As more and more Americans travel abroad for cheaper medical care, health insurers and employers have mostly watched from the sidelines.

Now the nation's second-biggest health insurer, Indianapolis-based Wellpoint Inc., is dipping a toe in the medical tourism marketplace.

Starting in January, Wellpoint will offer employees of Wisconsin-based Serigraph Inc. the option of traveling to India for nonemergency procedures such as joint replacement surgery. Serigraph will waive the insurance deductible and coinsurance for employees who agree to go, paying all medical costs as well as travel expenses for the patient and a companion.

"This is a leap of faith, obviously, to say if you go to India, we'll pay for the whole shebang," said Linda Buntrock, Serigraph's senior vice president of human resources.

"But the cost difference is so monumental."

Knee replacement surgery that costs between $60,000 and $70,000 in the United States can be done in India for $8,000 to $10,000, said Jill Becher, a Wellpoint spokeswoman.

Wellpoint joins a handful of U.S. insurers offering medical travel benefits.

Can Minnesota insurers be far behind?

Minnetonka-based UnitedHealth Group Inc., the biggest U.S. health insurer by revenue, said it doesn't yet have an international travel program but is seriously looking into it.

Blue Cross and Blue Shield of Minnesota and HealthPartners said they do get asked about medical travel, but no Minnesota employers have taken the leap. Medica said its clients have not asked about the option.

Savings of 30 to 90 percent

Some 750,000 Americans traveled abroad for medical care in 2007, and that's expected to rise to 6 million by 2010, according to the consulting firm Deloitte. Almost all are individuals doing so at their own expense.

Going abroad can cut 30 to 90 percent from a medical bill, said Robin Elsham, managing director of Patients with Passports, a Mendota Heights startup that arranges foreign care for individuals. But it's still a radical idea for most people.

"It's hard to get people to understand cheap doesn't mean inferior," Elsham said.

Serigraph is a specialty graphics company with 650 employees in West Bend, Wis. It is self-insured, meaning it pays directly for medical care for its employees, with Wellpoint administering those benefits.

For now, Serigraph employees are limited to hospitals owned by Apollo Hospitals Group in New Delhi and Bangalore, both accredited by the Joint Commission International, a hospital accreditation body. More facilities will be added later.

Buntrock said reactions from employees have ranged from "No way" to "Why not?"

She said the company is not just trying to save money, it's making a point: "This is a challenge to the U.S. medical system to say, 'What's wrong with this picture, guys?'"

Chen May Yee • 612-673-7434