How to Stretch Your Healthcare Dollar with Medical Tourism

As some followers may know, we’ve been bit by the travel bug years ago (and have our Travel Hacking 101 Series to help others travel on the cheap) and with Covid haulting all travel plans for 2 years now, we’re itching to get on the road.  We are planning a few trips within Canada this year as we speak but we also are going deep into the world of unschooling / worldschooling and day dream about all the adventures we could go on.

We realize how amazing some of the benefits that Canadian residents receive so we would not be willing to give that up at this time (universal health coverage, Canada Child Benefit, OAS – as it is based off years of residency, etc).  While universal health coverage here is not tied to your employer, there are some extended benefits that you can receive through a work sponsored plan such as massage, physio, chiro, dental, vision, prescription, etc.  We’ve been discussing what we should do in our post-FIRE life about health coverage and if we should get a supplemental health plan for the non urgent/doctor related ailments that will arise.  One of the considerations that came up while we were discussing options and potential costs was “what if we tried to plan (best we could) any major medical needs while travelling abroad for a few months each year?”

Many North Americans would scoff at this idea and immediately assume health coverage/cost/care is far superior here.  Thankfully I connected with Wes from Appolo Medical Travel through the ChooseFI Expat page who was willing to come on and share some insight into the field of medical tourism.

So without further ado, welcome Wes and come share some insight into your world!

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The health system in the United States is dysfunctional. It is a complex web of conflicting interests involving patients, physicians, employers, insurance providers, pharmaceutical companies, and the government. While the maddening details of the system are beyond the scope of this article, the result is that in the United States we spend $11,072 USD per capita while the average spending in similarly developed countries is just $5,496 USD. If you are a Canadian reading this, don’t worry. We’ll be discussing Canada too. 

So, in the United States we are spending twice as much as other countries. Are we getting better outcomes at a premium price? Let’s turn to the data from the Organization for Economic Co-operation and Development. 

As you can see, despite spending more on healthcare than other developed nations, the United States does not have better health outcomes. One area in which the US does well, however, is healthcare outcomes as defined by 5-year survival rates for cancer and outcomes for those with rare diseases.

A healthcare metric in which the United States excels is medical debt in collections. According to the Urban Institute, 15% of households in the United States have a median medical debt in collections of $1,835 USD. This medical debt affects 13% of households in white communities and 17% of households in communities of color, and the median medical debt in collections in communities of color is 6.25% higher than that of white communities. This does not include the far larger number of households carrying medical debt and making timely payments. 

Canada faces a different dilemma. While Canada has an annual per capita healthcare spending of only $5,418 USD, Canadians must deal with long wait times to get the care they need. According to the Fraser Institute, Canada’s median healthcare wait time in 2020 was 22.6 weeks, the highest since national estimates for wait times for medically necessary elective care were first calculated in 1993. 2020 data might be dismissed as a fluke, but the Fraser Institute argues that while the pandemic affected wait times, historical data suggests that they are the result of policy inertia. For some perspective, wait times in 2017 were around 21.2 weeks. 

Data on Canadian wait times, and what percentage of patients are treated within the acceptable “benchmark” standard. Data obtained from the Canadian Institute for Health Information. 

Ok, so the healthcare system in the United States is both expensive and not-particularly great and healthcare in Canada has long wait times. What can you do about it?

You can pull out your passport for your health.

Time is money, and many Canadians are willing to pay up to get their procedure in a timely manner. In a 2017 study by the Fraser Institute, an estimated 63,459 Canadians received non-emergency medical treatment abroad, largely to avoid long wait times. That same year, more than 1.4 million Americans traveled abroad for their care.

In this article, we will take a look at Medical Tourism and introduce several valuable resources to help you on your own healthcare journey.

What is Medical Tourism?

Medical tourism is the action of traveling to another country for medical care. Drivers of medical tourism include cost, wait times, and availability. As we saw previously, the big driver of Medical Tourism from the United States is cost and the big driver of medical tourism from Canada is wait times.

