Cruise lines are now accepting at-home COVID-19 test results to comply with updated CDC guidelines

Starting September 13, the U.S. Centers for Disease Control and Prevention (CDC) recommends that all cruise travelers, regardless of their vaccination status, submit negative test results to board.

A recent ruling in Florida indicated that the CDC's cruise guidelines are merely suggestions, not mandates; however, cruise lines are still dedicated to following these protocols on their ships. Vaccinated travelers will need to show negative results from a PCR or antigen test taken within two days prior to sailing from the U.S., while unvaccinated travelers must provide PCR results obtained within three days. This rule remains effective until at least October 31, 2021.

Due to the inability of many pharmacies to guarantee rapid test results, major cruise lines—including Carnival, Royal Caribbean, Holland America, Celebrity, Princess, and MSC—now permit vaccinated passengers to use results from self-administered at-home tests, provided these tests are FDA-authorized for emergency use and supervised virtually by a telehealth professional.

Which at-home tests are approved?

The preferred option for this testing is the Abbott BinaxNOW COVID-19 Ag Card Home Test.

Abbott provides various at-home testing options, but this particular test includes the eMed Telehealth Service, allowing it to be supervised by a telehealth professional and fulfilling the requirements for at-home pre-cruise testing. Other Abbott tests do not qualify when self-administered at home, although some do meet the criteria when administered in pharmacies with in-person monitoring by healthcare professionals.

Since this test is an antigen test, and antigen results do not satisfy the requirements for unvaccinated travelers, this option is suitable only for vaccinated passengers.

Where can I find a qualifying test?

If you're looking to use an at-home test, Abbott BinaxNOW COVID-19 Ag Card Home Test kits are sold in packs of one, two, three, or six, with prices ranging from approximately $50 to $150, depending on the quantity you purchase. You can purchase them online (with at least five days required for shipping) or at select local pharmacies, depending on your location.

You can also schedule an appointment with your doctor, a local pharmacy, or a major retailer like Walgreens or CVS, all of which provide various options for both antigen and PCR testing. This is particularly beneficial for unvaccinated travelers needing PCR tests. Be aware that results can take five to seven days to arrive, which may jeopardize your travel plans. The costs for these tests vary and may or may not be covered by health insurance.

Alternatively, some cruise lines are facilitating easier access to testing by collaborating with national laboratories. For instance, Carnival and its sister brands, Holland America and Princess, are partnering with Quest Diagnostics to assist cruisers in scheduling appointments at over 1,500 Quest locations, including retail pharmacies at select Wal-Mart stores. Prices vary, and insurance coverage is not guaranteed. Although there are no assurances, results are typically available within 48 hours.

Many major airports also provide rapid testing—both antigen and PCR—with same-day results if you're in a hurry. However, this service can be expensive, with prices often exceeding $200, and it's not usually covered by insurance.

At first, Carnival Cruise Line announced it would set up a mobile testing facility to provide paid passenger testing at the port on embarkation day for each U.S. sailing, but it later retracted this offer due to logistical challenges.

No matter where the testing occurs, all test results must be computer-generated to be deemed official; handwritten results will not be accepted. Results must contain the following information to fulfill boarding requirements: full name, date of birth, test type (NAAT or antigen), date and time of sample collection, test result as either "negative" or "not detected," and details of the laboratory, testing location, or healthcare provider.

Will cruise lines continue to provide testing on embarkation day at the pier?

Initially, a few cruise lines offered complimentary testing at the pier for unvaccinated passengers, but this was due to their low numbers, as most lines are operating with at least 95% of the passengers vaccinated.

Following the CDC's new guideline recommending testing for all passengers, regardless of vaccination status, cruise lines are largely shifting the responsibility (and expense) of pre-cruise testing back to the passengers.

At present, the only major cruise lines offering mandatory testing for all passengers (not just the unvaccinated) at the terminal on embarkation day are Disney Cruise Line and Norwegian Cruise Line, the latter operating with a fully vaccinated crew and passenger base. Testing on the day of embarkation is complimentary for passengers of both lines, and vaccinated travelers with either line do not need to be tested before embarkation day. (For Disney cruises, unvaccinated travelers must still be tested prior to arriving at the terminal and show a negative result.)

Other lines—such as Carnival, Holland America, Royal Caribbean, Celebrity, and Princess—will perform embarkation-day mandatory testing only for unvaccinated passengers, and this is in addition to required pre-cruise testing rather than a substitute. In simpler terms, unvaccinated travelers on those lines must be tested before arriving at the terminal, present their negative results, and then undergo further testing. Carnival, Holland America, and Princess will charge each unvaccinated passenger (including those under 12) a $150 testing fee. Royal Caribbean and Celebrity will charge $136 for each unvaccinated cruiser aged 12 or older, while testing for unvaccinated passengers under 12 is free.

In summary

All passengers must now provide negative test results (PCR for unvaccinated travelers and antigen or PCR for those who are vaccinated) on embarkation day before they can board the ship. The testing cost is the responsibility of each passenger, unless stated otherwise.

While at-home test results are permitted, the tests must be FDA-authorized for emergency use and conducted under the supervision of a telehealth professional.

Alternative testing options are available, but they may take longer to process, which could jeopardize timely results for passengers. If your cruise is approaching soon, plan accordingly. Avoid last-minute testing and do not assume you can receive a test at the pier on your departure day unless you are traveling with Norwegian or Disney.