[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Recipient's Name] [Recipient's Address] [City, State, ZIP] Subject: Authorization to Participate in Medical Plan for [Your Name] Dear [Recipient's Name], I hope this letter finds you in good health. I am writing this letter to request authorization to participate in the medical plan offered in Queens, New York. As a resident of Queens, I am seeking the benefits and coverage provided by this medical plan to ensure comprehensive healthcare for myself and my family. I would like to highlight that Queens, New York is a diverse borough with a bustling population and a wide range of medical needs. With its thriving healthcare system and access to quality medical facilities, Queens offers a plethora of choices for individuals seeking medical care. However, my intention is to participate specifically in the medical plan you provide, as it aligns perfectly with my requirements and preferences. By participating in this medical plan, I understand that I will gain access to a comprehensive network of experienced healthcare professionals, specialists, hospitals, clinics, and pharmacies, all conveniently located in Queens. The medical plan also includes coverage for prescription medications, preventive services, hospital stays, surgical procedures, and various diagnostic tests. Moreover, I appreciate the flexibility offered by this medical plan, allowing me to choose a primary care physician (PCP) who can coordinate my healthcare needs and referrals to specialists if required. Additionally, the plan offers assistance for medical emergencies, ensuring immediate access to urgent care facilities in case of unforeseen circumstances. I firmly believe that by enrolling in this medical plan, I will have peace of mind knowing that my healthcare needs, as well as those of my family, will be met promptly and efficiently. I consider it a valuable investment in ensuring our overall well-being. Therefore, I kindly request your authorization and approval for my participation in the Queens, New York medical plan under the aforementioned details. I have included my contact information above and would appreciate any guidance or documentation required to complete the enrollment process. Should you have any questions or require additional information, please do not hesitate to contact me at the provided phone number or email address. Thank you for your attention to this matter, and I look forward to your positive response. Sincerely, [Your Name]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.