Availability of treatments which may not be approved in the United States or Canada is also a big driver, particularly for treatments like stem cell therapies. For example, a who’s who of mixed martial arts fighters from the UFC travel to Colombia for stem cell treatments not available in the United States to recover from injuries.

For patients from the United States, Mexico and Canada are top medical tourism destinations, particularly for communities along the border. Medical tourists from the United States also commonly travel to Costa Rica, Colombia, and the Caribbean for medical care.

Canadians tend to make the same rounds, and Canadian snowbird communities in Southern California and Arizona often get their annual check-ups and prescriptions filled just across the Mexican border.

The author getting a cleaning at Sani Dental Group in Playa del Carmen, Mexico. 

How Much Can I Save With Medical Tourism?

Traveling abroad for your care can save you 50-70% on your medical care, all things considered. 

Say that you need a total knee replacement to improve your mobility and reduce pain. You can get this care at your discretion, meaning that it is an elective surgery. 

A total knee replacement (TKR) in the United States costs $34,513 USD according to Blue Cross Blue Shield, but costs just $9,000-10,000 USD in Mexico. In Canada, the same TKR would require a benchmark wait of 182 days, with a 27% chance that you’ll exceed the benchmark.

A roundtrip ticket from the United States or Canada to Mexico and a 2-week stay, including food and lodging, for a surgery that requires a 3-4 day hospitalization can cost well below $2,000 USD.

Taking the leap and getting your surgery abroad can save you north of twenty grand or many painful months on a waitlist. 

That’s the power of medical tourism. 

Americans commonly travel for elective procedures, optical services, dental care, prescription drugs, and more. You will notice that dental care, prescription drugs, and optical services are not covered at all by Medicare without the purchase of a Medicare advantage plan.  

Dental care is particularly common because even for insured patients, most plans are structured as 100%-80%-50% coverage with an annual cap of $1,000-2,000 USD. This means that the insurance covers 100% of routine care like cleanings, 80% of basic care like root canals, and 50% of major work like crowns and dental implants. 

At a cost of $4,000 USD in the US, a single dental implant can eat up a full year of dental insurance coverage while leaving the patient with a bill for $2,000 USD out of pocket.

Meanwhile, the same procedure can be completed in Costa Rica for just $1,100-$1,300 USD.

Case Study

I own a medical tourism company called Apollo Medical Travel. We have helped patients get high quality, affordable medical care for far less than what is available in the United States.  

One patient, who we will call Diana, is a teacher from Austin, Texas. Diana’s teeth began to deteriorate at a relatively young age due to complications surrounding a bariatric surgery procedure. 

She was quoted over $38,000 USD for a full mouth restoration in Austin, and so she reached out to us to see what options were available in Latin America. 

We connected her with our partners at OG Center in San Jose, Costa Rica. Dr. Oscar Guzman, a dentist trained in Costa Rica, the United States, and Germany, was able to provide her with upper and lower implant-supported dentures made of the best materials on the market for just $15,500 USD. 

She decided to travel with her mother, and all told her expenses were $20,000 USD including two round trip tickets for two, two one-week stays in a 4-star hotel, and in-country transportation. 

She saved $18,000 USD on her treatment and was able to schedule her care around breaks in the school year.

Is Medical Tourism Safe?

The vast majority of medical tourists have safe and uneventful medical trips, but some horror stories hit the news.

Medical Tourism carries all the risks associated with a medical procedure, as well as some unique risks such as air travel following a surgery, antibiotic-resistant bacteria, communication challenges, and continuity of care. All of these risks can be mitigated with some simple steps.

Get a Pre-Travel Consultation

When you decide to travel abroad for your care, the US Center for Disease Control recommends seeing your healthcare provider 4-6 weeks before your trip to discuss practical safety considerations for making the trip and specific risks you might need to account for in regards to your personal health status.

This is also a good opportunity to arrange for a follow up visit following your trip to ensure that your recovery is proceeding smoothly.

