Writing A Hardship Letter For Health Care Exemption

Health care insurance companies regularly change their policies and procedures. They also frequently change their prices, which is something that they are contractually allowed to do. With the new Trump Administration causing some doubt over the continuation of the Affordable Care Act, many insurance companies have started to change their polices and prices, which can cause significant difficulties, including hardship, for many people. If this is the case with you, you may be able to write a letter to your insurance company to allow an exemption.

How to Write a Hardship Letter for Health Care Exemption

The letter to your health insurance company is a formal letter and should be written as such. This means that you should proofread it properly so that it does not contain any grammar or spelling errors. You should address it properly and to the right person, and you should date it. The subject line should also indicate what you are writing about, as well as your policy number.

Starting the Letter

Start your letter by explaining that you would like an exemption from the latest policy change. Indicate when the change is due to take effect, and that you would prefer to remain on the plan that you are currently on. Indicate that should the new plan be imposed on you, it will cause significant hardship for you and your family.

Content of the Hardship Letter

State the amount you currently pay and how often you pay it, while also stating your deductible and your copay. Then explain how this would change under the new plan. It is likely that at least one of the three elements – the monthly coverage, the deductible, or the copay – will rise significantly although it is usually all of them for there to be real hardship. Indicate that your alternative would be to move to a cheaper plan, but this would mean you have less coverage but you need the coverage for your family.

Make it clear that in most cases, employees save a significant amount of money by not accessing their employer’s health insurance. However, this may not be the case for your family. Indicate how much you earn each year before tax, as well as how much others in your family make, and show that there is no company insurance to rely on. If this is the case, you may find that you are under the income cutoff for a family of your size, and that this means that under the State Exchange of the Affordable Care Act, you do not qualify for tax credits or subsidies. Explain that you would then have a higher copay and that you would not receive dental or vision coverage, if that is the case.

Essentially, you must make it clear that you wish to stay with the insurance company that currently covers you, because you appreciate what they offer, but that you will not be able to do so if they change their policy. Provide evidence from quotations you have received from other insurance companies and from your employer’s coverage if applicable.

Hardship Letter For Health Care Exemption Example

To Whom It May Concern:

I am writing to request an exemption from the new health care coverage that will go into effect on {date}. I would like to maintain my current plan, as the new one will be detrimental to my family and cause extreme financial hardship.

The old coverage cost us {amount} per month for a(n) {amount} deductible and a(n) {amount} copay. The new health care plan would require us to pay {amount} per month for a(n) {amount} deductible, which will cost me {amount} more per month for less coverage.

While I understand that in many cases, not having access to employer health insurance will result in savings costs for employees, this is definitely not the case for our family. While I earn approximately {income} annually in gross wages, my {husband/wife} makes {amount} per year with no company insurance, which puts our {number}-person family over the income cutoff to qualify for subsidies/tax credits under the Affordable Care Act’s State Exchange. We would also be receiving no vision or dental as well as a higher copay. It’s a big step down from the generous, affordable policy we’ve enjoyed through {Company Name}. We got quotes from a local insurance agent and they were just as difficult for our financial situation.

It is vital that we retain our current coverage. Not only does our family have ongoing health care needs, we have been counting on the {aspect} in order to provide {care} for our children. I have attached a copy of our {year} tax return as well as pay stubs and a copy of our recent health care costs. Thank you for your consideration.

Sincerely,

{Sender}