Top Three Medical Travel Destinations

Costa Rica

Few of the basic requisites of a medical travel destination are advanced health care system, availability of highly developed medical facilities, proficient doctors, caring hospital staff, great sightseeing options, suitable weather and a supportive national infrastructure for a trouble free healthcare journey. Costa Rica is one such place that offers all these things in great abundance with extremely superb medical and healthcare facilities, highly competent medical professionals and great support system in terms of staff and other facilities.

Costa Rica has a highly developed tourism industry. It is perhaps the world’s leader in eco-tourism with dense topographical rain forests, stunning mountains, diverse flora and fauna, fabulous beaches, suitable climate and friendly & generous people. All this combined with the high quality medical facilities available at amazingly low prices, every year thousands of United States citizens head towards Costa Rica to acquire treatment while holidaying.


A rich potpourri of various cultures and religions, India is also a preferred destination for medical tourism as well. It is perhaps one of the world’s least expensive medical tourism destinations.

Offering cost effective treatment for chronic heart diseases to cosmetic surgeries to years old Yogic & Ayurvedic spa treatments, India attracts patients from all over globe who want to acquire in-budget medical treatment as well taste the rich bio and cultural diversity, found in abundance here.

Rightly known as the land of Yoga and cultural diversity, India has been attracting millions of American, Australian, European and other foreign nationals to travel here for treatments ranging from cardiac and orthopedic. Several state-of-the art hospitals & medical facilities are available in New Delhi, Bangalore, Mumbai and Chennai. Indian doctors are world-over recognized for their expertise. The staff is extremely friendly and proficient in English.


The stunning land of Malay Kingdom – Malaysia experiences a great turnover of tourists coming every year to experience its rich topographies and affordable plastic & cosmetic procedures, dental surgery, orthopedic and bone procedures, to more severe open heart surgeries.

Healthcare facilities in Malaysia ensure that they provide world-class facilities to patients while creating personalized care that they may require while being in Malaysia.

Emerging as Asia’s one of the most recognized countries for medical tourism, Malaysia has a wide of specialist hospitals, clinics and surgery centers. The standards of health care services throughout the country, is of world class standard and the medical cost in Malaysia is one of the most competitive in the world-supporting it to emerge as most sought medical destination.

What Health Reform Takes Away, Medical Tourism Gives Back

The following points were stressed by Roy Ramthun, President of HSA Consulting Services, a former White House advisor on health initiatives and a key-note speaker at The First Latin American Global Medicine and Wellness Congress April 26, 2010, in San Jose, Costa Rica.

For the medical travel industry, the timing is right. U.S. Health Reform will mean (1) fines if you don’t purchase appropriate coverage, (2) higher premiums, higher taxes, and longer waiting times even if you do purchase appropriate coverage; and, (3) potential limits on access to new technology and treatments.

In addition, U.S. companies, from whom most employees and their families obtain their insurance coverage, will be under great pressure to drop coverage, shift full-time workers to part-time, or go out of business. Estimates of Americans who will lose their employer-based insurance range from 8 to 19 million.

Employers that don’t drop coverage will be under pressure to move their employees to HSAs.

The U.S. is already facing a critical shortage of physicians and nurses. Expanding coverage to 35 million more Americans will create problems access needed care by already insurance Americans. Projected reductions in payments to medical professionals by Medicare and Medicaid and lack of tort reform will only exacerbate the shortage problems.

  • More patients may be willing to travel rather than wait for services.
  • Americans with health savings accounts (HSA’s) are the most likely medical tourists. These are people willing to travel, internet savvy, and will be shopping abroad for value because these people are spending their own money.
  • New transparency provisions will raise awareness of costs.
  • Newly uninsured are looking for less expensive places to access care, for example workers converting to part-time and early retirees who lost coverage.
  • Americans are looking for new technology and treatments not yet available in the U.S.
  • US employers may be willing to send their employees overseas for procedures to lower the costs and avoid the excise tax.
  • Insurance carriers may do the same for their members.
  • Insurance companies are building relationships with foreign doctors and hospitals as they look for opportunities to sell insurance products in emerging markets.
  • U.S.-based insurance carriers growing international presence may make medical tourism easier; for example CIGNA, United, and Aetna are placing a greater emphasis on growing their overseas operations. – Source: Health Plan Week, Vol. 20, No. 13, April 12, 2010.
  • More wealthy seniors may retire overseas to avoid higher taxes on investments.

