The lastest wrinkle in our story is the mystery of the California Department of Insurance. We wrote to them several months ago, complaining about how Mega had applied our deductible. We had written to Mega, and didn't seem to be getting anywhere. The California Department of Insurance said they had no jurisdiction over Mega, and sent our complaint to the Alabama Department of Insurance. We received a response from Alabama, saying that that health insurance is federally regulated, and they had no jurisdiction in the matter.
Oddly, Mega, in their letter to us, cited our inquiry with California. The department had indeed sent them a letter, even though California stated to us they had no jurisdiction in the matter.
We later found out Mega doesn't have any office in Alabama, so why was our complaint sent there?
It's all very mysterious........
Saturday, September 22, 2007
Thursday, August 16, 2007
Will Wonders Ever Cease?
Received a letter yesterday from Mega. It seems we are the recipients of a "one time" consideration, and they are paying off the rest of our medical bills, and returning the $4,000 we paid to Mercy Air. We are wondering, what prompted all of this?
Their letter mentioned, "in reference to your inquiry with the California Department of Insurance". Could it be that Mega didn't want them looking too closely?
We are elated to have our life back, and to free of this nightmarish debt. Now if Stu's injuries would just heal........
Their letter mentioned, "in reference to your inquiry with the California Department of Insurance". Could it be that Mega didn't want them looking too closely?
We are elated to have our life back, and to free of this nightmarish debt. Now if Stu's injuries would just heal........
Monday, August 13, 2007
Hallelujah!
If I had any religious convictions, I would say "our prayers were answered". But I don't, so all I can say is "thank goodness". We received a statement today from Mega Life, they have paid our ENTIRE hospital bill!! It's all very mysterious, we don't have a clue as to what transpired. Could it be the current atmosphere regarding health insurers, something to do with the whole "Sicko" uproar??
The idiot's insurance finally paid us our settlement money, MINUS a small amount for the idiot's girlfriend, who claimed she suffered some sort of psychological damage. What a bunch of crap! I remember her at the accident scene, screaming her fool head off. It wasn't anyone she knew lying on the ground! I finally had to tell her to shut up. Judging by her appearance, she was damaged goods before this ever happened. At any rate, the $ will come in handy, we still have several medical related bills to reconcile.
The idiot's insurance finally paid us our settlement money, MINUS a small amount for the idiot's girlfriend, who claimed she suffered some sort of psychological damage. What a bunch of crap! I remember her at the accident scene, screaming her fool head off. It wasn't anyone she knew lying on the ground! I finally had to tell her to shut up. Judging by her appearance, she was damaged goods before this ever happened. At any rate, the $ will come in handy, we still have several medical related bills to reconcile.
Saturday, August 4, 2007
Trying to Pay the Bills
We still haven't received our pittance of 10k from the idiot's insurance company. (This is what we call the guy who caused all of this). They've been playing games with us for months because we refused to sign their forms, absolving the idiot from liability forever, and I wouldn't sign their non-disclosure. They finally re-wrote the terms, and we signed the paper at least two months ago. Now they say the check got "lost in the mail". It sure would help to pay down the bills. The other two guys signed immediately, thinking they would at least have that money for all the pain and suffering of this mess. Instead, their health insurance companies "subrogated" the money. What does "insurance" mean, if they get to pay themselves back out of your settlement?
Stu negotiated with Mercy Air, and we settled our bill with them for $4,000. He did a great job with that debt, they took less than half of what we owed them. Now if everyone else would be co-operative, maybe we could get these smaller bills out of the way.
We still haven't heard back from Palomar Hospital about our offer. Don't know if that's a good sign, or a bad one.
Stu negotiated with Mercy Air, and we settled our bill with them for $4,000. He did a great job with that debt, they took less than half of what we owed them. Now if everyone else would be co-operative, maybe we could get these smaller bills out of the way.
We still haven't heard back from Palomar Hospital about our offer. Don't know if that's a good sign, or a bad one.
Monday, July 23, 2007
The Argument for Universal Healthcare
I always look forward to reading Jane Bryant Quinn's articles in Newsweek. This one really hits home for me.
http://www.msnbc.msn.com/id/19886686/site/newsweek/
http://www.msnbc.msn.com/id/19886686/site/newsweek/
Friday, July 20, 2007
More Pictures of the Accident
I finally posted pictures from the accident scene on Webshots. Here's the link. http://community.webshots.com:80/user/krnsu100?vhost=community
Wednesday, July 18, 2007
Another Thorn in Mega's Side
I picked up this week's issue of People Magazine, there was an article on the cover that caught my eye. Lo and behold, there's an article in this week's issue mentioning Mega Life, about them screwing more people. The timing of this article is perfect! I hope the bad publicity drives them out of business.
