If you are uninsured or underinsured, medical tourism may look like an attractive way to save money on major procedures like joint replacements.

But there are risks to traveling abroad for joint replacement surgery. Medical guidelines, medical residency requirements and other important quality factors can vary worldwide, making it all the more important for you, the patient, to do the legwork before you get on a plane.

Where to start
Successful joint replacements require months and even years of physical therapy and physician follow-up, so start by getting a diagnosis from your U.S. doctor and ask if he agrees to provide follow-up care upon your return.

Most major medical associations have encouraged their members to work with patients who are traveling abroad for surgery, but it’s important to have this relationship in place before you go. If you come back with complications, many surgeons may be reluctant to step in.

“It’s a huge problem for a surgeon to pick up another surgeon’s complications and get it resolved,” says Douglas Lundy, MD, a surgeon with Resurgens Orthopaedics in Atlanta, Ga.

Once you’ve got a U.S. physician ready to back you, you can then research facilities online and contact an overseas hospital directly. Alternatively, you can go through a medical-tourism travel agency. In either case, make sure your chosen hospital is accredited by the Joint Commission International, or JCI, which means the facility met standards for things like infection control, error prevention, staffing and management.

Questions to ask
Confirm that the staff of your chosen hospital speaks English. Learn the details of the procedure and ask to speak with former patients about their experiences.

If you’re in your 40s or 50s, Dr. Lundy says it’s particularly important to find out what kind of implant you’ll be getting.