Every large cruise ship carries a medical centre, and most people never see it. The ones who do are often surprised by the bill, because it does not work the way healthcare at home works.
This guide covers what is on board, what it costs, and the preparation that matters if you take regular medication or have a condition worth declaring.
What Is Actually On Board
Ships carry a proper medical centre staffed by doctors and nurses, open for routine appointments during the day and available for emergencies at any hour.
Each ship carries two to three licensed doctors and three to five nurses, depending on its size, according to Royal Caribbean. They are available to passengers and crew 24 hours a day. Its facilities meet or exceed guidelines set by the American College of Emergency Physicians Cruise Ship and Maritime Medicine Section.
P&O runs its medical centre for routine appointments daily and an emergency service 24 hours a day. Turning up outside surgery hours for something minor may mean waiting.
It Is a Private Clinic
This is the part that catches people, and P&O states it plainly: it operates a private healthcare service, and charges apply for all services and medications dispensed by the ship’s medical centre.
Those costs go onto your onboard account and have to be settled before you disembark. A consultation for something that would be free at home produces a bill you pay before you leave the ship.
Medical charges are part of the onboard account, so they are paid at the end of the cruise like any bar bill. There is no invoicing you later.
Insurance Does Not Work On Board
Royal Caribbean is explicit that it does not accept land-based health insurance plans on board, though you may be eligible to submit a claim to your provider afterwards.
In practice you pay, then claim. Keep the itemised receipt from the medical centre, because that is what a claim is built on. If you bought travel insurance, or your cruise was paid on a card that includes cover, those are the routes to reimbursement.
Ask for a full breakdown before you settle the account. Reclaiming without one is considerably harder once you are home.
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Declaring a Condition First
P&O asks all guests with a pre-existing medical condition to complete an On-Board Needs Questionnaire through My P&O Cruises as early as possible before sailing.
Declaring in advance is what lets the ship prepare, whether that means storage arrangements, equipment, or simply knowing you are aboard. It is not a formality. Lines run their own version of this form, so check what yours calls it.
For more involved needs the requirements go further. Anyone travelling with peritoneal dialysis is expected to be independent in using it, and to bring rather more than the equipment:
- A fitness to travel letter from your specialist, confirming the specific itinerary.
- Full travel insurance covering all pre-existing conditions.
- Insurance documents including emergency contact details.
- Records of recent treatment.
If your doctor advises against travelling and you go anyway, your medical insurance may be treated as invalid. That turns a private medical bill into an uninsured one.
Carrying Your Medication
Keep prescription medicine in your hand luggage rather than your suitcase. Checked bags go to the porters at the terminal and arrive at the cabin some hours later, which is a long wait if your tablets are inside one.
Carry enough for the whole voyage plus a margin for delays. Keep it in the original labelled packaging, with a copy of the prescription. The medical centre can dispense, but at private prices, and it may not stock what you need.
Some medicines that are unremarkable in a British pharmacy are controlled elsewhere. Check the entry rules for each country on your itinerary through government travel advice before you pack.
Electrical Medical Equipment
If you travel with a CPAP machine, an oxygen concentrator or dialysis equipment, there is a technical problem to solve before you sail, and it is not the one most people expect.
Ships do not run on the domestic UK supply. Britain uses 50Hz at 240V; ships run at 60Hz, and the voltage varies from vessel to vessel. On P&O’s fleet that means 220V on Aurora, Iona and Arvia, 230V and 115V on Azura and Ventura, 230V and 120V on Britannia, and a mix of 220V and 110V on Arcadia.
The frequency is the part that matters. A machine built for 50Hz may be damaged by running at 60Hz, or may simply not perform as it should. Check with the manufacturer or supplier that yours is safe at 60Hz before you travel, because finding out on board is too late.
Only whoever made your equipment can tell you whether it tolerates 60Hz. The cruise line can tell you what the supply is, and that is a different question.
What a Ship Cannot Do
Royal Caribbean describes its onboard provision as limited professional medical services, and that word is doing real work. A ship’s medical centre stabilises and treats. It is not a hospital.
Anything beyond its scope means being landed at the next port, or evacuated in serious cases. That is where travel insurance stops being a formality.
Frequently Asked Questions
Yes. Royal Caribbean describes two to three licensed doctors and three to five nurses per ship depending on size, available to passengers and crew at any hour.
Yes. P&O states that it operates a private healthcare service and that charges apply for all services and medications dispensed. The cost goes on your onboard account.
Before you disembark. Medical costs form part of the onboard account and are settled at the end of the cruise.
Royal Caribbean does not accept land-based health insurance plans on board. You pay at the time and may be able to claim back from your provider afterwards.
Yes. P&O asks guests with a pre-existing condition to complete an On-Board Needs Questionnaire as early as possible before sailing, and other lines run an equivalent.
In your hand luggage. Checked bags are handed to porters at the terminal and reach the cabin some hours later.
The medical centre can dispense medication, but at private prices, and it may not stock what you need. Bring enough for the voyage plus a margin.
Usually yes, but ships run at 60Hz where the UK domestic supply is 50Hz, and voltages vary by vessel. Check with the manufacturer that your machine is safe at 60Hz before you travel.
It varies by ship. Across P&O’s fleet it ranges from 220V to 230V with some 110V and 120V outlets, and all of it at 60Hz rather than the 50Hz used in Britain.
A ship’s medical centre treats and stabilises rather than acting as a hospital. Anything beyond its scope means being landed at the next port or evacuated, which is where travel insurance matters.
The medical centre bills to your cabin account and settles before you leave the ship. Take the itemised receipt with you, because that is what any claim afterwards depends on.
How We Verify This Advice
We aim for practical, low-risk guidance. Before publishing and during updates, we check core planning details against official sources and current operator information.
What We Check
- Berth and terminal details, including whether the port is walkable or requires a transfer
- Transport options and realistic return timing for different port types
- Details that change frequently, such as fares and schedules, with up-to-date notes where relevant
Typical Sources
- Official port authority and terminal updates
- Cruise line port notes and day-of-call instructions
- Local transport operators and official tourism resources