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Should You Travel Abroad For Medical Care?

photo of asian pagoda with city in backgroundFlying to a foreign country for a vacation full of adventure is a dream come true for many Americans. For some people, the more exotic the location, the better. It’s great to see new sites, try new foods, hear new languages. Would it also be great to get a new knee while you’re away? Traveling abroad for medical care, known as medical tourism, is often significantly cheaper than getting the same procedure in the US, but is it safe? Would you travel abroad for medical care? Would you feel better traveling to another city in your own country?

What exactly is medical tourism?

Medical tourism involves patients who live in one country traveling to another country to receive medical or dental care. Patients travel for medical care to save money, to gain access to care and/or to seek a higher quality level of care. Domestic medical tourism is when patients travel within their own country to a different area or city.

A bit of history.

Americans concerned about healthcare costs set the stage for the medical tourism industry to significantly grow in 2010.  Patients traveled overseas for cosmetic and dental procedures not covered by their insurance. Others traveled abroad because they were denied health insurance due to pre-existing conditions or other exclusions. With the increased interest in traveling abroad for medical procedures, an industry was born. As a result, companies and organizations formed to help patients make decisions and plans regarding their overseas medical care. However, the Affordable Care Act threw a wrench in their plans by banning insurers from excluding patients due to pre-existing conditions and eliminating lifetime spending caps. As a result, medical tourism became less of a necessity for many Americans, although many still choose to travel abroad for medical care. However, domestic medical tourism is increasing as patients and employers look for excellent care within the US (see below).

That being said, medical tourism is still thriving. People living in other nations continue to travel to other countries to get access to care and/or to get higher quality care than what is available in their home nations.

The who, what and why of international travel for medical care.

How much money can patients save by traveling abroad?

The Medical Tourism Association states that procedures can cost up to 90% less.

Below are their estimates of a few price differentiations:

Who pays for medical care when you travel abroad?

For services that would not be covered under your insurance plan in the US, such as cosmetic procedures and some dental work, you’ll have to pay the full cost, including travel expenses. But even with travel expenses, you will likely be spending quite a bit less.

For medical procedures that your insurer would normally cover in the US, such as knee replacements and heart surgeries, you may be covered. Your insurer might pay for a portion of the medical bill, leaving you with a significantly smaller co-payment than if you had the procedure in the US. Or, your insurer might waive any deductible and co-payment as incentive to use a lower-priced provider overseas. And some insurers might even pay the travel expenses for you and a companion! According to MedicalTourism magazine, Aetna, UnitedHealth, WellPoint, and Humana are working towards expanding their coverage of treatments abroad.

How many people travel for healthcare?

PwC estimates that 14 million patients travel each year for medical treatment.

Where are patients traveling from?

According to a PwC report on medical tourism, the highest number of patients come from these countries:

chart showing number patients who travel abroad for care

Countries are eager to participate.

There is no doubt about it, patients bring in revenue. Not only is there revenue from the medical expenses but travel related spending such as hotels and meals can add up while the patient recovers. Hence, some countries make significant efforts to become the “go-to” spot for particular procedures. For instance, in 1997 the government of Thailand started a marketing campaign to attract plastic surgery patients. As a result, Thailand quickly became a popular country for comparatively inexpensive sex-change operations and is currently popular for all types of plastic surgery and other routine medical procedures.

What procedures are patients traveling for and where are they going? 

Patients are traveling all over the world for all types of medical care!

Here are some of the top destinations, listed in order of popularity of treatment type:

chart showing what kinds of medical procedures are popular for travelers

What about domestic medical tourism? 

In the US, many employers are newly focused on domestic medical tourism. In order to help their employees get the best care possible, many employers cover treatments at US hospitals deemed “centers of excellence”. (Centers of excellence are specialized programs within healthcare institutions that provide exceptional expertise in particular areas.) Furthermore, some employers even offer programs that help pay for employees’ travel expenses to get to these top-notch hospitals. In some cases, employers negotiate directly with these centers of excellence for discount pricing in exchange for higher patient volumes. While wanting to provide the best care for their employees, these employers also hope to save money since high quality care can reduce expenses associated with complications and readmissions.

Should you consider traveling for medical care?

Deciding to have a knee transplant in India or heart surgery in Mexico is not an easy decision and shouldn’t be made quickly. Similar to the US, some hospitals in other countries are great, and some are not. Above all, you must consider your health.  Therefore, you should carefully consider the pros and cons of traveling for care. Things to consider include:

Safety concerns.

