Medicare Coverage

Will the ship be registered as a Medicare approved facility? 

Cruise ship medical facilities must adhere to the standards set by the American College of Emergency Physicians. The ACEP guidelines dictate that the infirmary must contain the proper equipment to handle a range of treatments and diagnostics. Storylines will meet all required registrations related to any Medicare services covered on the ship. 
 
However, “The U.S. government does not provide medical insurance for U.S. citizens overseas. We do not pay medical bills. You should purchase insurance before you travel. Please review the country information page regarding the country you are visiting before you travel.” See Travel.State.gov for additional information about insurance providers for overseas coverage. 

Where does Medicare cover me?

Medicare will cover you in the U.S. and U.S. territories including: 

• The 48 contiguous states 
• Alaska and Hawaii 
• The District of Columbia 
• Puerto Rico 
• The U.S. Virgin Islands 
• Guam 
• American Samoa 
• The Northern Mariana Islands 

Medicare may also cover you in Canada if you’re traveling between Alaska and another state when you have a medical emergency and the Canadian hospital is closer than the nearest U.S. hospital that can treat you. 

Does Medicare cover me on a cruise ship outside the U.S.?  

Medicare will generally cover you on a cruise ship under the following conditions: 

• The doctor treating you is allowed to provide medical services on a cruise ship 
• The cruise ship is in a U.S. port 
• The cruise ship is no more than six hours away from a U.S. port when you receive the medical services, even if they are emergency services 

If you receive medical services more than six hours away from a U.S. port, Medicare will generally not cover you. 

How can I get medical coverage on a cruise ship?  

If you have Original Medicare (Part A and Part B) you can enroll in a Medicare Supplement plan to help you pay your Medicare out-of-pocket expenses. Medicare Supplement plans C, D, E, F, G, H, I, J, M and N generally cover foreign travel emergency care during the first 60 days of your trip. Once you meet a $250 deductible for the year, the Medicare Supplement plan may pay up to 80% of the charges for medically necessary emergency care outside of the U.S., including care on a cruise ship.  
 
Some Medicare Advantage Plans (Part C for example) require that I have a U.S. address or I can be disenrolled after 6 months.  Will Storylines be considered a U.S. address? 

Storylines will maintain a physical address in Florida which our residents are welcome to use. We do not know if that will satisfy the Medicare requirement or not.  

What if I have additional questions about Medicare coverage when traveling? 

Please contact your Medicare representative and clarify the coverage you have and what is not covered. Please forward any questions or concerns to our office so we can help explore additional options. 

In general, Medicare and Medicaid do not cover medical costs overseas, please check this website. 

Will medical staff file insurance claims on a resident’s behalf? 

Storylines will have an insurance specialist to assist in most insurance claims, including those involving Medicare when applicable.  

Some Medigap plans cover foreign travel emergencies that occur during the first 60 days of the cruise. What if an emergency arises after the 60 days?  

Should this occur, a Storylines group insurance policy would be activated if available.  If it is not, you might consider other private travel/health insurance products. Also keep in mind that out-of-pocket medical expenses are generally much more affordable in other countries.

Health Insurance

Please see our health & medical blog posts as well as our Corporate Partners page which includes a link to Insurance Consultants International where you can fill out Storylines Insurance Interest Form.

Medical Costs

What is included with the annual assessment fees? 

Check-ups with the doctor are included. Also dental cleaning, eye exams and hearing screenings that can be completed by a physician’s assistant, nurse or technician are included. Any abnormal findings that require treatment by a dentist or physician may have a surcharge. 
 

What is health care going to cost me when I’m living abroad if my current health insurance policy won’t cover me? 

While we do not have medical services pricing onboard the ship determined at this point, we want our community to know that we are here to nurture and care for each individual. Health and wellness are paramount to the Storylines experience. Regarding medical costs on the ship, our goal is to provide the best possible care at the most affordable rates possible. Some of our medical services will be included but where we incur costs, those costs will be passed on to residents and guests.  
 
