US Insurance Companies Expanding Medical Tourism Coverage

A growing number of insurance providers are exploring medical tourism as part of coverage

Once considered a fringe option reserved for the most desperate patients, medical tourism is gaining mainstream acceptance, transforming into a billion-dollar industry attracting both patients and healthcare providers alike.

Some argue it could be the answer to Obamacare. Medical tourism is a growing industry, enticing millions of Americans to travel abroad in search of cheaper healthcare.

US companies, such as Anthem Blue Cross and Blue Shield and United Group Programs, are now exploring the idea of including medical tourism as a part of their coverage.

But as the industry grows in popularity, critics warn that the cheap price can come at a much greater cost. For example, some members of Blue Cross and Blue Shield who chose to access this international option will have a dedicated case manager, who will coordinate all medical arrangements, including scheduling and concierge travel service. All travel arrangements will be booked and paid for, for both the member and a travel companion. The case manager will also help make arrangements for any necessary post-operative care upon the member's return to the United States.
 
According to the Center for Disease Control and Prevention, up to 750,000 Americans travel abroad each year for healthcare. It’s a trend the world is looking to take advantage of. Earlier this month, the Medical Tourism Association held its 6th annual World Medical Tourism and Global Healthcare Congress at Caesars Palace in Las Vegas. The conference connected thousands of medical providers from nearly 200 countries, including Turkey, India, Costa Rica, and Nigeria.
 
The five-day conference culminated with a class to certify attendees as medical tourist specialists. Antonio Kanickaraj traveled all the way from India to become certified in hopes of attracting more Americans to his country. “It basically adds credential to my business. People look for more reliable source because they put their life into somebody else’s hands,” Kanickaraj told NBC Bay Area.

MEDICAL TOURISM AND INSURANCE PROVIDERS

Joe Harkins of the Medical Tourism Association said that this year’s conference was the largest to date, and with the passage of the Affordable Care Act, he anticipates that interest in the industry will only continue to grow.
 
“Obamacare is a big topic, there’s uncertainty in what’s next and people are turning to medical tourism,” Harkins said.  “The bottom line is to get care if it’s cheaper if its quality you can’t lose.”
 
It’s an argument that has U.S. companies sush as Anthem Blue Cross and Blue Shield and United Group Programs exploring the idea including medical tourism as a part of their coverage.
 
“Health care has really gone global; there’s no reason that it needs to stay in your back yard,” Harkins said.

In recent years, medical tourism facilitators like 360 Global Health in Los Angeles have helped fuel the industry by connecting patients with doctors around the world.
 
“This will actually end up helping everyone in the United States who goes to an American hospital for surgery,” CEO Kelly Jenkins told NBC Bay Area. “It will force American hospitals to look at their inefficiencies and hopefully lower costs, so it will be more affordable all the way around.”
 
Jenkins is such a believer in the industry, she allowed NBC Bay Area cameras to travel with her from California, leaving arguably some of the best medical providers in the world, to Puerto Vallarta, Mexico for a procedure to repair a meniscus tear in her knee.

“It sounds nuts” Jenkins said. “I really did want to experience what our patients’ experience.”
 
Jenkins estimates the procedure to repair her knee would have cost $12,000 to $14,000 in the United States. In Mexico, the procedure will only cost $5,000, nearly a third of the price in the United States.
 
Jenkin’s doctor, Orthopedic Surgeon Dr. Max Grieg, allowed NBC Bay Area cameras inside the operating room for the procedure that will cost her $5,000.
 
Dr. Grieg said roughly 70 percent of his business comes from medical tourists traveling from the United States and Canada. The Investigative Unit tracked down another California woman in the operating room right next door. She was there for cosmetic surgery, including a tummy tuck, arm lift reduction, and breast implants.
 
NBC Bay Area asked how Grieg was able to keep his costs so low.
 
“If you compare what I have to pay every year for malpractice insurance here in Mexico compared to my colleagues in the U.S., I’m paying a tenth of what they may pay,” Grieg said.
 
COST OF CARE
 
The low costs abroad has more and more patients comparison shopping for medical procedures:


 
RISKS OF MEDICAL TOURISM
 
But as with domestic health care, medical tourism doesn’t come without risks. It’s a fact that plastic surgeon Dr. Barbara Persons is all too familiar with.
 
“I see a patient about every two weeks that has some issue,” Persons told NBC Bay Area.
    
At her practice in Lafayette, Persons regularly performs corrective surgery on patients returning home from a medical tourism trip gone south. Persons said while many of these patients may have been looking to save, but they end up paying in the long run.
 
“I think most medical professionals are a bit horrified,” Persons said
 
NBC Bay Area spoke with one patient Person’s treated after she traveled to Mexico and had silicone injected into her lips.
 
“My whole bottom lip was like a ruffle,” the patient told NBC Bay Area. “It was the wrong product.”
 
The procedure required multiple surgeries to fix. The experience was so distressing; she asked to be disguised for this story.
 
While the cost of American health care is more expensive, Persons argues that much of the added cost is designed to protect patients if something goes wrong and that doctors in the U.S. undergo more scrutiny and more oversight. 
 
“If they don’t pay anything for malpractice insurance and likely their overhead is much less because there aren’t all of the certifications we have. I would take that as a warning sign,” Persons said.

Still, supporters of medical tourism like Kelly Jenkins argue that if you do your homework and make sure you are in trusted hands, the price tag for global medicine is worth the risk.
 
“There is absolutely no doubt, I will probably never have surgery in an American hospital again,” Jenkins said raving of her experience in Puerto Vallarta.
 
Jenkins’ surgery was successful and she is now back home recovering.
 
For those considering medical tourism, the Centers for Disease Control and Prevention warns that the added complication of travel opens patients up to other dangers including blood clots, infections, and crime if traveling to a country with a travel warning.
 
For a list of medical tourism resources, click here.

If you have a tip for Elyce Kirchner or any the Investigative Unit, send us an email.

Contact Us