Appeal Letter to My Employer

OK, I finally sat down and wrote (with Mike's help) the following letter to the president of our company. I will e-mail this letter to him tomorrow morning. Let me know what you think:

Dear Mr. M,

I am writing to you for your assistance with a matter concerning our health plan. I am sending this appeal to you because I believe you are the only person in the company who can help me with this issue. I will try to keep this as succinct as possible.

My husband, Mike, has been an employee of [company name] for nearly eight years. I have been with [company name] for just over four years, and we both work here at the corporate office. Mike underwent a bone-marrow transplant back in 2003 due to a battle with lymphoma. Thankfully, he came through it just fine, but his extremely aggressive treatments left him 100% infertile. Since we were talking about marriage around that time, he was able to bank before his treatments in preparation for fertility cycles down the road.

Since our marriage in 2004, we have tried in-vitro fertilization (IVF) twice, and failed. We paid out-of-pocket since there was no IVF coverage available through our plan with Cigna. The emotional and financial toll was nearly overbearing.

Although this state is one of 15 states that require insurance coverage for infertility treatments, we have learned that companies which are self-insured are exempt from this mandate.

We had hoped the change to Blue Cross Blue Shield would bring IVF coverage. When we did not see it included, I felt that perhaps an appeal would help. While the new health plan is a welcome change, and the general benefits will help us a great deal, the absence of infertility coverage leaves us with a great financial burden to bear. I’ve spoken with human resources and Blue Cross Blue Shield and, of course, since this coverage is not in the policy they tell me nothing can be done.

Under different circumstances, we wouldn’t think twice about attempting to finance treatments on our own, but we are still left with the financial burdens of our failed cycles. We know this request may sound a bit desperate but, to be honest, that is how we are starting to feel. We are hoping something can be done to extend us infertility coverage on the basis of medical necessity, as IVF is the only method that can ever give us our own children.

Thank you for taking the time to read this appeal, and both my husband and I greatly appreciate any help or guidance you are able to give in our fight for a family.

Sincerely,
Lauren