Results 1 to 8 of 8

Thread: I need help in my fight!

  1. #1
    Join Date
    Jul 2010
    Posts
    2

    Default I need help in my fight!

    Hello everyone!! Though I am not new to the site I am a new registered member. This is my situation:

    I live in the state of Arkansas that is actually one of the 14/15 states that have a fertility mandate. The problem is that the insurance companies are stil refusing to abide by the law. What makes the situation even much more frustrating is that there exists a law here that in order for insurance companies to even provide insurance policies to residents of AR then they (out of state insurance) must recognize and abide by all mandates. I have been on this fight for 3 yrs. with no resolution. Can anyone help me? I am fighting but my faith is draining.

    Please help I a not trying to make any money, I just want the medical benefits that are owed to my husband and I.

    Thank you.

  2. #2
    Join Date
    Nov 2010
    Posts
    1

    Default

    I have never done advocacy work on an infertility insurance case, but my non profit has done a number of other advocacy cases and has not lost a case yet. I would be more than interested in helping you.

    Little background, my (now) ex husband and I did IVF in 2005 and were blessed with triplets who are now 4 (www.our3.blogspot.com) We had a male infertility factor due to his Cystic Fibrosis, and were actually chooses as INCIID from the hear recipients in early 2006 but were already pregnanty by then.

    Please email me at the email address on my site www.dafcf.org (don't want to post email address here b/c of potential trolls) if you are interested in assistance. All services are confidential and free, and I am a 501(c)(3)

  3. #3
    Join Date
    Dec 2010
    Posts
    2

    Default

    wantingmom-I just posted something similar to you fight. We have a infertility mandate in the state of CT. But my husband employer 's insurance doesn't have to follow it. I was wondering were I can go from here....please keep me posted as to some direction if you get anywhere or what to do...GOOD LUCK TO YOu!!!

  4. #4
    iwannabeamomx5 Guest

    Default

    Just wanted to give a *shout out* for Julie123, who offered help with this back in November ~ because on March 7, 2011, I read this thread here and I took a chance and emailed her, asking if she could help my DH & I with our insurance issues, and included our story in that email.

    Literally, within 3 hours she had written back with several questions, and a few hours after that she wrote back with lots of info for us, including what she found in IL Infertility Law that changed EVERYTHING for us and finally allowed us to WIN an appeal against our insurance company!!! We have dealt with their denial for 4 years and tried to appeal it twice before, to no avail. We really thought we had done all we could...and thought perhaps the only way we could win was by taking our story to the media and hoping some attorney who is active in reproductive law/surrogacy/egg donation/etc... would jump at the chance to respresent us in a civil suit against them, based on needing changes made to reproductive laws in IL, or to prove that exceptions to the rule need to be made for cases involving the ever expanding world of reproductive health - laws/rules that were affecting my ability to receive the infertility benefits I should have had access to, when it was deemed medically necessary.

    But Julie found something already in the law that dictated how my specific situation should have been handled all along, and that was proof that we never should have been denied IVF treatment in the first place!!!

    We emailed back & forth several times to make sure all the details were ironed out, and nothing was missed or overlooked. Julie even contacted the IL Dept of Insurance concerning my specific case, and received correspondance from them to verify that we had a legitmate argument against my insurance company. Then she drafted an appeal letter for us, and we faxed it to them on March 18th!!



    On April 22, 2011, we got word that we won, and I was being approved to begin treatment for up to the 4 full IVF cycles (and as many FET's that could result from these cycles) that I'm allowed under IL Infertility Law!!! And also, because for the first time in my life I took a gamble, I was already preparing to move forward with IVF by being on bcp's and by starting lupron on April 18th (hoping & praying for the approval!!) and now, baseline in Thursday, and stim start is Friday - so I am only 2 weeks away from retrieval!!


    Julie is AMAZING!!! She has changed the course of our life BIG TIME by helping us receive this HUGE opportunity to make our dreams come true! She didn't know me from Adam, yet she dove right in and was willing to help us as soon as she got my email!! This woman is such a HUGE blessing to many people - on her website for the non-profit org for CF patients, there are also many amazing testimonials from the people she has helped there too - she is a true gift from God for MANY!!!


    Thank you Julie - thank you, thank you, thank you from the bottom of my heart!! I will never be able to fully repay you for your help, but you can definitely count on a donation for your CF org once we get past paying for all the basic copays and other misc. stuff for our first IVF cycle coming up in 2 weeks!!!

  5. #5
    Join Date
    Dec 2008
    Posts
    1,235

    Default

    Congratulations on your cycle and awesome work Julie!!!

  6. #6
    iwannabeamomx5 Guest

    Default

    Thank you...I'm still in a bit of disbelief that it's actually happening!

    Baseline is tomorrow!!

  7. #7
    Join Date
    Dec 2008
    Posts
    1,235

    Default

    Woohoo!!! How exciting, keep us posted if you can!

  8. #8
    Join Date
    Jun 2008
    Posts
    76

    Default Was lurking and saw this, here is my story

    Way back when, over five years ago, our state, Maryland, has a mandate. However, ERISA plans were exempted. So my husband's plan was and ERISA plan but it never said it was an ERISA plan, just this is the insurer, blah blah blah. Anyway, I am an attorney and SUED his company stating that by not stating their med plan was ERISA it violated the law. Based on my suit the company agreed to pay for one cycle of IVF with the agreement that this was only because of this specific circumstance. My twins that resulted from the cycle turned 5 in March. I found that sending appeals, etc. was an long term never ending process that just led to frustration. Check the mandate in your state, ERISA is often exempted and your would not believe how many plans are ERISA these days. Good luck with things.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •