In December we were visited by an agent from Mega Life & Health, given a quote for insurance and stated that we would need to join the NASE in order to obtain this coverage. We were told everything about the policy except we were misled about the deductible.
We were told that the deductible was $2500 period. However, the deductible was $2500 per occurance... Not per year. We only found this out after I developed Sciatica caused by 2 Herniated Discs in my spine.
The MRI cost over $1100, the doctor fee was $275 for one visit and $75 (I think... Haven't gotten the bill yet). They did not pay any of this due to the deductible. Okay, right?
Based on the MRI results, I had to have two (2) Epidural Steroid injections in my back. The first one on May 1st and the second one on June 6. Each injection cost $1,348.75 for all the outpatient hospital charges.
Between the 2 injections, my wife and I had been reviewing the claims for all of our doctor and dental care, and were considering cancelling our coverage with Mega Life & Health. After doing some research (checking this web site, complaint, and the Better Business Bureau, 312 complaints in 36 months) we decided to cancel our policies.
On May 30 we sent Mega Life & Health a letter cancelling the four (4) policies (PPO plan, Accident plan, Dental Plan & Vision Plan). We sent this letter by Certified Mail, Return Receipt. They signed for the letter on June 1. My access to the Mega Life & Health web site has been closed by them.
Additionally, on May 30, I went to the bank and placed a stop on the automatic draft of $594.00 (this cost us $20). I did this because of what I had read on this report and the Better Business Bureau report. I thought this would take care of the situation. WRONG!!! * (See paragraph after the next one.)
In the meantime, I went to have my second injection on the 6th of June and found out how much they cost (since the insurance company had not paid anything on the first one... They are treating the injection as another occurance when it is in fact treatment for the diagnosis from the MRI). I had not received any information prior to this. I had to pay $300 towards my bill before they would allow me to get this second injection.
*The original draft was for $594.00 on the 6th of every month. Guess what they did... They changed the amount to $554.00 and drafted my account last night. It went through.
In my opinion, this is BANK FRAUD. Just plain THEFT. I am going to my bank when it opens today to see what they can do for us. Does anyone know if we can or should take legal action? Should we sue them for Fraud, Hardship and Mental Anguish? Or is it even worthwhile?
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