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
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