Medical Tourism: Would You Travel Abroad for Surgery?

Putting off that dental implant or knee surgery because you simply can’t afford it? If so, you’re not alone. According to the National Association of Dental Plans, 126 million Americans lack dental coverage, and for those who do have a dental plan, the quality and economics of coverage are not always optimal. Likewise with medical insurance. According to the Commonwealth Fund Biennial Health Insurance Survey 2014, 31 million Americans – or 23 percent of 19- to 64-year-old adults who are insured all year – had such high out-of-pocket costs or deductibles relative to their incomes that they were considered “underinsured.”

With exorbitant co-pays and cost sharing expenses for lifesaving or pain relieving procedures, and no coverage at all for many dental, weight reduction, fertility, or cosmetic treatments, it’s no wonder that the biggest cause of bankruptcy in our country is medical expenses.

But American consumers do have more affordable options available to them, if they’re willing to shop around for medical care – even across borders, said Josef Woodman, author of Patients Beyond Borders, a comprehensive guide to world-class medical tourism. In 2015, more than one million U.S. citizens packed their bags and headed overseas to countries like Brazil, India, Mexico, Turkey, and Hungary to realize a 25 to 90 percent cost savings on a myriad of treatments and procedures, including dentistry, cosmetic surgery, heart and orthopedic operations, weight reduction, and fertility treatments, to name just a few. And this number is only expected to grow, said Woodman.

Medical tourism – also called medical travel – is a trend that is growing at the rate of 25 percent yearly, and is particularly popular among younger people. “Millennials are sick and tired of being jacked around by the American health industry and they’re embracing a cost effective and often better level of care abroad,” Woodman claimed.

If you’re of the mind that no cost savings is worth questionable medical practices and unsanitary conditions in another country, you’re likely to be surprised. Many countries have invested billions of dollars into their healthcare systems, resulting in numerous world-class medical facilities with modern technology and treatment that meets or even exceeds U.S. healthcare standards. In fact, there are at least 50 countries with a combined 600+ hospitals and ambulatory clinics that are accredited by one of several renowned international accreditation agencies, including the U.S. based Joint Commission International (JCI). Many of these medical institutions are affiliated with U.S. hospitals, such as Johns Hopkins, Cleveland Clinic, and Harvard. And many of the physicians and dentists working abroad received their training in the United States, Canada, Switzerland, and Germany.

Other advantages of traveling abroad for your medical care? According to Patients Beyond Borders, many countries offer specialty treatments that may not be approved in the United States, shorter waiting periods for some surgeries, lower wound infection and complication rates, and less pressure for early discharge from the hospital. It’s not uncommon to see countries that cater to American medical travelers, offering English speaking staff or at the very least, translators, and package deals with everything from a pick up at the airport pre-surgery to an extended recovery period in a resort or surgical retreat, where postoperative follow-up professionals like physical therapists come to you to give treatment.

As for sightseeing, Woodman suggested that except for the most minor of procedures, medical travel should be thought of as more of a business trip than a vacation, due to postoperative or post treatment discomfort and limitations as well as fatigue. Still, it’s likely that you’ll take in some great views and enjoy the cultural differences and hospitality in a new country.

If you’re interested in joining the ranks of medical travelers abroad, you need to do your homework first, said Woodman, from exploring which country is best suited for your medical needs, to selecting a doctor, clinic or hospital, comparing costs, and planning who – and what – to take along. And while you don’t have to be a computer whiz, most of your research and inquiries are best done online. Here are some tips from Woodman:

■ Plan carefully. It takes time to research your options, even if you’re using a medical travel planner (WorldMedAssist.com and MedicalTourism.com are two such agencies). Even if much of the planning is done for you, you still should spend plenty of time checking out the credentials of your doctor, the hospital, and the travel planning agency itself.

■ Consider your savings. Carefully consider the amount of money you’ll save, taking into mind airfare and accommodations while gone. In general, if you’re not saving at least $6,000 on your medical journey, it may not be worth traveling abroad for care.

