When we were circumnavigating in the late 70s and early 80s, we had no medical insurance. We were young and thankfully had no medical problems pop up that couldn’t be dealt with easily. In the countries we visited we were able to seek medical attention and pay the same as the locals. This always amounted to less than what we would pay in the States. Steve was bitten by a falciparin malaria mosquito and was laid up in the hospital in Port Moresby, Papua New Guinea. Luckily there was an Australian doctor in residence who specialized in tropical diseases. Nine days later and being treated with quinine, he emerged shaky but cured, and it cost us around $90 U.S. total. Of course we had to cook his meals in the communal kitchen, the same one where locals were spitting betel juice out the windows.

But that was then and the reality is different now. Fast forward to 2008. Steve and I haven’t cruised full time for the past 25 years. Because we spend half our time in the States, it is important to have good health insurance. For years we paid Blue Shield of California huge premiums for catastrophe insurance. This meant that we were covered for the big expenses such as hospitalization, but with a $2500 deductible per person per year, we ended up paying big premiums and still paid out of pocket for all of our normal medical costs. And I found that buying prescription drugs in New Zealand (2005) and seeing a doctor in British Columbia (2007), costs about the same as at home.

Today, thanks to our being of a “certain” age, the government is providing us with Medicare and we have a Medicare supplement insurance policy. We are covered.

But part of your insurance on board is more than the policy you take out. Cruising extensively means that you must carry your own pharmacy. You have to be self sufficient and ready to handle medical problems even if you are far away from professional medical help. This is where having a good medical kit on board is important. Every year or two I sit down with our doctor and go over our supplies. He decides which prescription drugs we should have on board so that we have the necessary medication on hand should the need arise. If we come down with a lung infection, for instance, we contact him, describe the symptoms and he will tell us which antibiotic to use and for how long to take it. I also stock up on however many months’ supply of prescription drugs that we take for chronic conditions before leaving on a cruise.

Apart from prescription drugs, I stock a complete medicine chest of over-the-counter headache and earache remedies, cold remedies, bandages, etc. And this year I spent some time in Tucson, putting together items from a medical supply store. If there is an accident, for instance, medical personnel will ask for vital statistics. Now, along with a good thermometer, I have on board a blood pressure cuff, stethoscope and even a device for looking into the ear for obstructions. All of these were easy to buy without prescriptions and were fairly inexpensive.

There are several good books available which will help you put your onboard medical kit together. Peter Eastman’s book First Aid Afloat is a good one. And it is important to have a good medical reference book on board as well. The Ship Captain’s Medical Guide, put out by the Maritime and Coast Guard Agency in London, is a favorite of ours. They have a web site at www.tsoshop.co.uk . E-mail: customer.services@tso.co.uk .

Having a “safety first” mindset on board is a form of insurance too. Avoid burns by not cooking underway, or while wearing a bathing suit. Be mindful of how you maneuver around running machinery. Treat all open scrapes and cuts with antibacterial ointment and keep them dry.

A few years ago, I read of cruisers buying travelers insurance – this was good only when you were out of the USA – but I never looked into it, so I don’t know the particulars. Also, some of the premier credit card companies, such as American Express Platinum, provide emergency medical evacuations worldwide. But in looking into this service further, I found they have their own doctors evaluate the situation and only if there is no way you can get medical care where you are, will they pay to have you flown out. They do suggest names of English – speaking doctors in foreign countries, or provide a translator if needed.