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(*note added 2007 - this blog entry was posted in Aug ‘05, and has taken on a life of it’s own. It’s amazing how many people are wary of Mega) - Today, someone emailed me and asked me this - Obviously I noticed your posting on megainsurance. Here’s my answer -
Well Jeff, here’s the scoop. Playing the odds for most people, the insurance is not really that bad. BUT, just knowing theres the tiniest possibility that someone you sold to, (or worse yet, someone you know & love), actually does develop diabetes, or needs an organ transplant, or develops any cancer, or anything really bad, and you won’t sleep at night unless you stick your head in the sand. On Mega Life and Health, there’s no “maximum out of pocket”. That’s the key ingredient missing. 80/20 on a $75k hospital stay, after your $5,000 deductible can set you back 20 grand or more! And if it’s a quarter million or more incident? forget it, you’re bankrupt. Take a Mega health policy to your current (or any) competent agent and ask them what’s wrong with it. If only I had done that first! You know, I actually asked for one over and over, and never did get one to look at until my own came in the mail. By that point, I was selling it and making money, so who cared? To have saved some families a few bucks a month, but knowing it could cost them $55,000 on a $90,000 hospital bill is horrible. The only consolation was that once people found out how it worked, they left. I’m so glad none of them kept it very long… None of my customers ever called me like that, but I saw two good sales people get devastated by calls like that and leave in two months, right after I was the “Rookie of the year” in my district. As soon as I learned what we were really selling, I just quit producing. Then I was dead weight for a few weeks and finally left. Those that are successful actually believe the product is as good as anything else out there, and that all insurance has limits. Well, that’s true, and playing the odds, this insurance is not that bad. 90% of all hospital bills are still under $50k . That’s not a chance I was willing to take. The thing is, I think they just don’t know what they’re really selling and they don’t know the competition. They only know what they’re told, because none of them was in the insurance business before. It wasn’t until I went to a general agency for 4 months that I saw how REALLY full of other holes Mega was. Plus, I had been made to look stupid. ..That was the final straw. I had to stand there while a customer called their insurance company and proved me wrong, calling me a liar. I was told many times that “Fortis doesn’t cover you for injury on the job if you’re self employed” and that was a big selling point for business owners. I always mentioned that sentence in my sales pitch because people were shocked. Today, I’m with Fortis for coverage that’s tons better, 6 million limit, and has a $2500 per incident 100% accident rider, and a maximum out of pocket of $8000 in any calendar year! That’s even for a heart transplant! It’s amazing what you learn selling insurance… At Mega, when a client got hammered, the bosses would just say “Well Scott, all insurance has limits. The facts and coverage are laid out for the customer to read, and they could have canceled before she had a stroke and lost their home…” Well that’s true, and that’s why it’s a legal business, but that doesn’t make it right. I really hated the insurance business anyway. * Update 2007 - |
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I just met with a person who attempted to sell me a policy via NASE/Mega. What should I look out for? It sounds like a good deal, but your post made me a little sceptical. Any information would be greatly appreciated.
Well Nick, ask them this question…
On a $60,000 hospital stay, (a week inpatient with a minor surgery) what’s your maximum out of pocket?
And, on a $250,000 catastrophic hospital stay, like a transplant etc, what’s your maximum out of pocket?
Then make your choice from there…
I asked our insurance salesman about this because we are planning on signing up for Mega Health Insurance. He said we would have to pay the $5000, but that would be all of our expenses. He did say that some plans still have the 20% that you continue to pay. I believe our plan is the Preferred Member Plan. Have you heard of this?
Well that was my only gripe about Mega. They had NO maximum out of pocket.
the plane was great on the surface…You pay for all the little stuff, and then if something big kicks in, you pay your deductible, plus 20%. A 50k surgery leaves you out 10 grand plus your deductible.
I don’t know what state you’re in, but a plan that leaves you out of pocket only $5000 for a heart transplant is right there, and sounds livable. (also hard to believe it’s Mega)
When I was with Mega in Oregon they had nothing even remotely like this. Just a 1000, 3000 or $5000 deductible, THEN 20% of the bill up to the policy maximum coverage, 1 million dollars.
I’d read carefully concerning your “maximum out of pocket per person in a calandar year”. If you don’t see that, I’d run like the wind!
