Large employers are just beginning to offer employees the option of seeking medical care overseas. Americans with no or limited health insurance have been having health care procedures for years in overseas hospitals, pioneering so-called medical tourism in destinations like Thailand, Costa Rica, and India.

Doctors Care, based in Columbia, South Carolina, is one of the employers that is experimenting with the relatively new healthcare method. The company covers five procedures abroad for its employees: heart bypass surgeries, hysterectomies, total knee replacements, total hip replacements, and spinal fusions.

The savings are dramatic. A typical hip replacement surgery in the U.S. will cost $30,000 to $40,000 for uninsured patients. In Singapore, the same procedure goes for about $9,000 to $12,000.

Though the foreign hospitals are accredited by the Joint Commission International, concerns over quality of care remain. Questions have also arisen about a patient’s legal recourse in a foreign country if a medical error should occur.

Even though none of Doctors Care’s 1,000 employees have chosen to go abroad for services yet, the company remains confident that its health insurer is contracting with safe hospitals and plans to offer an expanded program of surgeries next year.