Complaint Review: Mega Life & Health Health Market Systems NASE Americans For Financial Security - North Richland Hills Texas

I had a BC/BS policy and was perfectly happy with it, except for the cost, of course. In July 2007, I was contacted by an agent of Mega Life & Health, R.C (his initials). He told me that Mega replaces more BC/BS policies than any other carrier because the Care One Value Plan Mega has to offer is so much better and more reasonably priced. Mistake #1: I scheduled an appointment with him. As others have said, he wrote some numbers done on a piece of copy paper as he talked but after he left, unless you remembered what the numbers meant, that piece of paper was worthless. He did leave me with a pamphlet on Global Emergency Services and a Motor Plan. He did not leave me with one written word about the plan or it's MANY restrictions. What he did explain was that I was getting a comprehensive major medical plan for my family of four. Even though I was getting a $3,000.00 deductible, compared to the $2500.00 I have with BC/BS, he said the cost savings would easily make up for that. Mistake #2: I wrote him a check and he was on his way. Dumb me, why would I pay in advance before a final rate had been determined.

About three weeks later, I received a call from the office of my son's orthopedist. He has had a prior back surgery and Mega needed records. That I expected. However, they had submitted the wrong form to the office. RED FLAG!!! The office faxed me the appropriate form, I signed it and returned it right away. WEEKS pass.nothing. Late August I called MEGA to inquire. I was told that they had not gotten the records because my son did not sign the release himself. What? Hes a minor. RED FLAG!!! I made multiple calls between MEGA and the copy service they use. The copy service said MEGA had not paid their invoice which is required before records are copied. MEGA says they did not have an invoice. Back and forth, back and forth. NO ONE took responsibility for getting these records. RED FLAG!!! I called the agent several times. I plainly told him that I was not at all happy with this customer no-service but he did NOTHING. RED FLAG!!!! Finally, in late September I receive a letter telling me that a policy had been issued and would be coming under separate cover but my son would not be covered because the medical records were never received!!!! What the heck? RED FLAGS EVERYWHERE!!!!!!

Early October I received a policy that covered three of us. My daughter takes Adderall for ADD so MEGA placed a rider on her for pharmacy and Emergency services. Since when does someone with ADD frequent the ER!!!!!! According to the agent, the rider is only a few dollars a month, but the premium was still the same as it was when my son was included. I admit that knowing that my son was not covered, I did not immediately review the policy with a fine tooth-comb. That was Mistake #3. I called the agent and MEGA. I explained to both of them that I would not be taking this coverage if my son was not covered. Within 3-4 days I received a call stating that the records had been received and my son would be covered with the exclusion of his back. I was quoted a new premium but I really can't remember the figure. At this point, it is irrelevant.

With the new premium I took time to review the policy. THANK GOD I DID. I am a nurse, so I know a bit about health care, particularly, outpatient services and their cost. After I highlighted the MANY weaknesses of the plan I called Mr. Crawford to tell him that this was just not acceptable. He acknowledged that Mega knew there weaknesses in the Value plan and then proposed that I review their new Care One Plan, which is supposedly much better. He never once asked if I had cancelled the Value plan nor did he tell me that I needed to.

Here are the problems I found with the policy: CRAPit's so full of holes, limits and exclusions, I don't have time to dig through it. I will admit, they much prefer in-hospital care over out-patient services. I guess that's because with today's technology, most services are provided as outpatient. Again, a way for them to avoid paying.

I'm just glad I wised up before I lost too much money or really needed health insurance.

COMSUMER BEWARE.

Mary

Kinston, North Carolina

U.S.A.