Thanks so much for your advice. We were so relieved after meeting with our insurance salesman because right now we have Priority Health and it’s getting too expensive for us. Of course, after reading your postings I’m very unsure of what to do. We haven’t been officially accepted into Mega yet, but if we are we will look over the paperwork closely. Thanks again.
I’m an insurance agent in Portland, Oregon, and I talk to people all the time who have Mega. Those who haven’t had a claim sometimes don’t know how bad it is, while those who have do. If you want to know your insurance options in oregon, give me a call.
1-800-259-0455-ext 129
What about Assurant. I am looking for insurance & had a mega salesperson pressure me to sign up now. It sounded good, but I wanted to investigate first. Just found your web site & glad I did. I will call the agent & ask about max out of pocket. In the mean time I saw a commercial for Assurant. Went to their web site, but would like your opinion. Thanks
Hi Kathy -
Assurant is a new name for one of the oldest (if not THE oldest) health insurance copmpanies around…Fortis. In Oregon, my own families health insurance is through Fortis, and there simply is no better or less expensive option (again, i’m speaking about Oregon).
That said, it is a bit harder ot qualify for Fortis, but everything from their generous plan limits to the timeliness of payment has been exactly as advertised. I’d rather fight than switch!
Kathy,
Just so you know, Fortis was Assurant’s old name. It is the insurance organization that I most highly recommend because, simply put, their plans are very strong, and usually more affordable than other carriers in Oregon. One reason for this is that in Oregon Assurant only underwrites non-smokers. While this limits the pool of potential insureds, those who are able to qualify are usually in better health meaning that they don’t have to charge as much.
Oregon is what’s known as an accept of decline state, and by law an insurance company is not allowed to “rate up” specific conditions like smoking. The consequences of this law is that lower-risk non-smokers essentially wind up subsidizing the premiums of smokers since both pay the same rate. From an insurance companies standpoint, the only way out of this is to not cover smokers which is exactly what Assurant has decided to do.
If you or any one else wants to know more about how to lower your premiums and also get better coverage, drop me a line: danielrluke@comcast.net
Daniel is correct. I really like Assurant (formerly Fortis)
By the way, I still do have a small dog in the insurance fight here at http://www.oregonhealthinsurance.net where you can get free health insurance quotes for any state in the US and look into Ameriplan.
If you’re in Oregon, give Daniel a call! Daniel, you should take a look at my Ameriplan pages there, please. Your customers might really benefit, and so might you! And thanks for posting here…
My wife signed up for Mega last week. The salesman said she could have her $409, first month payment and the $125 “administration” fee back (refunded)if she cancelled within 10 days of acceptance by Mega, is that true in your experience? The more I learn about NASE/Mega the more leary I am. thanks for the help.
It’s true in Oregon, but I can’t speak for other states. Actually, I think it’s 5 days if I remember right (It’s been a long time). You can still cancel though by not paying and look for other insurance right away.
I’d take the money back if you can and run like the wind. Always ask this question before signing up for healt hinsurance…”What’s my maximum out of pocket in a calendar year?” You might find that bargain insurance is anything but a bargain.
HRA 105 youright the out of pocket expenses off this is greatinsurance if you know how to use it.
I currently sell MEGA in Oregon and have not one negative event to relate. Most of the points made on this ‘blog’ are nonsense. Also, for an insurance agent to make false or misleading statements regarding another insurance company is a crime, I prefer not to do business with criminal insurance agents. Virtually every statement listed is wrong. I will give a full product presentation to anyone, anywhere in the State of Oregon and disprove every lie on this site. I write in excess of $500,000 in individual insurance applications per year in Oregon, and have done so for several years. Any agent making these ridiculous statements or any non-agent ‘guessing’ is welcome to call me for an educational journey through the maze of lies and misstatements contained in these postings.
To all agents whose lies are posted, please call me any time, or, if you prefer, remain in ignorance and stupidity if that better serves your personal needs, Mr. or Ms. lying insurance agent. Call Michael 503.207.5551, come on, and dial the number, I dare you.
Well, Michael called me, and he sounds like a sincere and honest guy. However, he truly believes Mega to be a decent product, and we had a heated discussion. He takes particular issue with the following points I made -
1. I said “there is no stop loss or OOP (out of pocket) maximum with Mega”. Michael claims that all the others that say they have a stop loss or OOP max are lying, because there can be exclusions that can not be covered in the stop loss or OOP max. Well, I’ll give him that, but I’d still rather have a stop loss and OOP max with some exclusions than nothing at all like Mega offers.