Monday, July 16, 2007
Suing Mega Life
While I was scouring the web, searching for articles to investigate Mega Life and their deceptive sales practices, I found an attorney. He had successfully sued our insurance company for fraud on behalf of a local woman who was left with $450,000 in unpaid bills. We contacted him last week, and went to West LA to see him today. We came away from the meeting with great hopes of getting our bills paid, he's pretty confident that he can win our lawsuit.
On top of that, the woman he won the lawsuit for was on Larry King Live last Friday night, blasting Mega Life and Health. I hope lots of potential victims will be spared the agony that we experienced.
On top of that, the woman he won the lawsuit for was on Larry King Live last Friday night, blasting Mega Life and Health. I hope lots of potential victims will be spared the agony that we experienced.
Saturday, July 14, 2007
Our Story, and a breakdown of the bills
We had group health insurance from Blue Cross, and the premiums were rising beyond what we could afford. I was receiving junk mail from the NASE, targeted towards small business owners. Their literature mostly touted their low cost group health insurance. I called the phone number, and a salesman came to our house in April of 2003, within a couple days of the call.
I told the salesman that we were looking for some sort of catastrophic, high deductible plan. We could cover our smaller expenses like doctor visits and routine care ourselves. I showed him my Blue Cross policy, and asked him what kind of price Mega would charge me for the same coverage.
He told me that Mega could sell a comparable policy for a lower price because of the fact that they only sold insurance to “healthy” people. He told me about the 1 million dollar lifetime benefit, which seemed adequate in 2003. What I didn’t notice, (or know anything about) was that there was no annual cap on what we would be paying out. I have since read many different companies policies, and now realize this is probably the most important part of any health insurance policy. I didn’t know much about buying health insurance before this happened to us.
It was only when my husband was in the trauma center that I realized what a horrible mistake I had made in signing up with Mega Life. A day after he was admitted, the finance lady from the hospital came to his room and told me our insurance was worthless, and that we were basically uninsured. I was absolutely stunned. She informed me at this point that we were “cash” patients. Little did I know at that time of the consequences of her statement. Cash patients are charged a lot more than ones that are properly insured.
About 4 days into his stay, the case manager of the floor took me aside. She urged me to get Stu out of the hospital as soon as possible, because we could not afford care there. She told me that the room charge alone was $1600 per day, and that Mega would only pay $500. (I later found out the room was actually $3642 per day). She suggested I find a nursing home or rehabilitation unit to place him in, because he was going to need intensive rehabilitation. She called Mega Life, and relayed to me that Mega doesn’t pay for any nursing home care or rehabilitation. We couldn’t afford to place him anywhere.
After 6 days, the surgeon that repaired Stuart’s injuries informed him that they were releasing him. I rushed home to rent a hospital bed, a wheelchair, and the necessary bathroom supplies. I had to buy him a walker, because he would not be able to walk unassisted. I also had to buy him a special leg brace before he could leave. None of this was covered by our policy. Up to this point, Stuart had never been out of his hospital room, the physical therapist did manage that day to physically prop him up in a walker. He was basically non-ambulatory.
I rounded up a friend with a van, and picked Stu up. With a hospital attendant helping, it took all three of us to lift him into the van. When we arrived home, I had two more big men there to lift him out of van and into the wheelchair, and help get him into bed. Thank goodness for wonderful friends.
I spent every waking hour of the next few months taking care of him. I now understand how people who are caretakers have such a hard time. It is exhausting, trying to take care of someone else’s every need, and take care of yourself at the same time. There were days when I didn’t get a chance to brush my own teeth or hair until noon.
Stu didn’t get any rehab, which resulted in him healing slower than he would have. We just couldn’t afford it. We’ll never know if he may have had a better outcome from his injuries with proper care.
I felt like such a fool for buying this lousy insurance that left us in such bad shape. I have since read dozens of stories on the internet, written by people who bought into Mega Life. Some of their stories are worse than mine.
Here's what we ended up with in unpaid bills after
insurance :
Palomar Medical Center $60,381
Mercy Air $10,309
Emergency Physicians $200
Anesthesia Consultants $551
North County Trauma $770
Valley Radiology $1151
Orthopedic Surgeon $1600
Total $74,962
I told the salesman that we were looking for some sort of catastrophic, high deductible plan. We could cover our smaller expenses like doctor visits and routine care ourselves. I showed him my Blue Cross policy, and asked him what kind of price Mega would charge me for the same coverage.
He told me that Mega could sell a comparable policy for a lower price because of the fact that they only sold insurance to “healthy” people. He told me about the 1 million dollar lifetime benefit, which seemed adequate in 2003. What I didn’t notice, (or know anything about) was that there was no annual cap on what we would be paying out. I have since read many different companies policies, and now realize this is probably the most important part of any health insurance policy. I didn’t know much about buying health insurance before this happened to us.
