CHENNAI, India — This is not how Jay Tronson pictured the hospital. In photos online — though maybe he was looking at pictures of the wrong hospital — he saw a modern glass structure sitting on a grassy hilltop, not this older building crammed into an busy neighborhood.

As he walks into the crowded, noisy lobby of Apollo Speciality Hospital, he tries to stay focused on the fact that he will be operated on by a well-regarded surgeon, that the reason he traveled here from Pearland, near Houston, is to end the pain in his hip.

"As long as the operating room is sterile and the doctors are competent, I don't really care" what the hospital looks like, he says, leaning on his cane.

In the lobby, a hospital staffer is waiting to whisk him up the elevator to the fourth floor, past a nurses' station and through double doors under a sign that says "Platinum Ward."

Suddenly, the slightly sour smell gives way to a sweeter aroma. Elevator music plays. There are leather couches and an aquarium. He walks into his hospital room, which includes a flat-screen TV and a laptop.

This is where the foreigners stay. He is pleasantly surprised — and relieved.

A recent report estimates that hundreds of thousands of Americans go abroad each year for medical procedures, primarily to save money.

They are not the only ones eyeing the bottom line. Some U.S. insurance companies — including Aetna and UnitedHealthcare — are considering paying for patients to go overseas for care, which could spark major growth in the medical travel industry. Wockhardt Hospitals officials said major insurers are requesting data that show how well the Indian company's hospitals treat patients, a sign that the insurers are investigating options in India.

"I don't know where this will stop," said Dr. Kushagra Katariya, a cardiothoracic surgeon and CEO of Artemis Health Institute in Gurgaon , near New Delhi.

Quests for care

Medical tourism isn't new. For decades, people from around the world have come to Houston, for example, in search of good doctors. Americans have long traveled within their country for specialized care — take U.S. Sen. Edward Kennedy, D-Mass., who went to North Carolina for surgery on a brain tumor.

And the American health care industry, like many businesses, is already outsourcing functions like reading X-rays to overseas providers.

Now, more and more Americans are traveling to countries like Singapore, Thailand and Costa Rica for medical procedures that are cheaper there than at home. Sometimes, they don't have insurance; sometimes, their insurance doesn't cover what they need.