Comparing hospital quotes across countries: reading past the headline price

Three quotes arrive for the same knee replacement: one from a hospital in India, one from Thailand, one from Turkey. One figure is clearly lower than the others, and it is tempting to stop reading there. Before you do, look at what each figure actually buys. Two quotes can describe quite different things, and the difference often sits in the lines underneath the total.

What a hospital quote usually covers

Most treatment quotes are a package price built on assumptions. A typical package includes some or all of these:

• the surgeon's fee, and sometimes the assistant surgeon's
• the anaesthetist's fee
• operating theatre charges
• a set number of days in a room of a stated type, sometimes with a set number of days in intensive care
• standard medicines and consumables during the stay
• routine tests before and after the operation
• one or more check-ups after discharge

Every hospital words this differently. One may list each item; another may say "package includes standard care". Ask for the list.

What quotes often leave out

The items most often missing are the ones that vary from patient to patient:

• tests the hospital repeats when you arrive, or extra scans the doctor asks for
• an implant or device of a different type from the standard one
• extra days in hospital or intensive care beyond the package
• treatment of a complication
• blood products, special medicines or physiotherapy after discharge
• the cost of an attendant's bed or meals in the room

The CDC advises patients to check which services are included in the cost, and warns that some overseas providers charge substantial fees for follow-up care on top of the base price.

Implants and devices

For a joint replacement, a heart valve, a spinal fusion or a dental implant, the device can be a large part of the bill. Two hospitals may quote the same operation with different implants, made by different companies, of different designs. Ask each hospital to name the implant or device, its type and its maker, and to say whether the price changes if the surgeon chooses a different one during your consultation. Keep the device details for your records, because your doctor at home may need them years later.

Length of stay assumptions

A quote is usually based on an expected number of days in hospital. If one hospital assumes four nights and another assumes seven, the lower quote may simply have fewer days in it. Ask what the daily rate is if you stay longer, and what the rate is for intensive care. Look at how long you are expected to stay in the country after discharge too, because the surgeon will usually want to see you again before you fly.

Currency and how the price is written

Quotes from different countries may come in US dollars, euros, Turkish lira, Thai baht, Malaysian ringgit, Mexican pesos or Indian rupees. Convert them on the same day, using the same source, before you compare. Then ask:

• Which currency will the final bill be charged in?
• Are taxes included?
• Is there a charge for paying by card or international transfer?
• How long is the quote valid for?

Exchange rates move, so a quote in a local currency can be worth more or less by the time you pay.

Costs outside the hospital

The hospital is one part of the total. Add flights for you and anyone travelling with you, visa fees, the room near the hospital for the whole stay, meals, local transport and an interpreter if the hospital does not provide one. A cheaper hospital that needs a longer stay, or a destination that needs more expensive flights from your city, can end up costing about the same.

Follow-up costs at home

Once you are home, your own doctors will see you for check-ups, blood tests, scans or dressing changes. The CDC notes that care for complications after treatment abroad can be expensive and may not be covered by your health insurance. The NHS suggests asking how easily you could return to the hospital if more treatment were needed, and what that would cost. Bring home a full set of records, including the operation note and implant details, so your local team does not have to repeat tests.

Why the cheapest number is not the whole picture

The lowest figure is fine to choose when it covers the same plan as the others. It is a problem when it is lower because it leaves things out, assumes a shorter stay, uses a different device or excludes follow-up. Compare the surgeon's experience with your operation, the hospital's facilities for your condition and the clarity of the written quote alongside the price. A quote that answers every question in writing is worth more than one that is vague.

How we ask hospitals to quote the same plan

At MediCurage, we send the same case summary and the same reports to each partner hospital, in whichever countries you want quotes from. We ask each one to state what its price includes and excludes, the expected days in hospital and the implant or device it plans to use. When a quote is unclear on a point, we ask the hospital to explain it in writing before you rely on it.

You then see the quotes side by side and choose. Each hospital sets its own price, and the choice stays with you and your family.