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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.



"Medical tourism" refers to traveling from one place to another to obtain medical care - commonly from one country to another, but also from state to state.

The most common reasons for medical tourism are:

  • To obtain less expensive medical care, primarily for people who are uninsured or who have a high deductible and for a treatment that happens just once and has a recovery that is quick. Savings from treatments abroad can be so significant compared to similar treatments offered in the United States that treatment requiring multiple trips may also be worthwile to consider.
    • People with high deductible health insurance can save money, and can also use tax-free dollars from a health savings account to pay for care and some of the travel so long as the procedure meets IRS criteria for qualified medical expense.
  • To travel to another country which offers treatments or procedures that are either illegal or unavailable in the United States.
  • A preference for care from providers from a similar culture. 

Historically, medical tourism has been about leaving the United States. These days, it is also possible to travel within the United States for lower cost medical care. For example, AARP reported a story of a man who found a hospital in Kansas that did a triple bypass surgery for $13,200 instead of the $80,000 it would have cost in his home area.

When considering traveling for medical care, expect to have your doctor at home make a diganosis and evaluate your fitness for travel. Then look for a doctor or other health care provider who:

  • Is well-trained,
  • Experienced with your situation,
  • Works in or with a high quality facility which has back-up in case a problem occurs and other medical disciplines need to be involved. 

Experts say that medical tourism works best if the need is for a procedure that involves low risk, and that has a quick recovery with little follow-up care.

If you are interested in Medical Tourism, consider the following steps, each of which are described in other sections of this article:

Step 1. Define your need.

Step 2. Research the alternatives (including other states in the U.S. which may be substantially less expensive than where you live).

Step 3. Check references when you narrow your search.

Step 4. Interview the doctor.

Step 5. Contact your local doctor and/or hospital.

Step 6. Budget your treatment and trip. Compare to costs at home.

Step 7. Get the agreement in writing.

Step 8. Consider purchasing travel insurance. (For information, see Travel Insurance Post Diagnosis

Step 9. Before you travel, learn how to travel safely.

Before you come home, get a copy of your complete medical record.

For a list of companies that connect patients to medical services, click here.


  • Keep in mind that your support team will likely not be with you when at the site. 
  • If there is a problem, medical malpractice laws in the U.S. rarely apply to foreign defendants. Even if they do, the amount of damages awarded can be low - if you can find an attorney to represent you on a contingency basis. Insurance companies are beginning to offer policies to protect against this problem. For example,    AOS Insurance Company Ltd. (based in Barbados)
  • Keep receipts for ALL expenses. All expenses for the trip, starting from the moment you leave home until you return, may be considered part of medical expense for tax purposes. Of course, if you take a side vacation while you're gone, that part of the trip is not a medical expense. To find out what expenses the IRS permits, see offsite link
  • Consider offsite link
    • The organization publishes a comprehensive guide called Patients Beyond Borders by Josef Woodman. It includes information about the best hospitals and clinics. The company also publishes country-specific and hospital specific guides.
    • PatientsBeyondBorders offers one-on-one advice in free 15 minute consultations. It also provides more in depth individualized information for a fee.

To Learn More

Advantages of Medical Tourism

  • Price.
  • A possible chance to tour a foreign venue.
  • Some providers offer more personalized care (such as a higher physician-to-patient ratio) than is commonly available in the United States or Canada.
  • Some treatments are available outside the U.S. that are not yet approved by the U.S. Food and Drug Administration.
  • All expenses for the medical trip are medical expenses for tax purposes including transportation expenses, (air, train, boat or car), lodging and in-treatment meals, recovery hotels, surgical retreats and recuperation resorts, and, of course, the cost of treatment. For more about medical expenses and taxes, click here

Risks Of Medical Tourism

  • It is difficult to learn information:
    • About a doctor's qualifications and background.
    • About a facility and the breadth and depth of the other doctors and staff. It's the nursing staff that will take care of you on a day-to-day basis.
  • Although many doctors have been trained in the U.S. and speak English, many hospitals rely on interpreters which increases a risk of misunderstanding.
  • You will be far away from your support systems.
  • Unless you're willing to stay in the country for a sufficient period of time, follow-up care may have to be at home (by a doctor other than the one who did the procedure).
  • You will be on your own if there are later complications.
  • Touring may be limited because of your condition or as a result of the procedure for which you're traveling.
  • If you are damaged by the doctor, hospital or treatment, seeking reimbursement for your loss can be difficult, if not impossible. According to reports, it may also be difficult to find an experienced U.S. doctor who is willing to treat you.

Step 1. Define Your Need

First, be an informed consumer when deciding whether you need a medical procedure. Understand the nature of your condition, the treatment under discussion including advantages and risks.

