- Report: #251977
Complaint Review: Mega Life And Health Insurance Company - North Richland Hills, Texas
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Mega Life And Health Insurance Company
PO Box 982009 North Richland Hills,, 76182-8009. Texas, U.S.A.
Phone:
800-527-5504
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Mega Life And Health Insurance Company Changing order of my insurance companies and medi Care with out consulting me. ripoff North Richland Hills, Texas
MEGA Life, NASE, PFL
I have had their Catastrophic Hospitalization Insurance. Basically a $5000.00 deductible and up to 10k they pay 80% after that it is 100% of the charges. Now I bought this back in 1986, in 1993 I had a brain tumor and the company I was working for paid for the operation. Then I thought really, PFL, Mega is my primary Insurance company. Their first coverage.
I called the company and told them this and they were over joyed, as it was a self insured company and the employees provided the pool of money. There was no problem, PFL picked up the cost, as they are my primary insurance company. The cost was $397,000.00 for the operation, MEGA PFL paid everything, that was covered. To say the least I was very happy with the company and though my rates are almost $700 per month for just my coverage, I recommended them to everyone.
Now they have decided that they are no longer my Primary Insurance Carrier, that my wife's coverage from her job is primary, medicare comes second as I am on SSD and Mega PFL is third.
How can they do this, they have been my primary insurance since 1986, my wife has had many jobs, no guarantee this will last.
This was all done with out my knowledge except the billing person at my Primary Doctor mentioned this when she was trying to refund money to Mega PFL. This has to be the biggest rip off and I am sure highly illegal.
They are doing it because all my wife's company had to do is deny the claim and it goes to Medi Care and then PFL. I am not 65, no where near that. So all PFL would have to pay, is what Medi Care did not pay, at the Medi Cares rate of about 37% of a Doctors normal charge. What a scam and a terrible thing to do for those who need Medi Care.
I intend to contact Medi Care Fraud Department as this was all done behind my back and I am not even required to keep the Medi Care, it's just an option and Medi Care has never paid a dime. With 2 other insurance companies ahead of them. I think this is collusion between the two companies to with hold payments on care and medications that I need, turn it over to Medi Care and MEGA PFL only pays what little Medi Care does not play.
I must say I am surprised, not all that much, but still surprised, as MEGA PFL has paid for the things they were responsible for till now. As I read through their list of problems, I remember back to the interview with the agent. She was brand new and I had to reminder her there were a couple of questions she could not ask.
I figured if I was getting pushed around, so must others be experiencing what I am today. I am shocked, but pleasantly at the agents that have come forward to say how this company does business now and reveal how it acts and operates behind the scenes.
This takes courage, that is so lacking in most people today. Their saying that they were duped and told false promises and not kept up date on their policies by the company they were selling for. This takes courage to admit you made a mistake in life and come forth to warn others. That is inner strength.
I only wish I had kept track of the company, with the rate increases I would think they were happy, but it is clear their has been collusion among the 2 insurance companies and I will be the loser. If any one knows about this happening or if they can do it with out notification, I would appreciate it. Also how to get to the people who make the decisions, I do not want to spend days going through the phone tree. This will really hurt me, I just don't see how they can assign positions, when I have been with them for 21 years and they have always been my first insured. Then swap with another company and assign a government benefit Medi Care at the second position. Who gives them that right. Now they say where the Government will pay
Any help or ideas most kindly requested and accepted. They sure have changed since 86.
Geoffrey
Big Lake, Alaska
U.S.A.
I have had their Catastrophic Hospitalization Insurance. Basically a $5000.00 deductible and up to 10k they pay 80% after that it is 100% of the charges. Now I bought this back in 1986, in 1993 I had a brain tumor and the company I was working for paid for the operation. Then I thought really, PFL, Mega is my primary Insurance company. Their first coverage.
I called the company and told them this and they were over joyed, as it was a self insured company and the employees provided the pool of money. There was no problem, PFL picked up the cost, as they are my primary insurance company. The cost was $397,000.00 for the operation, MEGA PFL paid everything, that was covered. To say the least I was very happy with the company and though my rates are almost $700 per month for just my coverage, I recommended them to everyone.
Now they have decided that they are no longer my Primary Insurance Carrier, that my wife's coverage from her job is primary, medicare comes second as I am on SSD and Mega PFL is third.
How can they do this, they have been my primary insurance since 1986, my wife has had many jobs, no guarantee this will last.
This was all done with out my knowledge except the billing person at my Primary Doctor mentioned this when she was trying to refund money to Mega PFL. This has to be the biggest rip off and I am sure highly illegal.