Let your home doc know that you are traveling out of the country for medical care, so you can get proper follow up care once you’ve returned home. You’ll also need records of your diagnosis and the suggested treatment plan.

■ Choose a reliable companion. If at all possible, take a companion – someone you trust and whose company you enjoy – along with you for help and support before, during and after your treatment or surgery.

■ Be prepared. Ask the travel planner, hospital, and physician what medical records or tests you need to bring with you to make things go as smoothly as possible. When you are ready to go home, you’ll need records of your treatment and recommended post treatment care.

■ Be realistic. Allow plenty of time abroad for basic recuperation, and don’t expect to do a lot of sightseeing.

Learn about your host country. Do your homework regarding currency, weather, transportation, food, and water, so there are no surprises to deal with when you’re under the weather.

WHERE TO GO
While there are many countries offering top quality medical care at deeply discounted prices, some of the most popular destinations, according to the book, Patients Without Borders, are:

✈ Antigua – Home of Crossroads Centre, a 12-step addiction and recovery program founded by Eric Clapton, at a 40 percent savings.

✈ Barbados – Barbados Fertility Centre offers IVF and a host of fertility treatments at a 40-60 percent savings.

✈ Brazil – Beauty conscious Brazil specializes in cosmetic surgery, with discounts of 20-30 percent.

✈ Hungary – Medical travelers from all over the world flock to Hungary for cost savings of 40-75 percent on dental work. In Gyor, located in the northwest part of the country, there are more than 150 dental clinics.

✈ India – Specializes in orthopedic and heart procedures with savings of 60-90 percent. Harvard-affiliated Wockhardt Hospital has performed more than 20,000 heart procedures, with a 98 percent success rate, far surpassing U.S. standards.

✈ Israel – Is a well-known center for inexpensive fertility treatment, with 30-50 percent savings on in vitro fertilization.

✈ Mexico – Boasts four first-rate American accredited hospitals offering bariatrics and weight management programs at a 40-60 percent savings. It’s also a leading country for dental work.

✈ Singapore – Ranks 6th in healthcare worldwide (compared to the U.S. 36th ranking) and specializes in many areas, especially cancer diagnostics and treatments at Johns Hopkins International Medical Centre; 30-40 percent savings on medical services here.

✈ Thailand – Boasts world-renowned Bumrungrad International, Asia’s first American accredited facility, and although notorious for many specialties, is known for meticulous cosmetic surgery. You’ll find an average of 40-75 percent savings in this country.

✈ Turkey – A coveted tourist destination, Turkey has more American accredited hospitals than any other country, and is popular for vision services, especially LASIK, at a 40-50 percent savings.

GO DOMESTIC
Put off by the possibility of language and cultural barriers related to traveling abroad for medical care? You may still be able to shop around within the United States for the best medical care at the best price. While many insurance companies limit their coverage to “in network” facilities within your state of residence, increasingly, some health plans, such as United Healthcare, are offering domestic medical travel plans, allowing you to explore your options.

And, said Laura Carabello, executive editor and publisher of Medical Travel Today and U.S. Domestic Medical Travel, large self-insured companies like Walmart, Lowe’s, and PepsiCo are introducing domestic medical travel options for employees for surgeries such as knee and hip replacements and bariatric procedures. “This is the fastest growing trend in medical travel today,” she claimed.

How it works, Carabello explained, is that companies get a discounted rate from a group of hospitals that are considered “centers of excellence,” – or American hospitals that score high for both reasonable cost and high quality care in areas such as transplants, surgeries and cancer. “The employer will then waive the employee copays for the treatment,” she added, “and in many instances, will even provide travel and lodging costs for the employee and a companion. This gives you access to the best care for a reasonable – or even no – cost.”

You can still choose to get your medical care close to home. But it may pay to check out an employer’s medical travel plan and be willing to go the distance – especially if it’s to a high quality medical facility at a huge cost savings.

By Linda Hepler, BSN, RN