Post-Reform Environment

Heightened Awareness of Cost
“Those who opt to go without insurance will always have the option of obtaining insurance if/when they get really sick because of guaranteed issue requirements. Bottom-line: Only those who are sick will purchase insurance, driving up insurance prices for everyone.” (source Laura Carabello, publisher of Medical Travel Today)

Pain forces change…

For The Working Young
According to Ramthun, one implication of Health Care Reform is that there are 3:1 limits on rating for age. Rates for young people could increase 70%. Ouch! Now that get’s your attention right in the pocketbook. How many will rebel and choose to “opt-out” and pay a fine?

For Baby Boomers
Due to rising out-of-pocket costs for beneficiaries of Medicare, and the additional cost of supplemental insurance to maintain acceptable coverage, more retirees may consider offshore care and even choose to live abroad. Boomers pride themselves on designing their own lifestyles – “not my father’s retirement”.

For Employers
Cleveland Clinic and Lowe’s have partnered on cardiac care. Lowe’s Companies Inc., second-largest home improvement retailer in U.S., struck a three-year agreement with the Cleveland Clinic. It’s the first time a multi-state national company has chosen one specialist hospital and made it available to employees.

The Cleveland Clinic has both domestic and overseas locations that will allow it to compete on costs. The incentive to employees: Reduced out-of-pocket costs to go to Cleveland for heart procedures.

One Georgia-based employer: “With the economy in the state it’s in, some businesses may consider paying the $2,000-per-employee penalty for not covering workers rather than paying higher benefit costs.” (source FierceHealthcare, April 1, 2010)

Compromised Access to Care
It’s human nature to fight to keep from losing what you’ve got – and many Americans will respond to the harsh reality of less quality care by casting their net wider – both domestically and globally to maintain their individual quality of life.

The process of “comparative effectiveness” could lead to rationing,” said Ramthun, who referenced a quote from Dr. Donald Berwick in his June 2009 interview for Biotechnology Healthcare. “The decision is not whether or not we will ration care; the decision is whether we will ration with our eyes open.”

Delays in New Technology Approval
We already experience that delay in stem cell and in vitro fertilization (IVF) procedures, and the example used by Ramthun was hip re-surfacing vs. hip replacement. Our concern for loved ones will drive interest in alternative treatments abroad.

Fewer Variation of Benefits
“Some insurance companies may leave the market,” said Ramthun, “either because of age rating limitations, the restrictions on the amount of revenue to be spent on claims, or less opportunity for product differentiation. The downside is that variations in covered benefits will decrease.”

Longer Wait Times
Waiting is not something Americans do well. And when the annoyance of “waiting” is coupled with lifestyle-busting costs, more people will proactively shop for value. Insurance carriers and self-insured companies are already shopping abroad ahead of that trend.

As an individual, just how long are you willing to “wait” to make a bad situation go away? And does it make sense to blindly settle for a limited menu of treatment choices without knowledge of all available options affecting your best health outcome?

Why will there be longer wait times? A shortage of doctors and others opting to retire early – and reduced Medicare and Medicaid payments are exacerbating limited access to care.

The wait can be as long as two months. Boston has the longest wait, averaging 49.6 days (source ABC News, June 2009).

Patients in northern Massachusetts travel to New Hampshire because of the wait times (source ABC News, March 2010)

There are strong indications that reductions in Medicare payments will exacerbate doctor shortages and hence result in longer wait times as reported in the article “Medicare and the Mayo Clinic – The famous hospital will no longer take some senior patients”, published January 8, 2010 in The Wall Street Journal.

