Medical Tourism aka Healthcare Geoarbitrage... Who's got a story to tell?

[J Boogie]

Looking at a $3,500 tooth implant for the wife that the internet tells me can be done for around $1000 in Costa Rica.  My dental coverage doesn't include implants so it's all coming from the HSA.  I hear you can purchase the flight with the HSA - I'm guessing I couldn't purchase my ticket with the HSA though.

I figure we'll spend about the same and get a sweet vacation, we've never gone on a true vacation/honeymoon together as our honeymoon was just a road trip.  Given the intensity of the procedure and subsequent recovery period, we should probably make sure we get most of our fun time in prior to surgery.

Anyone got any stories, good or bad? 

[Dicey]

Nothing to add, just want to follow.

[Peony]

Several years ago, before medical tourism was a well-known thing, my ex went from NY State to Belgium for a double (both hips) hip-resurfacing operation. He went there because at that time that procedure was only considered experimental in the U.S. and few doctors here were doing it, while in Europe it was the standard of care for his particular problem.

Even at $30,000, including airfare & hotel, it also was a *lot* cheaper than surgery would have been in the U.S., since he had no health insurance. At the time, he estimated the cost to do the closest procedure in the U.S. (two hip replacements, which he didn't want) would have been about triple what he paid. The double-hip operation required a full week of recovery in the hospital, followed by a week of physical therapy in a hotel. As a follow-up he had X-rays taken in the U.S. and sent to the Belgian doctor. All went well. Two friends actually opted to travel with him to help him out and enjoy a "vacation."

[Jeremy]

When we were ready to have a baby, we did IVF in Taiwan vs the US, as prices were about 80% off with 100% of the results

I've had general dentistry done in 4 different countries now.  The equipment and language varies, but it gets the job done

Any future health problems, we'll choose where we get care based on price, convenience, and quality

[dcheesi]

A coworker had his knee worked on in Thailand. They have hospitals that cater to medical-tourists, that are supposedly just as good as what you'd find in the US. Of course this guy had already spent a lot of time in Thailand, so that made it an easier call for him personally.

[Kris]

Following.

[Dicey]

When we were ready to have a baby, we did IVF in Taiwan vs the US, as prices were about 80% off with 100% of the results

I've had general dentistry done in 4 different countries now.  The equipment and language varies, but it gets the job done

Any future health problems, we'll choose where we get care based on price, convenience, and quality

Oh c'mon Jeremy, if you won't plug your site, I'll happily do it for you. Just click on that tiny little link below. It's a great story and good reading for anyone, but most especially for Mustachians with fertility issues. Go, Curry Cracker(s)!

[kendallf]

I've been thinking about traveling somewhere to have LASIK done, but the risk of post-operative complications and having to return for a 'touch up' makes me iffy.  I think I'm going to be back in Malaysia later this year and they had signs in the airport advertising medical tourism..

[Paul der Krake]

My story is small potatoes in terms of amounts, because I'm still a young invincible with ridiculously good teeth.

I go to France every two years or so. While there, I visit a dentist, a dermatologist, and an optometrist. I have yet to pay more than $200 for all 3 specialists combined.

Yes, they are all highly trained professionals who live in a first-world city with very similar cost of living to where I live stateside.
No, I am not mooching off their health system, it's all out of pocket. No government scheme is involved in the transaction, nor is my US insurer.
Yes, US prices are highway robbery.

I don't subject myself to the grueling 8 hour flight and back solely for this arrangement, but knowing that I avoid a shit show of misaligned incentives and opaque pricing, makes sitting in a cramped flying suppository a much easier sell.

[Jeremy]

When we were ready to have a baby, we did IVF in Taiwan vs the US, as prices were about 80% off with 100% of the results

I've had general dentistry done in 4 different countries now.  The equipment and language varies, but it gets the job done

Any future health problems, we'll choose where we get care based on price, convenience, and quality

Oh c'mon Jeremy, if you won't plug your site, I'll happily do it for you. Just click on that tiny little link below. It's a great story and good reading for anyone, but most especially for Mustachians with fertility issues. Go, Curry Cracker(s)!

Haha, sorry Diane :)  Here is a breakdown of our IVF costs
http://www.gocurrycracker.com/making-a-baby/

And here is a photo of the results

[Jeremy]

No, I am not mooching off their health system, it's all out of pocket. No government scheme is involved in the transaction, nor is my US insurer.
Yes, US prices are highway robbery.

