On May 3, 1802, the U.S. Marine Hospital authorized the admission of foreign seamen to Marine hospitals on a reimbursable basis. This policy allowed sick foreign seamen to receive care if space permitted, with costs paid by the master of the foreign vessel to the local collector of customs.

President John Adams signed into law in 1798 an act which furnished medical relief to merchant seamen. A monthly deduction from the seamen’s wage was used by the Federal Government to provide medical services for the seamen in existing hospitals or to build new hospitals.

The first marine hospitals were established in the port cities along the East Coast. As trade expanded along the inland waterways and the Great Lakes, the marine hospitals followed. One was erected even in Hawaii. The major function of the Marine Hospital Service until the 1870s remained the care of sick seamen. But after 1878 its functions were expanded greatly.

A more permanent home for the Boston Marine Hospital was found in 1804 in the Charlestown section of Boston. The rules and orders for this establishment were printed in April, 1808 and signed by Dr. Benjamin Waterhouse, who was the physician in charge from 1807-1809.

The first marine hospital owned by the Federal Government was purchased from the State of Virginia in 1801 and was located at Washington Point in Norfolk County. The hospital had been erected by the state of Virginia for use by merchant seamen. Following the Civil War, this facility was no longer used as a hospital. The building was demolished in 1933. Other early marine hospitals were established in the port cities of Boston, Massachusetts; Newport Rhode Island; and Charleston, South Carolina.