New Dehli, India ? Greg Goodell flew from Iowa to India to have his arteries unclogged. Rick Thues made the trip from California for a new hip. John Terhune ventured from Indiana for a hip-and-knee combo.

Combined, all three saved about $140,000, including the cost of travel and hotels, by having their surgeries last month in New Delhi instead of America – where the health care system simply had failed them.

All in their 50s and fully employed, these men are among the estimated 500,000 Americans who are taking their health into their own hands by choosing medical care abroad. Many are stuck in a growing gap of 45 million uninsured Americans – and millions more underinsured – who are too young for Medicare and left with only losing health care options: siphoning their retirement, living in pain or possibly dying.

“Our share of the American dream has been lost in the past five years,” said Thues, 53, a computer consultant from Orange, Calif. “Look at what we’ve outsourced – I’m even outsourcing my own health, for God sakes.”

Hip new procedure

He is fully covered under his wife’s insurance and could have had total hip replacement back home for about $5,000 out of his own pocket. But it’s not the newest procedure available and would have severely limited his mobility, kept him from his passion of skydiving, and possibly sent him back to the hospital in 10 years with more problems.

Thues lobbied to undergo hip resurfacing – a new, less invasive technique approved in the U.S. this year – but was denied.

Indian doctor Mukesh Tripathi removes the stitches of American patient Dodie Gilmore after a successful operation in October at a hospital in New Delhi, India. Of an estimated 45 million uninsured or underinsured Americans, some 500,000 trekked overseas last year for medical treatment.

That’s why he and his wife, Paula, hopped on a plane to Delhi and visited Dr. S.K.S. Marya, chief surgeon at the Max Super Speciality Hospital’s Institute of Orthopedics & Joint Replacement, who has performed some 150 hip resurfacing operations over the past two years for about $7,000 each.

Within a few days, Thues was up walking and already talking about his next jump from a plane in six months. The whole trip, including the surgery, airfares, lodging and a trip to the Taj Mahal, totaled about $12,000, none of which was covered by his insurance.

“I was so let down by my HMO, the whole idea that they denied me because they could,” he said while recovering at his hotel near the airport in New Delhi. “I’ve paid thousands of dollars in premiums over the years. It’s their job to look after me.”

‘We felt comfortable’

Greg Goodell, 57, from Shenandoah, Iowa, ended up at the same Indian hospital as Thues. In August while bicycling, he felt a strange tightening in his chest and realized something was wrong. But the self-employed finishing painter was uninsured and knew the price of an angiogram test alone, quoted at $4,000 to $29,000 by nearby hospitals, could have put a big dent in the family’s savings.

With a wife and five kids to consider, he said he put his faith in God and had an angioplasty with two stents inserted in India for about $10,000.

“When you first start, you’re not sure. You think, ‘Wow that’s a long ways away.’ But when you’re faced with the other option, you want to check it out,” he said two days after being discharged. “We felt comfortable. We didn’t really have any red flags, ever.”

Savings, despite setbacks

But Goodell did encounter a few downsides of traveling. He and his wife, Kriss, both experienced bouts of diarrhea during the trip and their luggage was lost for three days. Goodell also had a slight mishap while walking near Delhi’s congested roads: He sliced his head open on a metal sign, resulting in six stitches.

Still, he said the setbacks were minor, given that his heart was fixed without breaking the bank. The couple’s whole trip ran about $16,500.

Uninsured Indianapolis chiropractor John Terhune, 57, didn’t need any persuasion.

He underwent hip resurfacing surgery in his left leg a year and a half ago in the southern Indian city of Chennai and was so pleased with the results that he came back to have the right hip done by Dr. Marya in New Delhi.

And he got a partial replacement for his left knee to boot.

Both surgeries totaled less than $12,000 – about 85 percent off the U.S. price tag – plus another $3,000 for travel and accommodation.