Among those who travel for medical services, India is known for top-notch health care at low prices.

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When you really think about it, India has been in the health care business for centuries. Home to the 5,000-year-old practice of Ayurveda, people have been relying upon those ancient beliefs longer than any other medical system on Earth.

It should come as no surprise then, that today this country with a population of more than one billion—80 percent of them having to pay out-of-pocket for their medical expenses—would be at the forefront of medical care, cost containment and state-of-the-art health care facilities. As a result, India now provides some of the highest-quality and most affordable health care options in the world—care that Americans are quickly becoming aware of.
 
“Medical travel really is about finding that sweet spot between high-quality and affordability,” says Josef Woodman, author of the comprehensive must-read guidebook Patients Beyond Borders. “Who wants to get on a plane and travel for 12 or 24 hours and away from their families to get health care if the care isn’t great, and the costs aren’t affordable?”

So who is the medical tourist? Those who travel for health care cover a range of categories and income levels, including those without health insurance; those with health insurance policies that don’t cover the procedures they are facing; those whose health insurance offers the option of going overseas for their health care; those who want to save money, or those who want immediate care and choose not to wait to have their operation done in the U.S.  Medical tourism can also be a far less daunting alternative for business travelers, who already have a degree of comfort with international travel, than for the average American.

After years of 24/7 pain and doctors telling him that he was too young for a hip replacement, Doug Stoda, and his wife Ann, made the long journey from Tomah, Wisconsin to Chennai, India. They’d heard about the hip-resurfacing procedures being done at the Apollo Hospital there, and decided to go for it.

“After doing a lot of research, we found out that the procedure had a marvelous track record, was safe, and since Doug’s pain was getting pretty debilitating, we said ‘yup,’ we’ll do it,” says his wife.

In early 2006, when his procedure was done, the Apollo Hospital had not yet been accredited by the Joint Commission International (JCI) (it since has), the U.S. organization that provides approval to international facilities, thereby setting the standards for international quality of care. 

While the culture shock of India was “devastating” to the Stoda’s at first, and the 30-hour trip from their home to the hospital uncomfortable for Doug, the journey was a success on a number of fronts. For starters, Doug is now in great physical condition, and according to Ann, “He can do anything now that a 54-year-old is capable of doing.” As for the Indian experience, both are looking forward to revisiting the country for a vacation sometime. Then there’s the cost savings: With no health-insurance coverage, the price quoted to them for a hip replacement done in the U.S was between $70,000 and $75,000. Their cost in India in January for that procedure was $6,500.

According to Ann: “From doorstep to doorstep, including hotels in Chicago going and coming home, airfare, hotels in Chennai before the surgery, the surgery and recuperating at Fisherman’s Cove resort after the surgery, for everything—it was $11,500.”

 Stephanie Sulger had been an OR nurse for 30 years when she started the medical tourism company Medical Tours International in 2002. Sulger, now vice president of the consumer division for Denver-based medical tourism company BridgeHealth International (which purchased Medical Tours International in February), relates another such experience.

“We have a patient who, after leaving his government job, started a real-estate agency, and his insurance payments were very high and didn’t include a lot of things. He developed problems, and ended up having four surgeries in India—a torn rotator-cuff repair, back surgery, neck vertebrate disk replacement and a tummy tuck. He uses overseas medicine sort of as his primary care, and has a primary-care physician in India.”

Sulger estimates that the patient’s cost savings have been considerable. “He would have paid $80,000 in the U.S. for the neck disk replacement alone. He paid about $16,000 in India.”

When Irma Woodward began feeling short of breath after bike riding around Key Largo early last year, her doctor suggested she have an angiogram. Like Doug Stoda, she was without health insurance. So, she went to her computer, searched for “cheap angiograms” and began looking at her options. She elected to have her treatment at the Wockhardt Hospital, in Mumbai, a JCI accredited hospital and one also affiliated with Harvard Medical International.

The angiogram showed blockage in her arteries, and Woodward wound up having two stents put in. “Even if I didn’t need the stents and angioplasty, the cost of the airfare to get to India and the angiogram added together was cheaper than having an angiogram alone done here.”

Woodward’s out-of-pocket total cost for the entire trip was, including airfare and two weeks in India, about $15,000—a price that included airfare for her brother, who accompanied her.

Tempting as these price savings may be, traveling to India for any health care procedure is not for everyone. “You’ve got to be brave and able to handle diversity,” says Woodward, who had traveled to India 20 years ago and was aware of the country’s culture, massive population and wealth disparities.

But cultural changes aren’t the only things the medical tourist has to be able to handle. “Coming to India for care is not for patients that require multiple procedures,” says Vishal Bali, chief executive officer of the Wockhardt Hospitals Group. “You can’t be going outside of your own country if you are in need of things like dialysis or chemotherapy, where regular or multiple visits are necessary.”

Bali said that in India, medical tourism is more about elective surgeries and procedures, such as those within the orthopedic, cardiac and dental care arenas. That means those traveling for medical procedures need to first and foremost match their needs with what’s offered by a specific hospital. Research on this front is easy to do online, as all hospitals list the procedures they are expert in, as well as their costs. Interviewing a few hospitals is also a must, as is having a passport and visa, booking plane and hotel accommodations and traveling with a companion.
Rajesh Rao, the chief executive officer of IndUShealth, a Raleigh, North Carolina-based alternative-care services consulting firm, works closely with employers of small- to mid-size companies interested in saving money on their health care costs by incorporating care in India options into their existing health-benefits plans. He also works with individuals interested in seeking care in India.

“At first blush, going overseas for care sounds like a very complicated thing to do,” says Rao. “But we make sure every aspect of it is covered, including helping people apply for their passports and visas. The only manual labor on their side is potentially going and signing authorization forms to release medical records, so that we can get them forwarded to the hospital for evaluation.”

As with any health care procedure, there are risks involved. Two to consider before making the decision to fly halfway around the world are aftercare and unexpected problems. Deciding not to follow-through on rehab at home, or encountering mechanical problems with the apparatuses used in your operation could result in more costs and operations and possibly wipe out any financial savings your overseas treatment initially afforded.

In the end, there’s plenty of homework to be done before venturing abroad for health care procedures. Last year alone, about 2,000 Americans found their way to India to do so. This year, it’s quite likely to be more.