2. He claimed that my own insurance company, Fortis, does not cover people hurt on the job. Funny, that’s the same way I was trained at Mega, and I’ve verified that to be totally false. It was always the eaiest way to roll self employed people off of Fortis, until I found out it was not true.
3. He claims that if you get cancer or another illness, your health insurance company (in Oregon) can raise your rates or choose not to renew you. I say that’s just not true, and I encouraged him to call the insurance commission and verify his facts. I believe they cannot do that to you. IT”S ILLEGAL in Oreogn! If I’m wrong, someone please correct me.
In Oregon the insurance commission is at 503-947-7980 and the website is http://insurance.oregon.gov.
On the Oregon insurance commission website is the “Consumer Guide to Insurance Complaints”
In it, it says this, -
“A complaint index of 1.00 is average. That means the company’s share of confirmed complaints is equal to its share of business in Oregon. A complaint index of 2.00 means the company’s share of confirmed complaints is twice as large as its share of business.”
Out of ALL the insurance companies listed, Mega is rated the second worst for 2004 with 7.56. That’s 7 1/2 times more complaints than their fair share.
In 2003 it was the third worst at 12.43 and in 2002, it was the second worst with 8.79. Wow! I think I rest my case, Michael.
In the interest of full disclosure, Fortis was rated worse than Mega in all three of those years with a higher “complaint index”. I’m surprised by that, and have been real happy with them, but the facts are indisputable.
For those who like to live on the river De’Nile an imaginary stop loss is comforting, until the bills show up. Custom products require honest, informed, caring agents who strive to build plans that fit the needs of their clients. Not all products are right for all people. All plans offered throughout the U.S. have holes in them. I use statistics and client need to design plans that best fit. When a good fit does not materialize, I recommend alternative sources for coverage. I do this on a daily basis.
I do not discuss other insurers or their products with potential clients, in fact; I have not once in three years even looked over a competitor’s policy with a client (to reinforce my point). All info shared with the public (via licensed insurance agents) regarding insurance sales requires prior approval from the licensing authority in the state of business.
Thank you Scott for having the courage to stay on the phone with me for so long, I know it was unpleasant for you at times. My only motive in life is to seek the truth in all things and I enjoyed furthering that pursuit with you.
in texas nase/mega limits the dollar amount of ALL outpatient treatment… that is if nase agent even puts it on the policy… yes, that included cancer treatment and things like mri’s and cat scans… the limit is somewhere at 1000 a day… that wont cut it… they also limit doctor visits by number and dollar amount… have a crummy rx card and limit the amount of surgry and misc charges as well as a daily room rate for a hospital stay…. they recived much needed press in the wall stree journal in 2002 and a reprint in the local newspaper regarding the crooked practices of nase… they also have several class action lawsuits regarding their practices… the deductible in texas is per period of conf. vs. calendar year…. they are a joke
Hi,
I wish I had read this article before I landed in my bad experiences with NASE/Mega. The agent who came to my house repeatedly said that there was no fine print- that 100% would be covered by Mega for my wife’s preganancy related expenses. An example of one of the bills is : Approx 450 bucks is the total amount of which my liability is 389 bucks. There are some bills where out of 200+ , Mega has covered $23. Then there are classifications like “preventive is not covered” (even when the lack of treatment is fatal to the baby). My request to all who read this is - please inform your friends and relatives to keep away from this scam.
Scott is absolutely right in asking any MEGA sales rep to answer what the MAX. Out-of-Pocket (OOP) expenses, per calender year, could be.
ANY MEGA REP SHOULD BE REQUIRED TO CARRY THE SAME MEGA POLICY HE/SHE SELLS THE MOST . . . AND SHOULD NOT BE ALLOWED TO SELL IT UNTIL HE/SHE HAS RECEIVED A “REAL” HOSPITAL BILL FOR MAJOR/MINOR SURGERY, OR HAS A FRIEND OR RELATIVE WHO HAS RECEIVED A MAJOR/MINOR SURGICAL HOSPITAL BILL UNDER COVERAGE FROM MEGA LIFE/NASE.