Once you've decided to proceed:

Let your specialist or at least your primary care doctor know that you are considering obtaining the procedure outside the country. Get his or her opinion on the idea. The doctor may have an opinion about what part of the world would be best for your needs, as well as suggestions about health care providers and/or facilities. In any event:

  • Get a written description from your doctor of the medical terms for your diagnosis as well as the procedure you're seeking.
  • Ask your doctor if he or she is willing to forward the necessary medical information, as well as be available to communicate with the foreign doctor about you, your health condition and the proposed procedure.

Think about your priorities. For example, use our Prioritizer to list all the factors that could be relevant in your choice, and then number them according to your priority.

  • Price
  • Financing arrangements
  • Training of the doctor and other health care providers
  • Experience of the health care provider with your situation
  • Number of travel hours
  • Travel directly instead of with changes
  • Doctor and facility have malpractice liability insurance
  • Destinations you prefer
  • Destinations you should avoid
  • Consider how you want to go about doing the research and making arrangements. For example, do you want:
    • A company to recommend health care providers and destinations or do you feel that you are capable of doing the research on your own?
    • A company to make the medical arrangements for you or do you want to deal directly with the health care provider and facility?
    • A company to make travel arrangements?
    • A company to take care of you while abroad --from pick up at the airport to caring for your personal needs while abroad, to return to the airport?
    • To go alone, or is there a close friend or family member to accompany you? A companion can provide emotional support as well as act as your patient advocate. A companion may be able to stay with you in a hospital at no additional charge. Some providers include escorts for people who travel alone.

Consider whether you will be able to stay away longer than anticipated if there is a complication. Also check with your insurance company to find out whether you will be covered when you return home if there are complications, as well as for general follow-up care.

Step 2. Research The Alternatives

To learn about the available alternatives:

  • In order to have a base line for comparison, it is advisable to first learn the cost of doing what you need locally. In addition to calling experienced, qualified medical providers, consider checking such sites as offsite link.
  • Contact several travel agencies to get your initial questions answered including costs of travel to and from, cost of staying in the location, and the cost of the procedure or treatment. This will help you start to hone in whether it is worthwhile to travel for the procedure you need and, if so, to which part of the world. Look for agencies that have actually vetted health care providers and facilities abroad. A list of internet companies that connect patients to medical care outside the United States is below.
  • Search the internet using the name of the treatment/procedure in which you are interested and the names of various countries you would consider to find out what you can learn independently.

Look for facilities that are tied to a "brand-name" U.S. hospital. Leading U.S. health systems such as the Cleveland AClinic Johns Hopkins and the University of Pennsylvania have relationships with foreigh hospitals that have some of the same safety standards as the hospitals in the U.S. 

If there is no such facility, check to see whether the facility is accredited by a recognized accrediting organization. For example:

  • International organizations
    • The Joint Commission International (JCI offsite link) - the international affiliate of the Joint Commission on Accreditation of Healthcare Organizations. JCI accredits hospitals abroad. Accreditation is an ongoing process. After initial accreditation, facilities have standards to meet on an ongoing basis. To find an accredited hospital, go to the JCI website and click on "For Patients." Tel.: 630.792.5000. 
    • The British Standards Institute at offsite link
  • Local organizations: Check to see if there is an accrediting medical association in the destination country with respect to doctors and other health care providers just like there are in the United States.

Use the standards for choosing a health care provider and facility you would use if choosing such a provider or facility in the U.S. For example to help decide about a:

  • Health Care Provider
    • Primary care doctor, click here.
    • Specialist, click here
    • Oncologist, click here
    • Surgeon, click here
    • You can check to assess the doctor's fluency in English by requesting a conversation through a free video service such as Skype or over the telephone.
    • If you are considering a cosmetic procedure, look for a surgeon who is certified by the International Society of Aesthetic Plastic Surgery
    • If you are considering dental work, see the Organization for Safety, Asepsis and Prevention.  Go to offsite link. Click on "knowledge center" then "travel"
  • Facility
    • Hospital, click here
    • Cancer facility, click here.

Keep in mind that it is also advisable to check:

  • The other parts of the medical team, such as the anesthesiologist.
  • Other doctors who may be called in if there are complications.
  • The nursing staff.
  • Your rights. For example, that you have the right to receive full information about your condition and treatment, that you can refuse any and all treatment at any time, that you will be transferred to another facility if you request it. (For a list of rights, see: Your Rights In A Hospital.
  • The facility's position with respect to your end-of-life wishes if the unexpected happens. (To learn more, see Living Wills and Advance Directives.)
  • For complaints or negative news reports that represent red flags.
  • Whatever else is important to you -- such as special dietary needs.

