Americans travel abroad for all kinds of reasons — vacation, business, education, family visits. Increasingly, they also travel for medical care, which can cost a fraction of what it costs in the United States. Much of this demand centers on services not typically covered by U.S. insurers, such as dental treatments, cosmetic surgeries, and procedures considered experimental.
Mexico’s proximity to the United States and the allure of cost savings make it a popular destination for “medical tourism.” Roughly 1 million Americans visit Mexico for care each year, often seeking dental implants, veneers, tooth whitening, tummy tucks, breast augmentation, and liposuction. In the United States, the average cost of breast augmentation with implants is $4,875 — and this does not include anesthesia, operating room facilities, or other related expenses that combine to push the total cost closer to $10,000. In Mexico, by contrast, the total cost can be $3,000 to $5,000.
Even after adding travel expenses for the patient, a companion, and sometimes even a physician, the total cost of seeking care abroad often remains lower than domestic care. These savings attract those without insurance, with high deductibles, or who seek treatments not covered by their insurance plan.
Still, there are hidden costs, along with risks and policy turbulence that warrant examination. As domestic health care costs continue to rise, should policymakers and plan sponsors revisit medical tourism as a cost-containment strategy?
Why medical tourism hasn’t taken off
Despite potential savings, several factors limit medical tourism’s growth. Language barriers, cultural differences, and distance from family further deter many patients, who often prefer care closer to home. Further, medical tourism isn’t without risks.
Cosmetic surgeries can lead to complications, such as hematomas, infections, or nerve damage. Dental procedures may result in dry sockets, implant failures, or other complications requiring follow-up care in the United States. Some complications may be reversible with prompt care, while others may cause lasting harm if care is delayed. If complications are dealt with abroad, then the costs of extended stays can erode savings. Without travel health insurance, medical evacuation back to the United States can be prohibitively expensive.
Errors also occur, including wrong-site surgeries, excessive tissue removal, and unnecessary tooth extractions have been reported. Beyond the medical costs, pain, and suffering, legal recourse for medical errors made abroad is limited and often difficult to pursue.
Follow-up care after returning to the United States may be delayed or inadequate, with poor coordination between international and domestic providers.
Although rare, extreme cases of violence — such as a 2023 kidnapping in Mexico of four Americans, two of whom were killed — highlight the potential dangers of traveling to certain countries for care. Patients and their families risk being in the wrong place at the wrong time.
Not all medical tourism is created equal. Quality of care, location safety, and support systems in place all influence outcomes. Yet quality metrics and outcomes data — more commonly available in U.S. health care — are often sparse or unavailable for international facilities. This makes comparing the quality and value of options difficult and leaves patients and payers uncertain about the risks.
Consider two hypothetical patients traveling to Mexico: one receives care in a Joint Commission International (JCI)-accredited facility by a U.S.-trained physician with a companion present; the other visits an unaccredited clinic alone, treated by a provider of unknown credentials. (JCI sets quality and safety standards comparable to U.S. standards, but accredited facilities represent only a portion of foreign providers.) The outcomes and risks between these scenarios could differ dramatically.
Limits on international care coverage
Despite the potential cost savings, most U.S. health insurance plans offer limited or no coverage for planned care abroad. However, some self-insured employers have landed on a model that actively encourage medical tourism by covering the full cost — including travel — for approved procedures.
Some federal employee and military health care programs offer broader international coverage. TRICARE plans and the Federal Employees Health Benefit plan cover care in foreign countries, though the rules vary by plan. However, these programs don’t explicitly encourage medical tourism; they’re designed primarily for employees stationed or traveling abroad.
Medicaid does not cover health care services outside the United States under any circumstances. Medicare, however, may cover emergency and non-emergency ambulance services, doctor services, and inpatient care abroad under three narrow circumstances:
- You’re in the United States when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat you.
- You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat you.
- You live in the United States and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat you, regardless of whether you have a medical emergency.
On one hand, this limited ex-U.S. coverage is a potential cost-saver for the Medicare program. But on the other hand, it prevents potential cost savings that could flow through medical tourism where more costly domestic care is substituted for less costly foreign care.
Policy considerations for selecting a final destination
Medical tourism presents a policy paradox. It can potentially relieve cost pressures on self-insured employers and government programs, expand access, and reduce patient out-of-pocket costs. But if complications arise, follow-up care in the United States could end up costing plan sponsors and patients more than the original procedure would have domestically. Plan sponsors and patients must weigh upfront savings against downstream risks.
Despite the promise of significant savings, policymakers have not charted a clear course for how medical tourism can safely lower costs. Realizing predictable savings would likely require new policies for accrediting facilities, certifying providers, setting reimbursement rates, authorizing care, sharing information, and preventing fraud — all of which introduce overhead that could erode savings.
Any policy shift toward supporting medical tourism would need to balance multiple competing interests. Savings could flow to government programs and patients but at the expense of domestic providers who would experience lower utilization and lost revenue. The American Medical Association, American Hospital Association, and other trade and professional associations that lobby to advance the interests of health care providers would likely resist proposals to provide Medicare beneficiaries and/or Medicaid eligibles with a medical tourism benefit. And some policymakers may object because of the potential for waste, fraud, and abuse in less-regulated ex-U.S. markets.
Ultimately, medical tourism isn’t inherently good or bad — it’s a vehicle with potential benefits and risks. Its future depends on how stakeholders navigate its complex challenges. As costs rise and global care becomes more accessible, the question is not whether Americans will seek care abroad, but whether policies will evolve to ensure that the journey is safe and worthwhile. The best flight plan for medical tourism likely involves targeted approaches that balance cost savings with oversight, helping patients and payers reach a smoother landing.
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