It’s hard to imagine 2022 is half over! I hope it has been a blessing.

I am writing to make you aware of a concern with regard to our Medical Plan. As you know, 2021 was a difficult year for our plan financially speaking. It was an incredible blessing that funds from the Missionary Care Offering were available to offset the increase IMG was recommending to maintain our Medical Reserve Account.

Each year in June, we meet with IMG to review the plan’s performance for the current year. This year our plan is once again facing substantial financial challenges.

Multiple issues are contributing to this. We continue to see an increase in stateside utilization by our group. In addition, the ever-increasing cost of care, growing use of Tier 3 prescriptions, and a decreasing number of participants in the plan have played a role. The economy is also a factor. In recent years, the Medical Reserve Account investments have been profitable. With the downturn in the economy, those investments are no longer supplementing the plan.

Many of these things are beyond our control, but there are a few cost-saving options for each of us to consider.

1. Review your current prescriptions with your doctor.
   Universal RX recently sent letters to about 40 missionaries who are using Tier 3 medications when there are lower cost / equal quality medications available.
   In addition to reducing cost to the Medical Plan, your copays will be less if your doctor feels you can make a change.
   In some cases, you may be able to switch to a generic medication. The cost of generic medications saves the plan, and you will have only have a $5 copay.
   
2. Consider using Hostcare for preplanned surgeries or procedures.
   Hostcare works with IMG to “rate shop” providers. For instance, a routine colonoscopy in a hospital will average $4,000 – $6,000. That same procedure can be done at a specialty clinic for about $1,400.
   Hostcare also arranges Medical Travel surgeries. For example, if you planned to have knee surgery in Joplin, MO, they would “rate shop” that same surgery in nearby areas. If they found a hospital in Oklahoma City that was $10,000 less, Hostcare would arrange the surgery for you and also make arrangements to provide accommodations and such for your spouse or other person who would accompany you.
   The benefit to choosing this option is that Hostcare will share a portion of the savings with you in the form of a cash payment.
   
3. An even greater savings would be to utilize the International Travel Benefit.
   Several missionaries have used this benefit and their responses have been very positive regarding the experience.
   IMG will evaluate the proposed surgery to see if it meets the savings and criteria for the international benefit.
   They will arrange the surgery at a premier international facility and make travel arrangements for you and your support person.
   We have seen savings in the $25,000 – $50,000 range with this benefit.
   The benefit to you is, IMG will share the savings with you — up to 7% of the total savings.
   
4. If you have access to quality medical care on the field, consider scheduling routine treatment before returning to the states or after your return to the field.
   The United States has the most expensive healthcare system in the world. If you receive quality care on the field, it will result in a fraction of the cost to the plan.

All these things require thought, effort and maybe some sacrifice on our part. While IMG is doing all they can through negotiated discounts, the word “self” in Self-Funded Medical Plan means the responsibility falls to us.

As always, if you have questions or concerns, please do not hesitate to contact me!

Michael K Duff

mduff@bbfimissions.com