Shortage of Doctors
The shrinking number of physicians may force patients to travel or move to other areas for quality medical care. Ramthun quoted the following stat reported by many sources including the April 12, 2010 article in the Wall Street Journal “Medical Schools Can’t Keep up”:

“At current graduation and training rates, the U.S. could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges (AAMC). That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.”

According to an article “How Health Care Reform Will Affect Family Physicians”, published April 13, 2010 by The American Academy of Family Physicians (AAFP), the AAFP projects a shortfall of 40,000 primary care physicians. “currently, the United States has a deficit of roughly 40,000 primary care physicians, according to AAFP estimates. As the newly insured enter the system over the next few years, the primary care shortage is expected to worsen.”

“A survey by The New England Journal of Medicine suggests 46% of doctors may retire early,” said Ramthun, “and lack of tort reform may push others out early.”

Physician-owned Hospitals are in Peril. “The legislation virtually destroys over 60 hospitals that are currently under development, and leaves little room for the future growth of the industry.” (source Molly Sandvig, Executive Director of Physician Hospitals of America (PHA)

Disenfranchised physicians in the US may opt to open their own facilities in other countries. “Since the health care reform bill passed, you wouldn’t believe the number of doctors who have said they’ve had it and want to operate outside the system” (Dr. Brian Forrest of Access Healthcare).

Declining Value of Medicare
Not having access to Medicare was once considered the major barrier to retiring abroad. With access and benefits decreasing, a growing number of Boomers are tallying up the overall cost of living and opting to forego Medicare benefits in lieu of equally affordable and often better medical and wellness options available to U.S. seniors in other countries.

The time restrictions on appointments limit the perceived quality of a doctor visit, and the revolving door policy of only one issue to be discussed per doctor visit dramatically reduces the quality of the patient experience. It’s a burden for both the doctor and the patient to be in such a rat race.

According to Forrest, at one job interview, he was told he would be required to sign a contract saying he’d see a patient every seven minutes or have his pay cut. Most new physicians sign those contracts. Forrest, 38, wouldn’t (source May 24, 2010 Cash for Doctors article posted in The

As reported in the article “Medicare and the Mayo Clinic – The famous hospital will no longer take some senior patients”, published January 8, 2010 in The Wall Street Journal. The same article also suggests that 20% of hospitals may have to stop accepting Medicare because of payment reductions.

Drug Stores Drop Out of Medicaid
It’s not a good sign when national drug store chains start to drop out of Medicaid as indicated by May 16, 2010 article entitled “Walgreens: No new Washington Medicaid patients” published by The Spokesman Review.

According to Ramthun, “Medicaid expansions could make things worse as millions of new enrollees join the program.”

The Bottom Line
More people may be willing to travel or move to other areas, both domestically and abroad, for cost and quality healthcare considerations. And the increased interest in offshore care by self-insured companies and insurance carriers, is validating that trend.

I witnessed an impressive number of U.S.-based third-party representatives (TPR’s) exploring the option of medical tourism at The First Latin American Global Medicine and Wellness Congress.

Exhibit booths were visited by U.S.-based Human Resources (HR) representatives, banking organizations, insurance carriers and re-insurers, insurance underwriters and leaders of large self-insured groups like teachers unions, etc. One TPR could influence hundreds if not thousands of people to travel offshore for medical care.

The time is right for medical tourism to become a megatrend.

