We continue to receive questions regarding an adjustment to the BBFI General Physical benefit earlier this year. This post may be a little repetitive but hopefully it will clear up some confusion.
HISTORY:
The BBFI Medical Plan has a $500 yearly benefit for a “Preventive Care Physical Examination”. The exact wording of this benefit has always stated “Examination”.
In the past (Worldwide days and recently with IMG), the $500 benefit was applied toward the examination. Any remaining balance after the cost of the examination, was applied toward blood tests, labs, etc., even though the wording of the benefit was “Examination”.
In some cases, the remaining balance was sufficient to cover basic blood tests.
THE ISSUE:
As we all know, the cost of medical care continues to escalate.
Today, the cost of a general physical and the expanding range of tests associated with them routinely exceeds the $500 benefit. We are seeing claims in the $750 – $2,000 range depending on the number and type of tests ordered.
Because the benefit has a $500 maximum, charges over that limit are considered non-covered services and 100% of the excess charges are the missionary’s responsibility.
THE ADJUSTMENT:
To protect our group, we requested IMG apply the General Physical benefit as written.
The $500 benefit will continue to be used for the office visit / examination and blood draws, normally in the $150-$300 range.
Any tests associated with the physical are now processed under normal plan benefits. This means they may be subject to Deductible and Co-Insurance.
The confusion we are seeing is, if you have not met your Deductible or Co-Insurance, you may be responsible for a portion of the charges related to the tests.
The benefit of this adjustment is it protects you from being responsible for 100% of charges exceeding the $500 benefit.
NOTE: This does not apply to Preventive Health Benefits requiring 100% coverage by law.
As always, if you have questions, please do not hesitate to contact me at mduff@bbfimissions.com.
Michael K Duff
BBFI Medical Plan Coordinator