Mega Life&Health: Read Before Signin
Attention self-employed folks: Before patting yourself on the back for finding that deal with Mega Life & Health for health coverage, think twice, put the pen down, sign nothing and step back.
Anyone reading this blog for any length of time knows I have no great love for health insurers. I believe they bend backwards as far as possible to avoid paying claims while hammering their policyholders for more and more money. One of the primary reasons I supported Barack Obama for President was his promised pragmatic and transparent approach to health insurance.
With that bias disclosed, I have this to say about Mega: There is a special place in hell for insurance companies that victimize individuals who are forced to pay far too much for far too little, especially self-employed individuals who struggle daily to stay above water, much less tread it.
This all started with a friend's recent onset of chest pain. It continues, and without going into detail that would maybe violate privacy, it should have been resolved already. After all, if one pays exhorbitant premiums to insure for potential catastrophic health conditions, it stands to reason that chest pain is something that should be viewed as an emergency, right?
Maybe it's not a heart thing. Maybe it's one of a zillion other things, but without actually getting to an emergency room and being hooked up to an EKG there's not much chance of knowing for sure. Heart attacks don't exactly wait until the appointed time to threaten one's life, after all.
Only one problem: Under one of the weirdest provisions I've ever seen in a health insurance policy, if someone goes to the ER and pays for it themselves (because ER services aren't covered), there is a risk that treatment for the diagnosed condition won't be covered.
That's a problem. So instead of being examined, put on that EKG, monitored and diagnosed, another day goes by before getting to an approved non-emergency provider.
Chances are it'll all be fine, but would YOU willing to roll the dice on that? I wouldn't. If chest pain isn't a potential life-threatening emergency I can't imagine what would qualify. Death? Coma?
This is not cost management. It's not case management. It's flat-out profiteering on the backs of hard-working people who pay premiums with a good-faith expectation that claims will be paid and benefits available when they need them. Insurance is not a charity; it's a contract between insurer and insured. In Mega's case, it seems that they view it as one-way: Insured pays; they withhold or deny.