A Small Guide to Travel Insurance

Types of travel insurance

It is hard to foresee when health is affected, but the risk is higher when we travel abroad visiting countries in different climates, with different diseases, and – even more importantly – different healthcare systems. That is why, when planning holidays abroad, you should also remember about medical travel insurance that covers all the expenses you may encounter when having troubles with your health. The travel insurance can provide coverage for medical expenses such as: the services of a physician, charges for drugs and medical supplies, emergency transportation and your stay in the hospital as well as costs of treatments, exams and tests. A good travel insurance policy will also provide trip cancelation coverage. It is a reimbursement for lost travel expenses if you have to cancel your trip (for example if you or your family member gets ill). You can also insure your luggage in case it is lost, damage or delayed. If you want to take some sports equipment, you should indicate it in advance as it will probably cost extra to insure. There is also an option to include missed connection in your policy to avoid additional expenses if you miss your flight.

Things to remember

If you are an adventurous traveler you may need to ask for a special policy. For example if you enjoy extreme skiing or snowboarding or you plan to scuba dive, you should make sure it is all covered. You may also need to pay additionally if you want treatment of pre-existing medical conditions to be included in your policy as well. When travelling abroad, especially to a country with different language, you should always have the number of 24/7 emergency assistance hotlines of your insurer. The operator will take care of arranging medical care or transportation, and handle the payment procedures. Last but not least, when arranging a trip for a group of people, you should ask for group travel insurance to get a discount.

Important Things to Consider Before Medical Travel or Medical Tourism

Now days, individuals or even corporate have taken radical steps to save with the high cost of medical care in some countries such as the United States by considering medical tourism, oversee surgeries and medical travel. Many have visited to other destinations or countries to get health care healing at a lower price. This is known as medical travel, health care tourism or medical tourism. In other type of cases individuals in developing or poorer countries travels to a richer country to get medical treatment that is not accessible in their own country. An another motive for medical travel is to go from a country with long waits for some treatments as happens sometimes with national medical care to one with less waiting. Following are few reasons one should consider before setting up medical travel and health tourism.

Firstly, people of expensive medical cost countries, like United States and United Kingdom in specific, can save a lot of medical bills with oversee treatment. Surgeries in India, Cost Rica and Mexico are many times cheaper than in the USA, and the same is valid of many other countries. The expensive can be quite noteworthy, especially for treatment that are not covered by medical insurance, or for individuals who are not insured.

Secondly it is becoming frequent for medical insurance companies, agents or employers who want to cut medical expensive to encourage their consumers or employees to practice medical tourism. In this way they can save a lot of funds this way. They may pay partial refunds, or at least cover transportation and housing.

Thirdly, if someone is worried about the standards of medical care oversees; there is good amount assistance and information available. Many international associations and agencies, including the medical tourism associations study medical care facilities, infrastructure and hospitals around the world. They have grant accreditation to many international centers. The standards of medical treatment are a very complicated issue and may differ a lot within a country or states. Accreditation given to international medical centers at least provides some comfort in knowing there is a lower bound on the worth of an accredited facility.

Fourthly, be cautions that it may be hard or not possible to get reparation for misconduct in some medical centers in different countries. Occasionally misconduct claims are not permissible or very incomplete. In some cases, a negligence suit may be likely, but it may be very tricky to collect if you even win. Negligence should be exceptional, but it is fine to understand that the covers one has at home might not exist abroad.

Lastly, medical tourism and medical travel has some risks of its own. You might come across some diseases that are seldom if ever present at home. Communicable disease during recovery from operation or other treatments is a risky fixation. But the good thing is that medical care staff in the area you are visiting are certainly familiar with the diseases you could catch while there.

There are even risks from the general traveling. The idiom economy class condition refers to the danger of developing blood clots in the lower body due to being seated and unmoving during a long plane flight. Traveling while recovering from surgery raises the risk of this. This is also the one of the factor to consider when thinking about health travel.

Medical tourism and health tourism may be best alternative for many people, for non-emergency treatments of course. It is regularly used for hip, joint and knee replacement or dental surgery. Cosmetic treatment is another possibility. There are medical tourism consultants and facilitators who could provide guidance at every level. They can guide you about the options available in popular medical tourism destinations. These medical tourism consultants act much like a travel agency and set almost the whole things up for you.