This is the best part of Medical Tourism / everything that is wrong with the US system

You get transparent pricing in advance, pay a fair price for a service, and pay cash as you leave. 

[NearlyThere]

Thats the best return on investment Ive seen on these forums ever...

Congrats

[shadowmoss]

I had a bunch of dentistry work done in Honduras while I was living down there.  I actually liked the process a lot more than any dentist I've ever had in the US.  I am now going to Mexico for my dentistry work, and will have an implant done some time later this year.  The dentist I want to use has studied in the US and may not be the cheapest in Algodones, MX (I haven't had my first consultation with her yet) but I feel good about her qualifications.  Algodones is 4 hours from me in Phoenix.

[Peony]

I just remembered that a guy I am acquainted with told me he had knee surgery in Montreal, where he has close friends, because he couldn't afford it in NY State.

[arebelspy]

Following.

We're planning on our our medical being overseas from now on (baby, LASIK, etc.).  Very much looking forward to low-cost, high quality heath care.

[Jack]

I go to France every two years or so. While there, I visit a dentist, a dermatologist, and an optometrist. I have yet to pay more than $200 for all 3 specialists combined.

I've paid out-of-pocket to see dentists and optometrists right here in Atlanta. The amount they charged was a comfortable enough margin under $200 that I suspect I could see a dermatologist too if needed without going over it.

(For example: this company has occasional coupons for $29 eye exams, and the local dentist in my neighborhood charged me somewhere between $50 and $80 for my last cleaning -- I don't remember exactly because my wife did the shopping around.)

I actually decline dental and vision coverage at work because paying out-of-pocket is cheaper than the premiums, and the coverage limits are so low that self-insuring is trivial. In fact, I think at my new job the vision plan isn't even called "insurance" -- it's labeled as a "discount plan" instead. (I actually do have it since it comes "free" with health insurance, but I probably won't use it because I suspect that Zenni Optical or Coastal would be able to beat even the "discounted" plan prices!)

[Paul der Krake]

Jack, I also decline dental and vision at work because it's a example of selection bias at its best. I'm very curious how you've managed to find a reasonable dentist, and more importantly I wonder if they would remain reasonable for more extensive procedure. My wife was quoted thousands of dollars for a procedure that I know for a fact would not top $500 at my French dentist. I looked at going to a dentist here once but it looked like they all wanted me to pay a few hundred dollars to have my teeth x-rayed at the first visit if I wanted to become a customer. Apparently this is standard practice here.

I would love to hear your thoughts on Coastal and retail vision outfits (I was in a rush and spent $200 at target a few months back, smh), but we should probably start another thread.

[2527]

We go to Turkey every summer because that is where my wife is from.  One of her cousins is a dentist and we get our dental work taken care of there. 

[missundecided]

This is probably a duh question, but how do you find a good/reputable provider abroad, especially when you don't know anyone in the area for reputable word of mouth?

[Jack]

Jack, I also decline dental and vision at work because it's a example of selection bias at its best.

The really dumb thing about dental is that it doesn't seem to actually be insurance. By that I mean, insurance should have you pay a maximum out-of-pocket cost and then cover everything above that amount. Dental "insurance" is the opposite: they cover up to $X and then stop paying. (And then, of course, it has pretty big copays even for the "up to $X" part.) It makes no sense.

I'm very curious how you've managed to find a reasonable dentist, and more importantly I wonder if they would remain reasonable for more extensive procedure. My wife was quoted thousands of dollars for a procedure that I know for a fact would not top $500 at my French dentist. I looked at going to a dentist here once but it looked like they all wanted me to pay a few hundred dollars to have my teeth x-rayed at the first visit if I wanted to become a customer. Apparently this is standard practice here.

My neighborhood has two dentists in it (plus another in the next neighborhood over, and of course bunches more all around the city). My wife went and asked both of them what their cash prices were, and we tried the cheaper one. (I also read about them on my neighborhood's web forum to make sure they didn't suck first, of course.) I'll have to ask my wife about it when she gets home. In fact, I think we're overdue for cleanings...

I would love to hear your thoughts on Coastal and retail vision outfits (I was in a rush and spent $200 at target a few months back, smh), but we should probably start another thread.

I've actually only used Zenni, not Coastal. Zenni isn't bad, although I made a mistake on the frame style and don't like them very much. My main advice would be to pay close attention to all the measurements -- a lot of their frames run on the smaller side.

