While taking a cruise in the post-COVID era is largely as safe as other forms of travel and tourism, according to statistics, its still important for passengers to plan for the worst to avoid unmanageable expenses.

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The cruise industry is finally getting back on its feet after an extremely difficult year, with cruises resuming in the US, joining other regions that resumed operations earlier, such as Asia and Europe.

More than 400,000 passengers have taken to the seas aboard cruise ships since the pandemic brought the global cruise industry to a standstill in March last year, and only 50 to 200 or so (depending on sources) have caught coronavirus as a result of being on a cruise.

Cruise lines have developed robust health and safety protocols intended to protect passengers and crew, with multi-stage testing (before boarding, during the cruise and before disembarking), mask mandates, social distancing and other measures.

Cruise lines that aren’t enforcing masks and social distancing are instead relying on vaccine mandates, while still carrying out tests on passengers pre-boarding and 48 hours into the voyage. It’s because of these multiple tests that several passengers aboard recently resumed cruises were identified as having COVID-19.

In June alone, two guests aboard Celebrity Millennium in the Caribbean and two guests aboard MSC Seaside in the Mediterranean tested positive for COVID-19.

Celebrity Millennium is homeporting in St Maarten

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These news reports, coming just weeks ahead of the reopening of cruises in the United States, raise the question of how cruise lines will deal with passengers who catch COVID-19 while on the ship.

Here’s what passengers need to ensure their travel insurance covers:

Cancellation/re-booking of flights

COVID-19 treatment in the countries their cruise is visiting

COVID-19-related quarantine expenses

Cruise Law News has taken an in-depth look at Royal Caribbean’s policies after the Celebrity Millennium reports (Celebrity Cruises is owned by Royal Caribbean), and it provides a clear framework for some of the unanticipated issues that passengers should plan ahead for when cruising post-COVID.

Conditional Sailing Order

The Conditional Sailing Order issued by the Centers for Disease Control and Prevention (CDC), which regulates the resumption of cruises from US ports, stipulates that cruise lines sign agreements with port authorities for the provision of housing for the quarantine of passengers and crew, as well as arrangements for medical treatment of the infected.

MSC Seaside is cruising in the Mediterranean, of course, and EU authorities do not require such provisions (largely because Europe has public health insurance and it can be used across the EU), while Celebrity Millennium is cruising in the Caribbean from Nassau, and so does not fall under the CSO regulations.

On a side note, as an extra precaution, MSC Cruises has rolled out a 25 Euro travel insurance plan through Europe Assistance that covers COVID-19 treatment for passengers after their cruise. The plan also covers the cruise line’s Red Sea and Saudi Arabia cruises, but will cost 29 Euros.

The Celebrity Millennium cruises are specifically targetted at the North American cruise market, selling fly-cruise holidays, and most US medical insurance does not cover illness or injury outside of the country.

Additionally, most travel insurance companies exclude coverage for illnesses related to pandemics, although many are now updating their policies to take COVID-19 into account, Forbes Magazine has collated a list of cruise travel insurance providers that are currently covering COVID-19.

However, its still important for passengers to make sure they’re purchasing a travel insurance that covers the cost of COVID-19 testing, quarantine and healthcare in the countries their cruise will be visiting.

Cruise lines COVID-19 medical care and quarantine policies

This is because Royal Caribbean, and other major cruise lines will cover the cost of testing and medical treatment while on the ship, but not once the infected passenger has been medically evacuated ashore.

This based on the terms and conditions in the cruise ticket and related documents (for Royal Caribbean specifically, but it will be similar for other major cruise lines). Princess Cruises, for example, which is owned by a separate company, Carnival Corporation, also does not cover COVID-19 medical expenses ashore.

According to Royal Caribbean’s Healthy Sail Center, Refund and Cancellation Policy for COVID-19 and Cruise Ticket Contract, the cruise line will pay for all medical expenses onboard, but not in a hospital ashore. Similarly, there is no charge for passengers if they’re quarantined aboard the ship, but the cruise line won’t cover quarantine costs ashore.

Cancelled or re-booked flights

Similarly, the cruise line won’t cover the cost of changing your flights, or cancelling them altogether if you end up being hospitalized or quarantined for an extended period of time (unless booked through the cruise line itself).

Passengers should therefore ensure that their travel insurance will cover the cost of re-booking flights if they booked through a travel agent or directly through the airline (which might also provide such provisions). Emirates Airline in Dubai, for example, covers COVID-19 related medical expenses up to $500,000 for its passengers.