Get Travel Health Insurance

You should consider purchasing travel health insurance for the duration of your trip which includes medical evacuation insurance back to your home country. For those getting relatively minor procedures or those within driving distance of the border, this probably won’t be necessary.

Maintain your Medical Records

Take copies of your medical records with you, particularly any information related to the condition for which you are being treated. You should also bring all of the prescription medications you will need for your trip, with extra in reserve in case of a setback or delay, and copies of your prescriptions.

When you return home, bring copies of your medical records from your procedure abroad. Often, these records will be in a foreign language, but they can be easily translated by a freelancer.

Do Your Research or Contact a Professional

You want to ensure that you will be getting treatment by a professional who is highly qualified, and who can speak your language. Most clinics that advertise their services to international patients have at least one member on staff available to translate, but you should check to ensure this is the case.

Working with a medical tourism facilitator is also a smart idea. Medical Tourism Facilitators create networks of trusted clinics abroad and then help promote them to an international audience. The typical business model involves promoting the clinic and receiving a commission on the value of the procedure from the clinic, at no additional cost to the patient.

Facilitators know the ins and outs of procedures and are able to help patients find the best provider for them. Facilitators can also assist with the logistics of your trip.

Arrange for Follow-Up Care

You need to ensure that you have a plan in place for your follow up care. You should know whether you will be recovering at your hotel, with follow up appointments, or in a hospital. Many medical providers abroad will give you their personal cell phone numbers to check up on you. Other facilities offer recovery suites with a nurse on call.

When you return home, you should arrange for an appointment with your primary provider to ensure that your recovery is on track.

Travel With a Companion 

At Apollo Medical Travel, we have seen that patients who travel with a friend or family member have a much smoother trip. Any surgery, including minor outpatient surgeries, can be taxing physically and emotionally. Having a companion on your trip to help you get around, go out for food, and provide emotional support makes a big difference.

Resources for Medical Tourists

Here are some great medical tourism resources you should check out: 

The CDC Yellow Book on Medical Tourism

The CDC Yellow Book is an online publication by the US Center for Disease Control that provides a complete guide for medical tourists, including useful checklists.

Country Travel Safety Information

The US State Department offers up to date safety guidance regarding every country in the world. On their site, US Citizens are able to register in the Smart Traveler enrollment Program (STEP) which provides timely alerts for events happening in the country you will be traveling in such as disturbances, natural disasters, and political turmoil.

Personally, STEP was very useful for me as I was in Colombia in March 2020 as the COVID-19 pandemic shut down most international flights.

Tax Deductions

Did you know that US Citizens can deduct medical and dental expenses that you pay out of pocket and are not reimbursed by insurance if they exceed 7.5% of your adjusted gross income over the course of the tax year? Check out this medical and dental deductions article or check out the IRS’s page on medical and dental expenses. 

Conclusion

Medical Tourism can save you 50-70% on your medical care. If you are trying to get your money to work as hard as you do, pulling out your passport is a great way to spend less while getting the care you need. There are a plethora of resources out there to make the leap. If you have any questions or concerns, feel free to shoot me a message at wesley.c.jacobs@apollomedicaltravel.com. 

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Thank you Wes for taking the time to really dig into this topic for us!

I think many people assume health coverage abroad is inferior to what they have available at home and I hope after reading today’s post it at least gives our readers some food for thought.  Now of course I hope no one reading needs any sort of major medical procedures, but if you do, maybe medical tourism is right for you?

We know some Canadians in other areas that really struggle with either finding a primary doctor or waiting for a procedure so maybe this could be a workaround? Thankfully Alberta pays doctors the most compared to any other province so luckily we do not have a doctor shortage issue that many other provinces face.  However with UCP in power these past few years many doctors here are not happy with some of the recent changes – so who knows it might not look not too pretty in the near future and medical tourism might be the winning way if something does arise.

What do you guys think – would you ever consider leaving your country to get some medical work done elsewhere?  Or does this seem too far of a stretch in your eyes?  Would love to hear your thoughts!

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• Investing Newbies: Check out our free Investing 101 Series.
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