Looking at their website today, they appear to be more expensive than they used to be (their big schtick used to be "$6.95 glasses!" but I don't see frames that cheap anymore, and of course high-index lenses and things like that cost more). Even so, it's worth the risk: you can take several tries to get it right before you've spent as much money as you would at a brick-and-mortar eyeglass store.

[iris lily]

Thats the best return on investment Ive seen on these forums ever...

Congrats

And he got a super cute one, too!

Iris, not much into babies

[Rural]

$6.95 glasses at Zenni Optical:


http://www.zennioptical.com/u6.95-glasses/


I love mine, by the way.

[FIRE Artist]

This is probably a duh question, but how do you find a good/reputable provider abroad, especially when you don't know anyone in the area for reputable word of mouth?

I used to work overseas, expat forums are a great source of info. 

[Jeremy]

This is probably a duh question, but how do you find a good/reputable provider abroad, especially when you don't know anyone in the area for reputable word of mouth?

When we were in Mexico looking for a dentist, we asked local people with nice teeth who their dentist was :)
We met an American/Mexican couple living in the area for 25 years, and they pointed us to their fav dentist


When I had dental care in Bangkok, I found somebody via an online forum after searching for "dentist Bangkok review" or something similar

[shadowmoss]

To find my dentist in Honduras I asked the locals who worked on post.  One woman showed me her teeth and said he had rebuilt them all (not sure why...) and they were all even and nice looking.  She called and made the appointment.  She also assured me that the dentist spoke English, which he did.

The RV bloggers give write-ups of their experiences with the services in Algodonez, MX.  I went to one clinic, and it was ok.  Another blogger talked about a different dentist who had very good US board certifications.  I went to her website and verified this.  I will try her clinic when I can get an appointment.  I'm thinking she will be a bit more expensive, but probably not what I would pay here in Phoenix.

[Gimesalot]

I travel to Argentina often, to visit family.  If I travel in the winter, I almost always get sick.  My healthcare there has been excellent.  I normally go to the doctor, get prescribed an antibiotic shot, buy it at the pharmacy, and go back to have a nurse give me a shot.  Total, it sets me back about $25 since I am paying out of pocket for it all.  It takes me about an hour or two, so a little longer in than in the States.  I have had similar treatment in the states using an HSA as insurance and the cost has been about $175.

In addition, we have several friends that used to buy all sorts of medications in Argentina and bring them back.  The medication is high quality, incredibly cheap, and you don't need a prescription for most meds.

[Stash Engineer]

We do as much major medical stuff as possible in Mexico.  My first child was born there.  It was a cesarean-section and I paid $700 cash out of pocket for the birth.  My second child was born in the US (for logistical reasons) and with good insurance through my work, I still paid about $2k out of pocket.  The insurance covered the rest, which was almost $20k.  We paid $400 for my wife's knee surgery in Mexico.  We almost always go to the dentist while we're there and get cleanings and cavities filled.  I had a cleaning and 2 cavities filled down there last year for $50.  Medicine is plentiful and cheap and we always bring back a huge bag full of anti-biotics and other types of medicine. 

[jackiechiles2]

I went to a medical association conference a few years back and the CEO of this company was one of the presenters:

http://www.companionglobalhealthcare.com/

Apparently, a lot of larger corporations that are self-insured are starting to use medical tourism to cut down on medical costs.  The offer to pay for their employee's flight/food/family member to go as well, along with the surgery, and it still comes out cheaper.

From my memory, the presenter mainly focused on Costa Rica.  Apparently they have some 4 star hospital there with US trained doctors. They have gourmet food and massages, etc. for the people staying there.  The nurse to patient ratio is like 3/1.  Very interesting concept.

[kkbmustang]

Following because the likelihood of "deny because experimental" is something I'm facing head on, but related to my spine. I'm not inclined to roll the dice on my spine, because SPINE. But worth investigating for sure.

[Krolik]

My husband had 3 dental implants done in Poland. Total cost ~$2K. They have done excellent job. Lots of people from UK / Germany visit Poland for medical procedures. It is much cheaper and quality is very good (when you pay cash and don't relay on public health system).

We go to Poland every year to visit family so the trip was not only for medical purposes.

[CowboyAndIndian]

I got a complete physical in India for Rs 4000 (approx $80 USD at that time).