There is no guarantee of safety at any hospital, in the US or abroad. However, there might be an increased risk of something going wrong if you use a hospital in another country. According to a January 2019 report by the US Centers for Disease Control and Prevention (CDC), US residents picked up a rare, potentially deadly strain of bacteria while having surgery in Tijuana, Mexico. Some patients recovered, but some are still sick 4 months after returning to the US. And 1 patient died. The US Centers for Disease Control and Prevention (CDC) is urging people not to have any procedures at the hospital involved in at least 1/2 of the cases.

There have been other outbreaks as well, including cases tied to cosmetic surgery in the Dominican Republic in 2013 and 2017. In those instances, some patients developed severe skin infections, several of which were drug-resistant.

So beware!

Insurance coverage.

Call your health plan to learn what they will cover – both abroad and in your home country. Ask about coverage, including co-payments and deductibles, and ask if they will cover your travel expenses as well.

Hospital certification and accreditation.

Is the hospital you are considering accredited? The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. You can search their database of US facilities to learn if your choice has received their Gold Seal. The Joint Commission International certifies and accredits facilities in over 100 countries – conduct a worldwide hospital search here.

Doctor certification and accreditation.

There is a lot to consider when you are selecting a doctor. Is the doctor qualified? Do they have any accreditation or certification? Where did they train? How long have they been in practice? How many patients does he/she treat each year with the same procedure you are planning? What is the outcome of these procedures? Has he/she ever been found guilty of malpractice?

If you are using a medical tourism agency to coordinate your care, you can ask them these questions about any doctors they recommend. However, if you are not using an agency, you can ask potential doctors, or their staff members, these questions directly.

If you are planning a procedure in the US, there are many sources available to research a US based doctor. See the Zaggo resource center for a list.

In contrast, it can be tricky to evaluate doctors outside of the US. Try searching online by typing in the name of the country, “doctor”, and “registry” or “certification”. It might take you a few tries to find a government agency that oversees doctors in the foreign country you are considering.

The type of treatment and its’ risks.

Research your type of procedure and the associated risks of complications. If there is a high risk of something bad occurring, you might want to stick closer to home.

Language barriers.

Can you manage in a country that speaks a different language than you? Will the medical team speak your language? How will you communicate with your doctor and other staff members?

Post-operative care.

What is the plan for post-operative care? Where will you stay? How long will you need to stay in the area?

Consider these things before you book your trip!

The CDC suggests you consider these guidelines:

  • If you’re thinking of traveling abroad, see a travel medicine specialist in the US at least a month before your trip. They can provide you with the guidance, vaccines, and medicines you may need for your travel.
  • Ask your doctor if you are healthy enough to travel, either domestically or internationally, for medical or surgical procedures.
  • As discussed above, research the health care provider who will perform your procedure, as well as the clinic or hospital where you will be receiving care. Be aware that standards for providers and clinics abroad may be different from those in the US.
  • Similarly, look for clinics and hospitals accredited by international organizations. But realize that using an internationally accredited facility doesn’t guarantee that you won’t face complications and risks.
  • If you are traveling abroad, consider the health and safety concerns at your destination.
  • For both domestic and international travel for surgery, there are risks to consider:
    • Any prolonged travel after surgery increases your risk of developing blood clots in your legs. Avoid traveling for at least 10 days after surgery on your chest or abdomen (belly). The American Society of Plastic Surgeons recommends that patients wait to fly at least 7-10 days after having cosmetic procedures on the face or after laser treatments.
    • Consider the risks of participating in typical vacation activities after surgery. Avoid sunbathing, drinking alcohol, swimming, taking long tours, or participating in strenuous activities or exercise.

Help with decision making.

The non-profit organization, Medical Tourism Association (MTA) has a wealth of information to help you decide. You can search lists of their certified members, including hospitals and “facilitator” agencies that help patients plan their trip and care.

MedicalTourism.com, managed by the MTA, has information on many procedures, including:

  • Length of procedure
  • Expected duration of hospital stay
  • Length of recovery before you can travel home
  • Travel tips
  • Procedure details and expected results
  • Potential risks and complications
  • Major destinations offering the treatment
    • Information on hospitals within each destination, including specialties and accreditations

No matter where you choose to go, consider this.

No matter what country you choose for your medical care, there are things you should consider before any hospital stay. In order to reduce your risk of issues and complications, read these blog posts for more information:

Final thoughts.

There are no guarantees in life, and certainly not in medicine. Being a patient in any location, at any hospital, poses risks. But medical tourism carries its’ own additional set of risks. Traveling to a foreign country for medical care is not a decision you should take lightly. Maybe the risk isn’t worth the savings for you. Or maybe it’s the only way you can afford a procedure, so you are willing to take a risk. At the end of the day, you must make the decision that seems best for you.

NOTE: I updated this post on 1-24-19.

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