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NBC 5 Responds: Unfair Denial or Discrimination?

A Chicago couple says a stunning statement by a major insurer stymied their path to parenthood

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Not very long after their very first date, Adam Motz and Tee Lam discovered one major thing in common: they both want a family. 

“What really sealed the deal was that we knew we both wanted family, and we wanted it really soon,” Tee told NBC 5 Responds. 

Soon is now. After the Chicago couple married last year, they started making plans. And the stars started aligning.  

First, Motz's best friend from high school offered them a priceless gift: her eggs.

“It was definitely emotional,” Motz said. “It’s a very intense process for the egg donor…she just wanted to do this for us.”   

The next need: a surrogate, and another generous offer from their very own lives. Lam's longtime friend offered to become their surrogate.  

Yet finding each other, finding an egg donor and finding a surrogate turned out to be the easy part, they say. 

“We just never imagined that one of those obstacles would be that our health insurance company Blue Cross Blue Shield would deny us the same coverage they would extend to any other couple in our position,” Adam said.    

“Any other couple,” straight or lesbian, they allege, would have had egg donor-related medical costs, now nearing $15,000, covered. Theirs were denied.  

Motz said a Blue Cross Blue Shield of Illinois agent, in a recorded call, told him exactly why. 

“Because we are a male/male couple using a surrogate, those were their exact words,” Motz said. “They refuse to give me the recordings.”   

If that sounds problematic, their fertility doctor says it would be. 

Dr. Mary Wood Molo of Chicago’s (Center for Reproductive Health) says she has seen egg donor costs covered for patients of other sexual orientations.  

“For hetero and lesbian couples, yes, but not for same-sex male couples- with any insurance,” Wood Molo said.    

To help appeal the denial, Wood Molo wrote Motz and Lam the letter they say BCBSIL requested, explaining why these two men cannot become pregnant.   

“It was very obvious that Adam and I cannot have kids I mean, I don’t know how much more obvious it could be. To even write it down,” Lam said.    

But that simple fact is crucial in the eyes of Illinois’ Fertility Mandate. The law requires coverage for anyone unable to conceive after one year of trying. Only certain employers are exempt from that law, and Motz's is one of them. He is an assistant state’s attorney with Cook County, in the criminal appeals division.    

Despite the exemption, Cook County says its policy does meet the state law, that its 22,000 employees and their families have extensive coverage for fertility treatments including egg donor procedures. The county said it did intervene in Motz's case, asking for a full review by BCBSIL, its claims administrator. But said it did not hear back.  

Still leaving open the question: why this denial?  

“That would be very, very concerning to me if the insured in this case is not getting coverage because he is married to a man,” American Civil Liberties Union attorney Ameri Klafeta told NBC 5 Responds.    

The ACLU says concerns raised in Motz and Lam's case are very much current ones. 

“There are a lot of protections in federal and state law, to make sure that people are not treated differently because of their sexual orientation, and I would be concerned in this case that that’s exactly what might be happening,” Klafeta said. 

Blue Cross Blue Shield of Illinois declined to answer NBC 5’s specific questions,  but after our inquiry, Motz said, changed course and paid about about $2,000 of the disputed claims.  

In a statement, the company says it is committed to providing quality health care to members consistent with terms of their benefit coverage, regardless of sexual orientation, among other qualities.    

A struggle that has slowed, but not changed, this dream.  

“There’s really nothing that could take away our excitement for starting a family. There are just some things that made it more difficult,” Motz said.   

The rest of the disputed charges are now under review, Motz said. He and his husband now hope for the best news of all, soon: in the form of a pregnancy.    

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