They are doing it because all my wife's company had to do is deny the claim and it goes to Medi Care and then PFL. I am not 65, no where near that. So all PFL would have to pay, is what Medi Care did not pay, at the Medi Cares rate of about 37% of a Doctors normal charge. What a scam and a terrible thing to do for those who need Medi Care.
I intend to contact Medi Care Fraud Department as this was all done behind my back and I am not even required to keep the Medi Care, it's just an option and Medi Care has never paid a dime. With 2 other insurance companies ahead of them. I think this is collusion between the two companies to with hold payments on care and medications that I need, turn it over to Medi Care and MEGA PFL only pays what little Medi Care does not play.
I must say I am surprised, not all that much, but still surprised, as MEGA PFL has paid for the things they were responsible for till now. As I read through their list of problems, I remember back to the interview with the agent. She was brand new and I had to reminder her there were a couple of questions she could not ask.
I figured if I was getting pushed around, so must others be experiencing what I am today. I am shocked, but pleasantly at the agents that have come forward to say how this company does business now and reveal how it acts and operates behind the scenes.
This takes courage, that is so lacking in most people today. Their saying that they were duped and told false promises and not kept up date on their policies by the company they were selling for. This takes courage to admit you made a mistake in life and come forth to warn others. That is inner strength.
I only wish I had kept track of the company, with the rate increases I would think they were happy, but it is clear their has been collusion among the 2 insurance companies and I will be the loser. If any one knows about this happening or if they can do it with out notification, I would appreciate it. Also how to get to the people who make the decisions, I do not want to spend days going through the phone tree. This will really hurt me, I just don't see how they can assign positions, when I have been with them for 21 years and they have always been my first insured. Then swap with another company and assign a government benefit Medi Care at the second position. Who gives them that right. Now they say where the Government will pay
Any help or ideas most kindly requested and accepted. They sure have changed since 86.
Geoffrey
Big Lake, Alaska
U.S.A.
3 Updates & Rebuttals
Geoffrey
Big Lake,Alaska,
U.S.A.
Mega Life and Health Insurance Richland Hills Texas, made the choice for me.
#2Author of original report
Tue, November 06, 2007
Mega Life and Health Insurance made this choice for me. I never elected to have Medi Care benefits, I did not need them, I had 2 insurance companies. Mega Life and Health was always my Primary Insurance company since 1986. I am not over, or even close to 65 years old. Some how I just ended up on MediCare. Something I opted out of when offered, I could use the cash better then the no coverage that medi care provides. I don't know how this happened but just got a letter from my wife's insurance, saying Mega Life and Health wrote them saying they were n ow first in line, medicare was second and Mega Life and Health was now 3rd. In other words now a Medi Care supplement insurance policy, as they will not pay anything past what Medi Care covers. So my suggestion is to read the policy and sit down with an Attorney in Insurance Law and see what is going on before you sign. Now most Attorney's looking at these will say, this is what the courts are for, but they may point out some hidden traps. Mega Life switched everything around and I got on medicare with out signing a thing. So the rebuttal that they had do this, holds no valid ground. Things were changed with out my knowledge and signatures. This seems wrong to me and I basically am paying $700.00 a month for a medicare supplement policy. I would not care if Mega Life and Health went second as they are catastrophic policy. However this kind of change came out their office , not me signing up for Medi Care. Seems like a good way to maybe get rid of a long time buyer of their products, who may have future problems as I age. I paid a lot of premiiums, recommended this company for 20 plus years now I think some kind of wrong actions may have occured and will take some investigating. Proceed with caution with this company is my recommendations.
Miss C
Chesterfield,Missouri,
U.S.A.
The company was following Medicare's guidelines.
#3Consumer Comment
Mon, November 05, 2007
Because you are disabled, Medicare is the one who determines who pays primary. Your spouse's insurance would be primary if you are over 65 & her employer has over 20 employees or if you are under 65 & her employer has over 100 employees. Medicare states this in the coordination of benefits section of the Medicare & You book. This is not a policy determined by your insurance company. If your wife loses her job or changes her employer, then, this change in circumstances may change which insurance is primary.
Frank
Jay,Maine,
U.S.A.
Drop Mega Quick Quick Quick
#4UPDATE EX-employee responds
Fri, June 15, 2007
I worked for a short time for UGA Field Services which sold Mega Health. When comparing it with Anthem it is a scary experience if you are on the Mega holding end. It has more holes in it than a seive. Get out of it as quick as you can and get into a reputable company.