Regarding medical costs off the ship, it is important to know that medical care outside of the United States is much more affordable. Many ex-pats pay for health services out-of-pocket because they receive excellent care abroad at an excellent price. It is important to have a health insurance policy in the USA because of the extremely high costs of receiving medical care in that country. We urge you to research medical tourism and ex-pats and we think you will find that health insurance is mostly necessary for emergency situations when residing outside the US.  

Is emergency helicopter evacuation covered by insurance?

An insurance product is offered through our Insurance partner that covers evacuation by emergency helicopter to the nearest hospital listed within the insurance plan. If you have a different hospital in mind, you would need to organize that with a private insurance company. There may be cases that a resident/patient might be taken back home if they need long term care. Insurance often covers this. When the patient is well they can come back to the ship at their own expense.

Are there any age restrictions for infants and kids onboard?

Children must be two years of age or older to sail onboard MV Narrative. The ship’s facilities are not equipped to medically assist and support conditions that might affect babies under two.

PLEASE NOTE: a similar situation applies to expectant mothers. MV Narrative is not equipped to properly support and assist pregnant women. Sailing during this period is not allowed.

Will I be able to fill my prescriptions onboard and get OTC supplements such as vitamins, laxatives, incontinence supplies, eye drops, CPAP supplies, etc.?   

Yes, we will have a well-stocked pharmacy that will also have high grade supplementation and compounding capabilities. Certain medications will be overstocked for prevention. 

Will the ship be periodically surveying residents for current medications to ensure they are available on board? 

Yes, but more so each resident will ensure they have submitted their required pharmacy needs to Storylines and ensure they have at least 3 months’ supply on-hand to give the ship adequate time to stock any uncommon medications.

Will we be able to provide a list of our regular meds so the ship can keep them in stock since it will be hard to get mail with refills?

Yes, any specialty prescriptions will be given to the medical steward at least 6-12 months before departure.

Do we get prescription renewals from the practitioner back in our home country or would a ship doctor take control of those prescriptions?

These would be preferentially be done remotely via the patients’ prescribing physician and if needed through the physician overseeing the ship’s pharmacy.

Will the medical staff prescribe and provide narcotics, i.e. opioids? 

These drugs will only be available in minimal quantities and prescribed only in emergency or extreme cases treated intravenously in the infirmary.  

How much will my medication cost on board? Does the onboard pharmacy accept insurance?

The pricing for all medications will be dependent on what our medical partner Vikand sources. We anticipate the costs to be significantly less than USA retail prices, and more comparable to prices in Australia and Canada. The onboard pharmacy does not bill your insurance provider but can provide a receipt if you wish to submit a claim for reimbursement. In that case, you would need to confirm that your plan covers external pharmacies outside of your state/country. Another option it to have your prescription medicine filled by the mail order pharmacy that your health insurance plan partners with. These will often approve 3 months of refills to be mailed to you quarterly.

What is the PhD Medical Study?

This is a project that will be offered to several universities and will also be offered to several universities and their grad students to work on their PhD. It will have many direct and indirect data implications primarily around the effective use of new medical wearables to decrease disease transmission, increase health outcomes and decrease fatalities. If we have any science based or PhD researchers as residents on board who would like to get involved, they can contact Dr. Brian Martin directly.

Are there plans for a retail pharmacy?

Yes. Dr. Martin is working on that. We have plans for a pharmacy, which will be in one of our retail spaces.

MV Narrative offers a full-service clinic on board including medical doctors, nurses, pharmacists and physiotherapists. As these services will be provided by a third party, they are outside of the annual fees. 

A range of additional services will also be available such as weight loss, anti-aging, Botox, immune therapies, detoxification treatments and dietary planning. 

I understand the practices of complementary medicine, functional medicine, integrative medicine, naturopathic medicine and holistic medicine. For a patient that is more familiar with western medicine, what can they expect that might be different when you are their primary care physician?

A combined approach with more focus on the prevention of disease, increased vitality and quality of life using functional tests including genomics, diet, nutrition, exercise, mental and emotional support, nutraceuticals, hormonal replacement and removing toxins, specifically heavy metals.

