Texas woman’s first cruise ends in medical emergency and $14,000 bill on Royal Caribbean voyage

A Texas woman on her first cruise with her boyfriend developed a life-threatening gastrointestinal bleed aboard a Royal Caribbean voyage from Galveston to Mexico, then faced steep medical bills after the trip. Khiali Baxter, who did not have travel insurance, became violently ill just two days and five hours into the cruise, prompting an onboard medical evaluation and an emergency transfer to a hospital in Mexico.

Baxter’s ordeal began on Sept. 8 as she and her partner were cruising toward Costa Maya. In a video posted online, she described waking with severe symptoms: vomiting blood, alternating between consciousness and unconsciousness, and feeling freezing cold. The ship’s medical team conducted an initial assessment and found an active internal gastrointestinal bleed with critically low hemoglobin levels. Baxter was treated in the onboard emergency room and then waited four hours before the ship reached Costa Maya, where she was transferred by ambulance to a Mexican hospital.

Once at the Mexican facility, the medical bills began to accrue quickly. Baxter’s family reported that hospital staff demanded an upfront payment of $2,500 just to look at her or perform any work, a condition her father, Craig Baxter, said was laid out at the outset. “We’ll work as far as the $2,500 will take us,” he recalled in an interview, reflecting a sentiment many travelers without insurance face when care is sought abroad. After the initial payment, doctors slowed the bleeding, but Baxter’s hemoglobin remained critically low for hours, and additional blood transfusions were eventually administered.

According to a GoFundMe fundraising page created by Baxter’s family, the medical staff conducted an endoscopy and a colonoscopy, but could not determine the bleeding’s source during the initial evaluation. The family said the treatment sequence raised concerns about both the timing and the necessity of repeated testing, while money continued to accumulate. They said Baxter’s bleeding stopped at one point, but the care teams could not identify a definitive cause, and her condition remained unstable as tests rolled on.

The family’s accounting shows a mounting bill: roughly $9,970 from the Mexican hospital plus $4,048 billed by the cruise line’s medical facilities. They also incurred costs for emergency passports and travel, lodging, and flights as they coordinated care and support from the United States. Baxter’s GoFundMe notes that she returned home with no diagnosis yet and that the family faced a substantial financial burden even after an evacuation with the assistance of Aid America, a medical-evacuation service referenced in the fundraising post.

Baxter and her family say the episode has been harrowing in part because the care described as “initial treatment” appeared to slow decisive action for several hours. “The initial ‘treatment’ was deeply troubling. Khiali was given medication to slow the bleeding, but then left for nine hours with her hemoglobin critically low before doctors administered additional blood,” the GoFundMe said. In another update, the family said Baxter was medically evacuated back to the United States with Assist America’s help, and she returned home but remained without a confirmed diagnosis.

The Baxter family’s experience has drawn outcry about the financial and logistical challenges travelers can face when medical emergencies occur outside the United States, especially for those without travel insurance. Baxter’s father has used the incident to urge younger travelers to secure coverage before international trips, emphasizing that an illness or injury can escalate quickly and lead to substantial costs regardless of the traveler’s age or health status.

As of the latest updates, Baxter has returned to her home state but remains without a formal diagnosis. Her family continues to pursue answers while managing medical bills that reportedly totaled more than $14,000 across hospital and cruise-line facilities. Her father told local media he hopes the episode serves as a cautionary tale for other travelers and underscores the importance of travel insurance in covering medical emergencies abroad. "If you're travelling outside of the US, please make sure you have travel insurance," he said. "I can't tell you how much I wish I would have had it."

This incident underscores a broader reality about travel-related medical care: when illness or injury strikes far from home, patients can face complex medical decisions and steep, upfront costs before insurers or consulates can intervene. The sailing date, the duration of the shipboard stay before transfer, and the ultimately unresolved medical questions contribute to a stressful emergency that extends beyond the patient’s health—impacting families financially and emotionally as they navigate care across borders.

The Royal Caribbean voyage involved a relatively short time at sea before the emergency medical transfer, and the sequence highlights the vulnerabilities that can accompany international travel, especially for individuals who do not carry travel insurance. While insurers sometimes coordinate flight arrangements or evacuations, the experience described by Baxter’s family suggests that costs can add up quickly even when medical care is ultimately provided. Travel medical insurance is designed to mitigate these risks by covering hospital bills, emergency evacuations, and related expenses, providing a framework for access to care and financial protection in foreign countries.

As Baxter continues to recover at home, her family says they are seeking a clearer accounting of the care provided and the charges incurred. They hope their experience will inform other travelers about insurance options and the realities of medical care on large cruise ships and in international destinations. The incident also reverberates in policy discussions about medical billing practices for nonresidents and the affordability of urgent care on cruises, where the nearest hospital may be in another country and where the cost of care can escalate rapidly in the absence of insurance coverage.

For readers planning international travel, health experts reiterate the core messages that underpinned Baxter’s case: secure comprehensive travel health coverage before departure, verify what medical facilities are covered by your policy, understand deductibles and upfront-payment requirements, and confirm how evacuation and repatriation would be handled if a serious illness arises. The goal is to ensure patients can obtain timely, appropriate care without facing unsustainable bills that compound a medical crisis with financial stress.