Chelsea Insurance Group: Fill & Download for Free

I agree with Chelsea Meissner. I’d suggest that you ask your doctor to go to bat for you in appealing to the health insurance company. When he/she explains why you need the progesterone cream and what may happen if you do not receive the treatment, underlining how expensive it may be to them at that point, sometimes they will cover it.I know because I once worded a letter for the general surgeon I worked for so that a man with diabetes could get coverage for orthopedic shoe inserts. He had a sore on the sole of one foot, and the doctor stated in his notes, which I transcribed, that if this did not heal, the patient could wind up with partial foot amputation, but he doubted the insurance group would cover the inserts. I went to him and asked if I could draft the letter for his signature, and he agreed but without much hope. I made it brief and to the point that if John Doe did not get the shoe inserts so that he could keep pressure off the sore, they may be seeing a permanent disability claim in future. They said yes!

The insurance policy is part of the benefits package an employer provides. The cost is negotiated with the insurance company essentially for a group rate that the employee gets to buy into at that lower cost. However, the employer does not provide the funds for the insurance itself (meaning it isn’t the employer that pays for the healthcare), nor does it cover the cost to maintain the policy (which is why you still have to have the cost deducted from each paycheck). If you pick up your prescription, the insurance company pays for part of the cost and you pay the rest. Your employer has nothing to do with that money exchange.Women should not expect their employer to pay for medications because that isn’t how it works. Women should have the expectation that their insurance policy that is required by law to cover reproductive healthcare to cover just that. The employer should not have any rights to dictate how an employee utilizes their health insurance or manages their health. There are also a number of reasons to be on birth control pills that aren’t related to preventing pregnancy. A misguided attempt to be the moral police by trying to decide what a woman can and cannot do to maintain the health her body isn’t actually moral. It’s illegal and blatant gender discrimination, and violates her right to work in an environment free from harassment and discrimination.