Will I be able to get my annual wellness check on board? 

Yes. Annual exams are included in your annual assessments while certain labs, treatments and supplements are available at an additional cost.   

Will dental check-ups be available such as cleaning and x-rays? Is that included?

Yes, these will likely be included for the residents with any advanced procedures, surgery, or treatments outsourced for an extra fee.

Will medical staff be able to provide dental emergency services such as tooth infection/extraction, broken tooth?  
Our dental technician can work with our GP to provide antibiotics and pain relief until you can get to a reputable dentist on shore for treatment. Storylines maintains a list of shoreside services. A dentist visits the ship periodically.   
 
Will medical staff be able to conduct auditory exams? Provide basic hearing services? Get hearing aids adjusted/cleaned? 
Diagnostic and other services that can be conducted by a technician will be available on board and inclusive. Anything that requires additional machinery or a specialist will require a visit to shore. Storylines maintains a list of shoreside services. It is unlikely that Storylines will have an audiologist on board.     
 
Will medical staff be able to provide basic vision services? Fix glasses, provide contact lenses or ophthalmological services, i.e., eye infections, corneal abrasions? Diagnose and treat vision problems i.e., macular degeneration, glaucoma, cataract abrasions, eye infections? 

Simple diagnostic screenings and other services that can be conducted by a technician will be available on board and inclusive. Anything that requires additional machinery or specialists will require a visit to shore. Storylines maintains a list of shoreside services. It is unlikely that Storylines will have an ophthalmologist on board full time although we do have a resident ophthalmologist who has offered their services and the MD can treat some things such as eye infections. In the case of eyeglasses and contacts, those can also be ordered online and shipped worldwide. 

Can oral health, hearing and vision care specialists be brought onboard periodically for services needed?  
Yes, we will be bringing medical professionals onboard that are generally only available in land based facilities, except where specialized equipment is necessary. We cannot guarantee these specialists will be part of your health insurance network, but keep in mind that out of pocket medical care in other countries costs much less than the United States.    
 
Will  medical staff be able to recommend local medical providers in ports for services and/or medications not available on board? Yes, Storylines has an ongoing project to identify a) main medical treatment facilities and specialists in all ports, and b) accessory non-emergency professionals. These professionals may in some cases also be invited onto the ship to give lectures and some treatments.                

Will the ship doctor be able to do skin biopsies to determine if a questionable spot is cancerous? If it is, will the ship doctor be able to do surgery to remove it?

Yes, this will be done under the regular checkup from our attending physician and removal is done with a laser machine (called laser ablation). This uses a high-intensity beam of light to destroy cancer cells. We also plan to have cryotherapy which is used most often for pre-cancerous conditions such as actinic keratosis and for small basal cell and squamous cell carcinomas. For prevention and early detection, we are also investigating newer technologies such as Dermtech which uses a proprietary process to painlessly extract RNA and DNA from skin tissue samples to find genomic markers of melanoma specifically and accurately that occurs at a level 10,000 times closer than the traditional biopsy care pathway. Another is called reflectance confocal microscopy (RCM), that uses a low-power laser to scan skin lesions. We also plan to use new smart apps that use remote care, such as SkinVision.

What contingencies are there if a resident is on an apparatus (i.e., oxygen) that requires electricity and the ship has an electrical outage.  
The ship will have backup power in any case of loss of power, and the infirmary will also have a dedicated standalone backup power source. 

Will medical staff be trained in psychological and emotional  counseling, such as depression, suicide, anger/rage management, substance abuse services, cognitive assessments, happiness coaching, etc.? 
The ship will have staff to address any maintenance or acute flare-ups of these conditions and create proactive programs to improve the life of these individuals. This includes advanced symptom and medication monitoring, and when indicated, provide prescription and non-prescription functional medicine and detox programs in addition to further support with nutritional, fitness and biofeedback programs. 

Will residents be charged for basic first aid needs  i.e., bandages, aspirin, masks, canes, knee braces? 
In the case of non-critical injuries that require a trip to the infirmary, supplies used to render care including the use of crutches, splints and wheelchairs will be provided by Storylines. Ordinary supplies for home use will be available in the ship’s pharmacy and market.         

