Prescription meds

I have had fluctuating blood pressure and it was mentioned by my doctor possibly but not necessarily taking meds.
I haven’t decided yet as it’s not become a drastic issue.
My question is just how does the coast guard check on what prescriptions Mariners take. Is it possible to pay cash so it’s not reported through insurance companies?
I’m on my last renewal and dont work professionally except on occasion on a water taxi.
Thank you for your comments

The USCG is unlikely to check your medical records. Once you have a medical card, you are out of sight and out of mind. You are under no obligation to tell the USCG when you start taking new medications.

The USCG medical card has terms of: one year for pilots, two years for STCW, and five years for “national licenses.” Running a water taxi would fall under national license, so it may not be an issue for you.

If you have a prescription then there is a record of that. It doesn’t matter how you pay for it.

If you decline the prescription, and instead go to Canada (which will probably require a prescription from a Canadian doctor) or go to Mexico (where you can buy most things over the counter without a prescription) the USCG cannot find a record of that.

Talk to your doctor about WHY you have fluctuating blood pressure. It could indicate a serious condition which makes it risky and irresponsible for you to run a water taxi, or it may simply be caused by stress and anxiety.

There are often viable alternatives to prescription medication, such as improve diet and exercise, stop smoking, lose weight, reduce alcohol and caffeine, yoga and meditation, take baby aspirin, etc.

I don’t know whether fluctuating blood pressure would be an issue for renewing a USCG medical card or not. That would probably depend on why you have fluctuating blood pressure and what medication you are taking. Prescription antidepressants for anxiety ring alarm bells.

A couple of thoughts @oldpro: If you have a health issue, it’s certainly advisable to listen to your doctor. If it is controllable with medication, then you should list it on your medical cert application. The doctor should stipulate and write in the comments that it is controlled and does not affect your ability to be fit for service. That may require followup with the CG medical evaluator, but if it is not serious and is controlled, that’s generally good enough.

As for prescriptions, they don’t “check” on what your taking if you don’t tell them you are taking something.
Insurance companies don’t report anything. But if there is an incident on the water taxi, and it turns out you are taking prescriptions that you didn’t disclose on your medical cert application, then you’d be pretty well screwed.

All that aside, if as you said it is not a drastic issue, and you nor your doctor think you need meds, then there’s no meds to report. But you still will want to be honest in filling out the renewal.

Medical certs aren’t there to keep you working, they’re there to keep the rest of us safe while you’re driving.

As one who ignored medical advice (and visits) for years. . . don’t. . . .I spent a month in the hospital and am lucky to be alive. . .


Here we go again with someone trying to game the system,

There is a reason the CG is interested in your med list. You can start by reading some NTSB accident reports. Medications, depending on what they are, can have an effect on cognition and alertness, among other things.

I am on a common blood pressure med. I list it on my 719k. It’s no big deal, really. If you do end up taking one, you shouldn’t need more than a short adjustment period where you become accustomed to it. They are not banned or prohibited medications. Don’t try to lie, please, especially where safety of yourself and others are at stake!

Ps–don’t eschew a med if you need one. The CG will not give you a hard time over benign essential hypertension. Have you tried lifestyle changes first? Low sodium (DASH) diet, cut back on booze/coffee etc? Give it a try if not.


if you need medication for BP then get it !! people who put it off and such end up babbling idiots that walk in circles … get it?
you may have to take a physical every couple years but anything beats having a stroke or something!


As someone who DID put off treatment, I fully agree. It came very close to killing me last year. . …

1 Like

I’m on BP medicine. As long as you take it as prescribed and it controls your BP the CG doesn’t take issue.

1 Like