This is a complicated question, with no clear answer. It’s very jurisdiction-specific.Just to illustrate, a popular case I (and many other) students read in law school is Duldulao v. St. Mary of Nazareth Hospital Center, from the Illinois Supreme Court in 1987. Just to give an idea how divisive this question can be, I’ll give an excerpt of that case. I normally omit citations in quoting cases on Quora, but I’ll leave them in here, because that’s kind of the point. I invite the reader to skim this quote, not necessarily read it carefully.The contractual status of employee handbooks has been the subject of a great deal of litigation in recent years. Several courts have rejected the notion that an employee handbook or manual can ever create binding contractual obligations. (See, e.g., Uriarte v. Perez-Molina 487*487 (D.D.C. 1977), 434 F. Supp. 76 (applying D.C. law); White v. Chelsea Industries, Inc. (Ala. 1983), 425 So.2d 1090; Heideck v. Kent General Hospital, Inc. (Del. 1982), 446 A.2d 1095; Muller v. Stromberg Carlson Corp. (Fla. App. 1983), 427 So.2d 266; Shaw v. S.S. Kresge Co. (1975), 167 Ind. App. 1, 328 N.E.2d 775; Johnson v. National Beef Packing Co. (1976), 220 Kan. 52, 551 P.2d 779; Richardson v. Charles Cole Memorial Hospital (1983), 320 Pa. Super. 106, 466 A.2d 1084; Reynolds Manufacturing Co. v. Mendoza (Tex. Civ. App. 1982), 644 S.W.2d 536.) However, the overwhelming majority of courts considering the issue have held that an employee handbook may, under proper circumstances, be contractually binding. See, e.g., Vinyard v. King (10th Cir.1984), 728 F.2d 428 (applying Oklahoma law); Lincoln v. Sterling Drug, Inc. (D. Conn. 1985), 622 F. Supp. 66 (Connecticut law); Barger v. General Electric Co.(W.D. Va. 1984), 599 F. Supp. 1154 (Virginia law); Smith v. Teledyne Industries, Inc.(E.D. Mich. 1984), 578 F. Supp. 353 (Ohio law); Brooks v. Trans World Airlines, Inc. (D. Colo. 1983), 574 F. Supp. 805 (Colorado law); Leikvold v. Valley View Community Hospital (1984), 141 Ariz. 544, 688 P.2d 170; Pugh v. See's Candies, Inc. (1981), 116 Cal. App.3d 311, 171 Cal. Rptr. 917; Salimi v. Farmers Insurance Group (Colo. App. 1984), 684 P.2d 264; Finley v. Aetna Life & Casualty Co. (1985), 5 Conn. App. 394, 499 A.2d 64; Jackson v. Minidoka Irrigation District (1977), 98 Idaho 330, 563 P.2d 54; Wyman v. Osteopathic Hospital of Maine, Inc. (Me. 1985), 493 A.2d 330; Staggs v. Blue Cross of Maryland, Inc. (1985), 61 Md. App. 381, 486 A.2d 798; Toussaint v. Blue Cross & Blue Shield (1980), 408 Mich. 579, 292 N.W.2d 880; Pine River State Bank v. Mettille(Minn. 1983), 333 N.W.2d 622; Enyeart v. Shelter Mutual Insurance Co. (Mo. App. 1985), 693 S.W.2d 120; Morris v. Lutheran Medical Center (1983), 215 Neb. 677, 340 N.W.2d 388; Southwest Gas 488*488 Corp. v. Ahmad (1983), 99 Nev. 594, 668 P.2d 261; Woolley v. Hoffman-LaRoche, Inc. (1985), 99 N.J. 284, 491 A.2d 1257; Forrester v. Parker (1980), 93 N.M. 781, 606 P.2d 191; Bolling v. Clevepak Corp. (1984), 20 Ohio App.3d 113, 484 N.E.2d 1367; Langdon v. Saga Corp. (Okla. Ct. App. 1976), 569 P.2d 524; Yartzoff v. Democrat-Herald Publishing Co. (1978), 281 Or. 651, 576 P.2d 356; Osterkamp v. Alkota Manufacturing, Inc. (S.D. 1983), 332 N.W.2d 275; Hamby v. Genesco, Inc. (Tenn. App. 1981), 627 S.W.2d 373; Piacitelli v. Southern Utah State College (Utah 1981), 636 P.2d 1063; Thompson v. St. Regis Paper Co. (1984), 102 Wash.2d 219, 685 P.2d 1081; Mobil Coal Producing, Inc. v. Parks (Wyo. 1985), 704 P.2d 702.This court has never specifically addressed the issue of employee handbooks. Our appellate court, however, has addressed the issue several times, with conflicting results. In Carter v. Kaskaskia Community Action Agency (1974), 24 Ill. App.3d 1056, the court held that an employee manual, which was introduced after the employee began working and was written with input from the employees, created enforceable contractual rights. However, in Sargent v. Illinois Institute of Technology (1979), 78 Ill. App.3d 117, the court distinguished Carter and held that the handbook in question was not binding because it was given to the employee when he first began work and was not specifically "bargained for." (78 Ill. App.3d 117, 121-22.) Still another appellate decision, Kaiser v. Dixon (1984), 127 Ill. App.3d 251, rejected Sargent and held that an employee manual may be binding notwithstanding that it was not "bargained for."Federal courts applying Illinois law have reflected the split in our appellate court. Two Federal cases have followed Sargent. (See Enis v. Continental Illinois National Bank & Trust Co. (N.D. Ill. 1984), 582 F. Supp. 489*489 876; Rynar v. Ciba-Geigy Corp. (N.D. Ill. 1983), 560 F. Supp. 619.) However, since Kaiser, several Federal courts applying Illinois law have followed Kaiser as the better reasoned approach. See, e.g., Pelizza v. Reader's Digest Sales & Service Inc. (N.D. Ill. 1985), 624 F. Supp. 806; Kufalk v. Hart(N.D. Ill. 1985), 610 F. Supp. 1178; Pudil v. Smart Buy, Inc. (N.D. Ill. 1985), 607 F. Supp. 440.What’s the takeaway? The takeaway is that the answer to your question is complicated. If you’re asking out of idle curiosity, I’m afraid I can’t satisfy it. If you’re asking because something happened at work and you’re considering litigation, talk to a lawyer in your jurisdiction, who will know the local law.