Once you have honed in on one or a few health care providers and/or facilities,  consider asking:

  • How long can you anticipate being in the medical facility?
  • Is there an English speaking patient representative?
  • Is there an international patient coordinator on staff? (A coordinator will help make the necessary medical arrangements, as well as post-procedural recuperation and local travel arrangements.)
  • What is the food like?
  • How accessible is the facility to your friends?
  • What happens after you are discharged? Do you have to go to another facility for less extensive medical care? For example, will you have to move to a physical therapy facility? If so, what kind and for how long? (Do the same research about the secondary facility you do about the primary facility).
  • Does the facility make arrangements for a place in which you can recover?
  • What it will be like being in the country after the procedure -- for instance, costs of getting around. Is it safe to get around on your own?

Find out about follow-up care.

  • What follow-up care is usual?
  • Is standard follow-up care included in the price? (If not, how much is it?)
  • What follow-up care could be needed?
  • How is it provided?
  • Does the health care provider or the facility make a commitment to do follow-up care?
  • How long is it prudent for you to stay there in case of need?
  • What if you don't need follow-up care until you're back home?

Ask about costs. Consider:

  • The cost of the treatment/procedure.
  • The hospital stay or stay in another health care facility.
  • Travel costs (including the costs of getting from the airport to the facility, as well as passport and travel visa fees)
  • Cost of living at the destination before flying home. 
  • Cost of communicating with loved ones at home. Calls from abroad can be a lot more expensive than calls from the U.S.
  • How much will you have to pay up-front?
  • Will you have to pay for the procedure before you leave the facility?
  • Is there any financing available?

What happens if there is a problem?

  • Does the contract with the facility limit damages? If so, how and to what limit?
  • Do the local laws permit malpractice damages?
  •  Does the doctor or other health care provider and/or the facility have malpractice insurance? If so, what is covered? What are the exceptions to coverage? What is the limit? 
  • Has the provider made arrangements to be allowed to be sued in U.S. courts?
  • If the procedure is to occur in a clinic, how far is the clinic from an accredited hospital in case of emergency?

After you have picked a provider and facility, consider contacting the American Embassy or consulate in the local area. You may be able to get a person there to tell you unofficially what he or she knows personally about the provider and/or facility.

Finally, ask your doctor what you need to do to safely travel to and from the destination. For example, will you need shots? Can you tolerate the shots?

To Learn More

Step 3. Check References When You Narrow Your Search To One Or More Potential Health Care Providers

Ask the doctor or other health care provider and facility you are considering using for references (and contact information). It is particularly useful to ask for references frompeople who were treated for the same procedure you are considering. Ideally, the references also had similar medical and other needs and preferences to yours.

If you are using a Medical Tourism Agency, also ask the agency for references about the health care provider, and, in particular, the treatment or procedure you are considering..

Once you have the references, it is advisable to call the people and speak with them directly. Have a list of questions handy before you call. Among other questions, consider asking a catch-all question such as “Is there anything you would tell your best friend about the doctor or facility that we haven’t discussed?”

Step 4. Before You Make A Final Decision, Interview The Doctor

If the doctor speaks English, perhaps you can call from home before making a final decision. If the doctor doesn't speak English, speaking with his or her interpreter will give you a taste of what it will be like to communicate with the doctor abroad.

If calling is expensive from your telephone, perhaps you have a friend who can let you use his or her computer to call for free or little money.

If you can't arrange a phone call, consider e-mail.

Have your medical records available when you call in case you're asked medical questions for which you don't have a ready answer.

Among questions to consider:

  • What medical records will the doctor want to see? Can you send them ahead of time in case there is something in them that would prevent or alter the procedure?
  • What tests will the doctor want? If you've already undergone some of the tests, will those results be acceptable or will the tests have to be repeated? If the tests are acceptable, what does he or she need you to bring?
  • Can initial medical work be done at home before leaving?

Let the doctor know you will need a written copy of a full medical report. (You may have to sign a document permitting release of your medical records.)

Step 5.Once You Know All The Facts, Contact Your Local Doctor And/Or Hospital.

Perhaps you can use the foreign dollar amounts as leverage to bargain for a lower price here in the U.S. – or the doctor or hospital will help you find free or low cost care.

The doctor may also have strong reasons why care abroad is not a good idea for you.

Step 6. Budget Your Treatment And Trip. Compare To Costs At Home.

Your travel budget depends in large part on the way you travel and your lifestyle.

When budgeting as part of a decision making process:

  • You do not need to know the exact dollar each item costs. Estimate in ballpark terms. You can refine the numbers if the costs seem comparable, or when you start to make reservations.
  • Many people do not want to be alone while traveling for treatment and take a companion. If you will pay for the cost of a companion, include the costs in your budget.