It included

• Blood work (glucose/CBC/lipid profile/Liver function/PSA)
• Chest X-Ray
• Cardiac Stress Test (treadmill) EKG
• Echo cardiogram
• Urine test
• Meet with doctor at end to discuss everything
• Hearing check
• Eye checkup

I went in early morning (7 or 8AM) and was basically done by about 1pm  or so.

It also included breakfast after the bloodwork.

It was a pretty decent hospital, and did not look shabby compared to the ones in the US (http://india.columbiaasia.com/hospitals/mysore).

Only negative was waiting between tests. I could have been done in a couple of hours if there was no waiting.

[OlyFish]

If we have to do IVF, we will go to a clinic in Bogota where my sister is. Less than 1/3 the cost of out of pocket expenses here.

[tn3sport]

Dental implant procedure in Costa Rica.
No issues. Would do it again.

[infogoon]

Looking at a $3,500 tooth implant for the wife that the internet tells me can be done for around $1000 in Costa Rica.  My dental coverage doesn't include implants so it's all coming from the HSA.  I hear you can purchase the flight with the HSA - I'm guessing I couldn't purchase my ticket with the HSA though.

I figure we'll spend about the same and get a sweet vacation, we've never gone on a true vacation/honeymoon together as our honeymoon was just a road trip.  Given the intensity of the procedure and subsequent recovery period, we should probably make sure we get most of our fun time in prior to surgery.

Anyone got any stories, good or bad?

One of my neighbors just did this; he needed extensive dental work, so he flew to Costa Rica to have it done. As he put it, why not save a ton of money _and_ recover for a couple of weeks in a hammock in paradise?

[FIRE me]

Looking at a $3,500 tooth implant for the wife that the internet tells me can be done for around $1000 in Costa Rica.  My dental coverage doesn't include implants so it's all coming from the HSA.  I hear you can purchase the flight with the HSA - I'm guessing I couldn't purchase my ticket with the HSA though.

I have no personal experience, but have you considered Mexico? I read long ago that many cross the border for less expensive dental and medical care.

http://www.theatlantic.com/health/archive/2014/05/americans-are-getting-dental-care-on-the-cheap-in-juarez/361727/

[Dr. Pepper]

I'm in the health care field. I would say buyer beware. If it was me and I needed an operation, I would get it done where people speak the same language as me and work within a social/legal frame work that gives them reason to care about complication rates/sterility/following best practices. Even elective stuff has complications, depending on your health you may need extensive pre-op workup. IE if you have a history of heart failure, OSA, HTN , diabetes etc.... If you just go out of country for a hip or hernia and the guy says sure I'll do it no pre op testing or clearance needed, pay cash, and you have an MI or CVA on the table who is responsible? What if you get a post op nosocomial infection, and need IV antibiotics or a stay in the ICU? What if you need removal of hardware? What if you have chronic post op pain and need to be followed long term by a specialist? What if you need post op rehab? These things happen, all the time. People need to look at the totality of the scenario, rather then just the procedure itself. Also and this is a more subtle point, you have no way to know what you are getting quality wise. I'll give an example, tissue repairs of hernias have a very high recurrence rate , it was shown a while back that a tension free mesh repair is superior with respect to recurrence, at 1-2%. However the mesh cost will increase the cost of repair. Many places in the world don't use mesh and just accept the higher recurrence rate, that is their standard. If I was going to get my hernia fixed I would want mesh, to reduce the chance I would need a second operation. If I was a lay person, unless I knew how to do a literature review, I would have no idea unless the surgeon told me, I would just think I was getting a bargain. Just one example from my specialty, I'm sure others could be made. I'm not saying not to do it, just buyer beware. If you were planning on medical tourism, you really would need to be well educated about what you are going to have done, find a good surgeon and know what the potential complications could be.

[Zikoris]

I was strongly considering going to Costa Rica to have my tubes tied many years ago because it's REALLY hard to find a doctor in Canada willing to do that for a 21 year old. I believe it would have cost a few thousand including flights and recuperation. I would have done it, but the stars aligned and I finally found a Canadian doctor who understood that it wasn't the 1950s anymore. So no actual story to tell, but I've heard good things.

[klystomane]

I did LASEK in South Korea for approx. $1300 USD (based on today's exchange rate) for both eyes.

The surgeon is quite reputable, has his own clinic, and got his degree at John Hopkins university.

I've been told it's upwards of $5k+ here in the States.

[scrubbyfish]

Following (because, contrary to popular belief, health care is not the cat's financial pajamas in Canada)