It was only when my husband was in the trauma center that I realized what a horrible mistake I had made in signing up with Mega Life. A day after he was admitted, the finance lady from the hospital came to his room and told me our insurance was worthless, and that we were basically uninsured. I was absolutely stunned. She informed me at this point that we were “cash” patients. Little did I know at that time of the consequences of her statement. Cash patients are charged a lot more than ones that are properly insured.
About 4 days into his stay, the case manager of the floor took me aside. She urged me to get Stu out of the hospital as soon as possible, because we could not afford care there. She told me that the room charge alone was $1600 per day, and that Mega would only pay $500. (I later found out the room was actually $3642 per day). She suggested I find a nursing home or rehabilitation unit to place him in, because he was going to need intensive rehabilitation. She called Mega Life, and relayed to me that Mega doesn’t pay for any nursing home care or rehabilitation. We couldn’t afford to place him anywhere.
After 6 days, the surgeon that repaired Stuart’s injuries informed him that they were releasing him. I rushed home to rent a hospital bed, a wheelchair, and the necessary bathroom supplies. I had to buy him a walker, because he would not be able to walk unassisted. I also had to buy him a special leg brace before he could leave. None of this was covered by our policy. Up to this point, Stuart had never been out of his hospital room, the physical therapist did manage that day to physically prop him up in a walker. He was basically non-ambulatory.
I rounded up a friend with a van, and picked Stu up. With a hospital attendant helping, it took all three of us to lift him into the van. When we arrived home, I had two more big men there to lift him out of van and into the wheelchair, and help get him into bed. Thank goodness for wonderful friends.
I spent every waking hour of the next few months taking care of him. I now understand how people who are caretakers have such a hard time. It is exhausting, trying to take care of someone else’s every need, and take care of yourself at the same time. There were days when I didn’t get a chance to brush my own teeth or hair until noon.
Stu didn’t get any rehab, which resulted in him healing slower than he would have. We just couldn’t afford it. We’ll never know if he may have had a better outcome from his injuries with proper care.
I felt like such a fool for buying this lousy insurance that left us in such bad shape. I have since read dozens of stories on the internet, written by people who bought into Mega Life. Some of their stories are worse than mine.
Here's what we ended up with in unpaid bills after
insurance :Palomar Medical Center $60,381
Mercy Air $10,309
Emergency Physicians $200
Anesthesia Consultants $551
North County Trauma $770
Valley Radiology $1151
Orthopedic Surgeon $1600
Total $74,962
Month # 6 of the medical economic nightmare
An underinsured driver turning left caused all of this.
Stu (my other half) was in a motorcycle accident (more like "explosion") last January. He's been riding for forty some odd years, he's no rookie. We had health insurance, didn't give finances a second thought. We were sure we were covered. After all, didn't I buy a "major medical, catrostrophic" policy from the nice NASE (National Association for the Self Employed) salesman?
How did we end up with over $74,000 in unpaid medical bills? I'll tell you how, we had a Mega Life and Health policy.
When the bills started coming in, it wasn't much of a surprise. The hospital financial advisor from Palomar Pomerado Medical Center told us on day 2 of the 6 day stay that our insurance was worthless. That's when we found out what being a so called "cash" patient was all about. Cash means they charge you 10 times what an insurance company would pay them. Our bill from the hospital alone was an astounding $79,700. That's $13,382 per day.
Thank goodness for the internet. Hours of research led me to hospitalvictims.com . I emailed them with our problem, and they immediately responded. A woman named Maureen called the next day, and we talked for a long time. She said she had other cases with the same combination of our hospital and insurance company on her desk. She asked me to send her the bill, and she would have it analyzed.
Within a week, we had the results. Their philosophy is, Medicare plus 25% is adequate payment, backed by the testimony of experts before Congress. The determination was that Medicare would have paid the hospital $4490.85, so our payment should be a total of $5614.
How did we end up with over $74,000 in unpaid medical bills? I'll tell you how, we had a Mega Life and Health policy.
When the bills started coming in, it wasn't much of a surprise. The hospital financial advisor from Palomar Pomerado Medical Center told us on day 2 of the 6 day stay that our insurance was worthless. That's when we found out what being a so called "cash" patient was all about. Cash means they charge you 10 times what an insurance company would pay them. Our bill from the hospital alone was an astounding $79,700. That's $13,382 per day.
Thank goodness for the internet. Hours of research led me to hospitalvictims.com . I emailed them with our problem, and they immediately responded. A woman named Maureen called the next day, and we talked for a long time. She said she had other cases with the same combination of our hospital and insurance company on her desk. She asked me to send her the bill, and she would have it analyzed.
Within a week, we had the results. Their philosophy is, Medicare plus 25% is adequate payment, backed by the testimony of experts before Congress. The determination was that Medicare would have paid the hospital $4490.85, so our payment should be a total of $5614.
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