Items to consider are:


  • Legal documents
    • Passport
    • Visa
  • Costs at home
    • Baby/pet/house sitter
  • Travel 
    • Air/Boat/Train
  • Treatment
    • Cost of the treatment
    • Cost of other doctors who are likely to consult, if any
    • Ancillary costs such as drugs
    • Hospital room and the like
    • Lab charges
    • Tips for the staff
    • Other charges
  • Post Treatment
    • Lodging while recuperating
    • Physical/occupational therapy
    • Medications
    • Local Transportation
  • Vacation (if you will take additional time to tour)
    • Travel (air/boat/train/car/taxis)
    • Sleeping accommodations
    • Food
    • Touring costs
    • Entertainment
    • Other


  • Cost of treatment - uninsured portion only 
  • Recovery costs
    • Home health aide/nursing care
    • Food
    • Uninsured physical/occupational therapists
    • Medications

Step 7. Get The Agreement In Writing

Once everything is in place, ask the provider or agent to put the agreement in writing. The agreement should describe the services to be provided to you as well as the agreed price. The agreement should include everything that has been agreed upon. Preferably, ask a lawyer and your doctor to read over the contract for you.

Pay particular attention to:

  • What happens if you get sick and can't go?
  • What happens if you change your mind about undergoing the procedure after arriving?
  • What happens if you want the procedure, but the medical team at the destination determines that you can't have the procedure because of your then medical condition?
  • What happens with follow-up care?
  • What happens if something goes wrong?

To Learn More

More Information

How To Choose A Lawyer

Step 8. Consider Travel Insurance

It would be ironic if you have to cancel a trip for medical care because something happens before you go, but it could happen. Rather than lose all the money you spent booking the trip, consider travel insurance.

You can purchase travel insurance in spite of your health condition. A travel agent is a good source of information. One company of which we are aware that sells travel insurance despite a pre-existing health condition is AIG Travel Guard, offsite link.

For more information, see: Travel Insurance Post Diagnosis

To Learn More

Step 9. Before You Travel, Learn How To Travel Safely With A Health Condition

Traveling with a health condition takes preparation. It also may require you to upgrade your ticket to a higher class.

To learn about travel with a health condition click here.

NOTE: Get your doctor's e-mail information if you don't already have it so you can stay in touch and/or ask questions from your destination if necessary.

Before You Come Home, Get A Copy Of Your Complete Medical Record.

Get copies of film such x-rays or MRIs as well as a copy of the written medical record.

Be sure to get the doctor's and facility's contact information in case you need additional records after you get home.

Give a copy to your primary care doctor and specialist if you still have one.

Companies That Connect Patients To Medical Services

Following is a list of companies that help arrange medical care for people in different parts of the U.S. and throughout the world. We have not had personal experience with any of these companies. If you do, please share your experience by email to Survivorship A to Z. Please keep in mind t hat this industry is not regulated and anyone can enter t he business.Look at how long the company has been in business and ask for personal references. Call the references. Also check to see whether the company is affiliated with any health insurance companies or major employers. 



  • Companion Global Healthcare offsite link Tel.: 800-906-7065, Columbia S.C. includes all procedures outside the U.S. - a subsidiary of Blue Cross Blue Shield of South Carolina. The CEO, David Boucher, is quoted in Kiplinger's Personal Finance magazine as follows:  "We physically visit every hospital in our network. Our onsite survey takes five to nine hours, and sometimes a couple of days for large hospitals."  Companion does not accept referral fees from hospitals. Patients pay a case-management fee, in addition to the cost of travel and medical care.
  • Companies that arrange care in India:
  • offsite link - Medical care in Europe, contact the USA office at Tel.: 512.784.5824
  • offsite link, Medical care inside and outside the U.S. Located in Boston, MA.  Tel.: 888.691.4584 or 617.418.3436
  • offsite link - Plastic surgery in Margarita Island, Venezuela
  • offsite link -- The website doesn't list a contact phone number or address. To contact the agency, you have to complete a form which asks for your name, address etc. as well as the procedure you want and countries you'd be interested in.
  • offsite link, Tel.: 888.499.8658, 415.659.8282, San Francisco, CA
  • offsite link Arranges provision of medical care in a variety of locations outside the U.S. Tel.: 877.876.3373. Located in Vernon Hills, IL
  • offsite link, Tel.: 888.MED JRNY, 212.931.0557 Located in New York, NY
  • offsite link -- Arranges cancer treatments and other procedures overseas -- with people abroad to help you on arrival. Tel.: 800.243.0172 or 818.591.1668. According to Kiplinger's Personal Finance, Planet Hospital typically recommends three or four hospitals for your to choose from,. Although the company is paid by the hospitals in its network, staffers have no incentive to recommend one over another.  As of 2012, patients pay for concierge service that costs $100 per day for the first three days and $75 a day thereafter.
  • offsite link - Located in the United Kingdom, arranges medical procedures around the world.
  • offsite link -- Located in Concord, CA Tel.: 866.999.3848


NOTE: If an agency you're interested in is based in the United States, check it out with the local Better Business Bureau. Also type the name in several search engines to find out if there are comments about the agency from past customers.