What priorities and/or privileges will residents receive over transient guests?  
Residents have a designated appointment schedule and take precedence over guests. The only exception would be in an emergency.   

Will medical staff be able to treat kidney problems i.e., lithotripsy (stones)? 
This is being discussed. We are considering shock wave lithotripsy.  

Will the medical staff visit individual residence for assessment and treatment?  
Most medical and health services, treatments and testing will be mobile and when possible combined with other related services, for example medication delivery + X-ray + vitamin IV.   

Will medical staff initiate follow up calls/visits to ensure the resident is following treatment plans?   
Once registered with the medical team in one of the ship’s programs, Storylines’ advanced medical monitoring systems and specialized staff act as each resident’s personal health coach to support success and compliance. 

Will the medical staff provide seminars and discussions to educate the community on preventative measures i.e., balance clinics, mental stimulation, heart healthy diets?  
The onboard enrichment programs will include Dr. Martin’s ‘Optimal Aging & Living’ education. In addition, Storylines has access to the world’s experts that will be coming aboard for educational and treatment purposes – the ultimate in medical tourism.    

What is the ‘Optimal Aging & Living’ program? 
    
Dr. Brian Martin’s ‘Optimal Aging & Living’ medicine programs are dedicated to teaching, motivating and guiding residents to become, not only healthier….but happier. The program focuses on lowering chronic disease by maximizing a person’s overall quality of life. This includes the proper testing and safe use of bio-hormones, targeted nutraceuticals, nutrition and dietary changes, intravenous therapies including chelation (the removal of heavy metals from the body), decreasing stubborn weight, lowering inflammation, and improving sleep, energy & sexual function.  

Does the ship provide travel indicated immunizations? 
The ship will have a Travel Safety department that will provide information on each area and the current risks. Immunizations will be available, costs of which have not yet been determined. Each resident is also encouraged to consult with their primary physician before boarding to not only ensure optimal use of their existing insurance, but to assess the risk-benefit of immunization to their medical conditions. We will also have the most recent Covid-19 vaccinations on board. 

 
If I have a medical emergency while the ship is in port and I’m ashore, or if I have an emergency on the ship and need to be moved to the closest medical care facility, what, if any, support will the Storylines medical staff provide or coordinate? For example, if we are in Africa and I’m out on safari and I break a leg or have chest pains and there are no local medical providers, who will help me get back to the ship for treatment and care?  
Storylines is a family: if one of our residents has an emergency off or on the ship, our Medical Advocacy program will assist. This could be a fellow resident or a designated member of our medical staff on-call to accompany the resident, facilitate safe transport and communicate to all relevant medical staff.     

Will we have Infrared saunas on board, and how many? Please discuss availability of stem cell treatments available, both as a healing modality and also as anti-aging therapy.

We have two infrared and two steam saunas located in the spa/wellness space.

Stems cells – we start with plasma rich platelets (PRP) and human growth hormones and then with visiting doctors we may be able to add in various other stem cell technologies.
 

What will the ship’s medical center be like? 

The facilities will be similar to most small, acute care clinics on land. 

What will these facilities include? 

They will include intensive care units (ICU), treatment & examination rooms and a dedicated isolation and infection control area. 

What type of accreditation will the medical area have? 
The medical areas will be accredited to international healthcare quality standards and certified to ISO standards to meet or exceed the American College of Emergency Physicians. You can review these guidelines at the ACEP website. 

What will the standard equipment be? 

This includes wheelchairs, a stretcher, back board for spine immobilization, lab capabilities for standard blood & urine tests, oxygen, EKG, defibrillators, cardiac monitors and other equipment to gauge vital signs. Mobile units will also allow the medical team to provide care and testing in the comfort of Storylines residences. 

Will there be an EKG machine on board? Can those EKG tests be checked periodically?

