Medical Tourism: What Medicare Beneficiaries Need to Know

Every year, millions of Americans travel abroad to destinations like Mexico, Costa Rica, Colombia, Brazil, India, South Korea, Singapore, Thailand, and the Dominican Republic for medical procedures that are prohibitively expensive here in the United States.

Each of these countries has excellent clinics and hospitals that can provide first-rate treatment for 30 to 75 percent less than what American providers charge.

For example, a U.S. resident who needs a full set of dental implants can expect to pay $40 to $60 thousand for the procedure in the U.S.

Non-emergency dental care is not covered under Medicare, so Americans frequently look to schedule more expensive dental procedures abroad.

By flying or driving into Mexico, Americans can routinely save 40% or more on the cost of implants – all from internationally accredited clinics, and often from dentists who are board-certified in the United States as well as Mexico.

According to the Centers for Disease Control, approximately half a million Americans travel to Mexico every year for dental treatment alone.

But dental treatment is just the beginning: Common procedures Americans schedule abroad as medical tourists include cancer treatment, organ transplant, in-vitro fertilization, bypass surgery, weight loss surgery, and orthopedic surgery procedures such as hip and knee replacement.

For services not covered under Medicare, for those without access to a health plan, and those who have very high deductibles and other out-of-pocket costs, each of these services when scheduled abroad can be had for thousands of dollars less than their cost in the United States.

The Risks of Getting Health Care Abroad

While many of these countries have excellent, state-of-the-art facilities for treating American medical tourists, not every facility is top notch. Overseas facilities sometimes lack formal accreditation from recognized healthcare quality control organizations.

They also may not be subject to the same medical regulatory oversight as the United States.

And sometimes the facility itself may be excellent, but absent FDA oversight, some drugs obtained abroad may be counterfeit, expired, poorly stored, or contaminated.

Foreign medical facilities also don’t face the same strict privacy laws that U.S. facilities do, such as HIPAA. They may not hold your personal medical information strictly confidentially.

If there are complications, other countries have different legal systems. Getting compensated for negligence or malpractice that occurred outside of the U.S may be difficult or impossible. Even if you got a judgment, it may be nearly impossible to collect on it.

How to Mitigate the Risks of Medical Tourism

Do your research. Speak to people who’ve been to those clinics and hospitals abroad, and who will give you a frank, unbiased review.

Check to see if your facility is accredited by the Joint Commission International.

Hire a translator/escort/fixer. Many medical tourism agencies will provide, for a fee, a translator and escort for you to act as your advocate, and make sure you can communicate with the hospital staff.

Arrange for a place to stay to recover. You may not be up for traveling right away after undergoing a medical procedure in a foreign country. Plan ahead for transition care, whether in a rehab and recovery facility or a clean hotel.

Check in with a U.S. doctor as soon as you get back. Your primary care physician will want to inspect the surgical wound, if any, and make sure you are on the proper antibiotics.

Who Should Consider Medical Tourism?

If you’re a Medicare beneficiary, medical tourism makes the most sense under these circumstances:

• Medicare does not cover the procedure
• You are on Original Medicare but have no Medicare supplement insurance (Medigap)
• You have a Medigap Plan A or similar plan that still leaves you with high out-of-pocket costs
• You have a Medicare Advantage Plan and the procedure is not covered
• You don’t want to join a waiting list
• You are not a member of a Medicare-compatible healthsharing plan, such as Medi-Share 65+.
• You need a transplant but can’t get an organ within the United States.

Where to Learn More

Speak with your primary care physician about scheduling medical procedures outside of the United States. He or she may be able to refer you to some reputable providers. You should also ask about standard recovery protocols and timelines, so you’ll have an idea of how long it will be before you can expect to be able to travel safely post-procedure.

Other possible resources include:

Patients Beyond Borders
The Centers for Disease Control and Prevention

Medical Tourism Magazine

And finally, our own outstanding team of Personal Benefits Managers here at MediGap Advisors. Please don’t hesitate to contact us with any questions you have about paying for healthcare, whether here at home or abroad.

Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors