Have had extensive experience With NASE/MEGA and none of it pleasant. After cancer diagnosis, my surgeon was called by their Rep and told they were sure it was pre-existing condition and they would be investigating and not expect payment. Surgeon informed them he had just diagnosed it and how could it possibly be a prexistant condition. MEGA still insisted and even after several phone calls maintained their position.
I used retirement benefits to guarantee payment for the services which MEGA did eventually end up paying. Their 2500 deductible/year is in fact a 2500 per hospitalization X 3 so since I was hospitalized 4 times that year I finally met the deductible on the fourth admission.
I defy anyone but a lawyer to be able to interpret this in their policy and it certainly wasn't presented this way upfront. Their policy also denies claims for lab and x-rays unless within timelines of an admission so any diagnostic testing is on your dime unless you are in or going straight into the hospital. CT scans being standard tests for cancer run 3000.00 ea and certainly are not encouraged or paid by MEGA unless hospilized.
They state hospital board and room are 100% coverage but when the statement comes they break out board and room on the bill and apply your deductible to this leaving you with a higher amount of the cost since you gain nothing from the 100% coverage.
I could go on and on but the short version is after about 80000.00 in cancer treatments, hospitalizations and surgerys NASE/MEGA paid about 20000.00 leaving me the rest which I am still paying off out of retirement and social security disability benefits 3 years later.
Needless to say we disenrolled took the rest of my family to another policy and put myself into VA care system just to keep from being bankrupted or worse to pay medical bills. As this was going on rates were being increase 2X/year at 45.00 each time This is not a company I would recommend anyone to do business with. I learned my lesson from these people.
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