Preventing, stabilizing and in some cases reversing cardiovascular disease (heart attack and stroke) is a high priority for Storylines – the hospital is well equipped with one full time physician having advanced training in emergency medicine. Testing will include on site blood work, stress and resting EKG, new wearable tech to monitor heart arrythmias, falls, along with all emergency medications including medications to treat a heart attack including thrombolytics and antiplatelet agents to help dissolve a clot.

Those residents that opt-in for optimal aging/preventive care will also have available to them advanced testing, nutritional, hormonal, and intravenous therapies, including chelation and immune treatments.

“Results of TACT Overall: there was an 18% reduction in heart events (death, another heart attack, stroke, stenting or bypass, and hospitalization for heart pains) by EDTA infusions above and beyond that provided by our effective treatments including statins and aspirin2 . When the group that took the EDTA infusions plus oral vitamins was analyzed, the reduction was by 26% compared with placebo. The effect was even more striking in patients with diabetes, where there was a 41% reduction in clinical events, including a 43% reduction in deaths over 5 years. There is nothing comparable in diabetes therapies.”

What additional emergency equipment will be on board? 

Additional equipment includes a dialysis machine, ICUs for cardiac emergencies, CPAP machines, electronic infusion devices, and mechanical ventilators. There is also a well-stocked compounding pharmacy and a clinical laboratory that can give some results within hours. 

How extensive will the on-board lab tests be? 
The ship has all the required diagnostics tests, some of which will be included as part of the annual checks. The ship has the ability to test for red and white blood cells, blood sugar, liver and kidney function, electrolytes and lipids. The ship will also have innovative functional medicine testing and wearable monitoring available for markers such as hormones, heavy metals, and gastrointestinal disease. Common rapid tests are available for pregnancy, strep throat, h.pylori, and COVID-19 or equivalent.  

What additional advanced diagnostic equipment and treatments are available? 

Digital 3D X-rays (mobile and fixed) to quickly diagnose fractures; ultrasound, CT scan and/or MRI equipment; doppler ultrasound for soft tissue injury and clots; functional lab testing including hormone testing and stem cell; prolotherapy treatment equipment; and vitamin & nutritional intravenous treatments. 
 
What is the ‘wearable technology’ program? 

The Storylines experience includes technologically advanced solutions at the forefront of health tracking. This includes wearable technology and medical kiosks to monitor O₂/CO₂ levels, blood pressure, temperature, heart rate, fitness levels, personal nutrition record, dietary plan and even menu options. Our team takes a holistic approach to health on all levels.  

Will annual mammograms be available on the ship?

This is still being discussed, however we will have thermography, an emerging technology that gives extra early detection and monitoring.

Will the medical staff provide specialty services including assisted living services, palliative and/or hospice care? 
While the ship is not intended to be an assisted living facility, it does offer many of the same amenities such as prepared meals, room service, entertainment, ADA accessibility, housekeeping, laundry services and onboard physicians. However, it is most suitable for active people who enjoy travel and have good cognitive function.  

Long-term residents of Storylines who are still highly functional (meaning thinking, eating and walking) may have access to additional personal care (fees apply); to be determined on a case-by-case basis. Just as with land based assisted living, if residents become acutely ill or get to the point where they need a higher level of care and Storylines were unable to assist, then they will need to get a live-in caregiver or move to a more qualified facility. While Storylines is not a good option for people who require palliative or hospice care, individuals who wish for a peaceful end-of-life transition should speak with the onboard doctor to make a future plan. 

The ship has a small capacity morgue and is subject to all laws and regulations including the Death on the High Seas Act. Options related to transport of the remains will be available to each family member or executor.   

Burial at sea

According to the United States Environmental Protection Agency (EPA), ‘The Marine Protection, Research and Sanctuaries Act (MPRSA) general permit authorizes the transportation and burial at sea of non-cremated and cremated human remains in ocean waters under specified conditions.’ For more information, please visit the EPA website.

Are cremation services available on the ship if a resident were to pass away?

Cremation cannot be on the ship although there will be a morgue for the remains. The remains would then be transported to their country of residence or cremated on shore as directed by the estate/family.