett knows firsthand.
How to protect yourself before setting sail
If you're planning a dream cruise vacation in the near future, there are several precautions that you may want to consider. Bill Coyle from KHM Travel Group in Brunswick, Ohio, shared some tips for cruise travelers with News 5 Cleveland:
- Make sure you're healthy enough for the trip.
- Bring documentation about your medications and medical history.
- Consider comprehensive travel insurance that explicitly covers emergency evacuation.
Booking with a premium travel credit card can also be beneficial in expensive medical scenarios. Premium credit cards typically offer several medical protections when used to pay for travel, including cruises. These protections can include:
- Emergency medical and dental coverage (typically $2,500-$10,000).
- Emergency evacuation and transportation (typically $50,000-$100,000, with some cards offering unlimited coverage).
- Travel accident insurance (typically $250,000-$1,000,000).
However, these benefits may need to be approved by the card issuer’s administrator. Additionally, coverage may only apply when you're at least 100 miles from home.
Because of this, before you click "book now" on that cruise deal, take some time to understand exactly what medical resources will be available if there's an emergency — and make sure you're properly insured.
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Cory Santos is a finance writer, editor and credit card expert with over seven years of experience in personal finance. Having lived and worked worldwide, Cory now calls South Florida home, helping consumers find their ideal credit card and offering impartial and approachable advice to help them navigate their best financial lives. Cory joined Wise Publishing from BestCards, with bylines in numerous digital publications across North America, including AOL, MSN, Yahoo Finance, the Miami Herald, St. Louis Post-Dispatch, and more. When he isn't scouring for the latest credit card deals and offers, Cory can be found working on his various historical research projects, jogging, or hanging out with his cats, Bentley, Cougar, and Pumpkin.
