In 2018, our Medical Plan performed very well. The exception was our prescription benefit. Dramatic increases in the cost of prescription medications continues to be the number one detriment to our Medical Plan. I want to share some information that may help save you and the Medical Plan money. First, let me explain the tier system our prescription plan uses. The tiers for prescription medications are determined by insurance industry standards.

NOTE – The tier system does not apply to medications purchased on the field.

• Tier One

Tier One applies to Generic Drugs. Normally these drugs have expired patents and are now manufactured by more than one company.

A Tier One drug will have a $5 out-of-pocket co-pay regardless of the cost of the drug.

• Tier Two

Tier Two applies to Brand Name Drugs. These drugs may be a more expensive generic drug or a drug with a patent still in place.  In many cases a generic version of a brand name drug may be available.

A Tier Two drug will have a 20% out-of-pocket co-pay. For example, a $200 medication will cost you $40 out-of-pocket.

• Tier Three

Tier Three applies to Preferred Brand Name Drugs. I like to call these TV drugs because they are the newest medications flooding the market. These are brand name drugs that don’t have a generic equivalent.

The primary increase in our prescription costs (and rate increases) over the last three years has been driven by the increased use of Tier Three drugs.

A Tier Three drug will have a 25% co-pay plus $25. For example, a $1,500 Tier Three  medication would have a $400 out-of-pocket co-pay.

If you are taking Tier Three (or Tier Two) medications, talking with your doctor about Tier Two or generic alternatives could save you and the Medical Plan money. You are in no way obligated to change.

Another issue with the increased use of Tier Three medications is that we have an $18,000 yearly maximum (per individual) on prescription benefits.

• Expatriate Prescription Services (EPS)

While on the field, you have an opportunity to save money by using EPS instead of “backpacking” medication into the country.

It is not uncommon for a missionary to carry a year’s supply of medication to the field. EPS can deliver your medication into most countries at a greatly reduced cost to you and the Medical Plan.

If your medications are not available locally (in country), we would encourage you to investigate the EPS program. We have about a dozen missionaries using the program with a 98% satisfaction rate.

As always, if you have questions or concerns, please don’t hesitate to contact Michael Duff at the Mission Office!