Washington State’s Insurance Commissioner forced MEGA LIFE/UICI to “cease and decist” selling policies through NASE, due to massive complaints of “deceptive marketing practices.” THAT MEANS THEY ARE BANNED FROM SELLING IN THE WHOLE STATE ! ! ! MEGA LIFE was told it was required to revamp their marketing “tactics” and sales/policy literature before they can sell again. Ask Micheal to explain why, nationally, MEGA LIFE/UICI has had to “settle” a class action lawsuit covering the exact same fraudulent practices. And when they “settle” they’re not admitting to any “wrongdoing.”
The MEGA rep who is still selling, like “MEGA MIKE,” might say that there will always be a bad egg here and there, which is true . . . but one Florida MEGA/NASE regional sales manager was quoted as saying that she was told by her “superiors” to basically train agents to misrepresent, “gloss over,” or “not fully disclose” any gaps in coverage (exclusions in MEGA policies).
ALSO . . . MEGA “FINE PRINT” STATES A MAXUMUM BENEFIT AMOUNT . . . PER MAJOR/MINOR SURGERY OR CATASTROPHIC SURGERY. That means that if MEGA will only pay a maximum of $25,000 for open heart surgery, you pay the rest. In our case . . . the MAX. “surgical benefit” was $20,000, per event. They have the final say on what they consider “reasonable & customary charges” for any surgery or procedure, as far as what they will re-imburse. A HOSPITAL, SURGEON, LAB OR ANESTHESIOLOGIST CAN SEND YOU A BILL FOR WHATEVER YOU WERE “UNDERCOVERED” FOR (WHAT MEGA WON’T PAY), BASED ON WHAT THEY CHARGE. And the deductable is for a per-event basis(per hospital confinement), so if you have to have the same surgery or a different one in the same year, you have to pay your deductable again.
REMEMBER . . . a good insurance company will pre-negotiate all surgical/proceedural costs with hospitals/networks so that you only pay what has been negotiatied.
MEGA’s INPATIENT room charges benefits can also leave you seriously exposed to uncovered expenses, by 60-80%, unless you buy additional MEGA “RIDERS.” IT’S AS THOUGH YOU’RE EXPECTED TO GAMBLE ON WHAT MIGHT GO WRONG WITH YOU.
THE BEST WAY I CAN EXPLAIN A MEGA LIFE POLICY . . . is it’s like buying Swiss Cheese with all the holes in it. If those holes are all the things that could go wrong with your body, Mega wants you to figure out which problems you may face, in advance, rather than offering a policy that has fair coverage in all areas. Many of the former NASE/MEGA reps said even they didn’t know what they were selling, so they couldn’t begin to explain the heart of the coverage and its limits . . . or they do know what they’re selling, but they’re making too much $$$ to care.
My wife and I have lost at least $20,000 on UNCOVERED medical issues due to MEGA/NASE’s “lack of full-disclosure.” Remember that the plan they push the most, 98%, is what Mega calls a “Preferred Plan,” and it is the plan that leaves you the most exposed to Out Of Pocket expenses. It is the policy they make the most profit on, because it covers the least. It’s often marketed/explained as a MAJOR MEDICAL POLICY, but it’s only Basic Expense coverage.
Their marketing is driven by the fact that people are lazy, believe in people, and are too busy to read the “FINE PRINT.” These were our mistakes. Shame on us . . . but I still have the hand-scribbled coverage that the agent begrudgingly left for us on a piece of paper. He had no MAX. coverage literature to leave, and they are trained to not leave such documentation. I could go alot deeper into what we went through, and I have at least 100 pages of “FORUMS” from NASE Agents & Victims that can show you that MEGA & UICI don’t care about what happens to those who don’t read the fine print.
There may be honest MEGA agents out there, but the parent company, UICI’s, corporate culture is making profits by hiding behind these bogus, “non-profit associations,” like NASE, where they are bound by fewer regulations from each state insurance commissioners . . . and they are investing $$$MILLIONS in each state’s political arena, to persuade your congressmen/women & senators to loosen regulations for these “associations” even further.
The associations, like NASE, are lawsuit-proven “marketing arms” of MEGA LIFE/UICI. If they really cared about you, why would they only offer MEGA. WARNING: Other major insurance carriers have seen the profits UICI has made and are hopping on the bandwagon, buying up these “non-profit associations” to use for their own risky insurance plans. REASON: profits are so high, that a few class-action lawsuits here and there don’t offer enough of a penalty to keep them away.
We missed the fine print in our policy . . . like when my wife had to have one tumor removed from each foot, on separate occasions, and a benign tumor removed from her breast . . . all were OUTPATIENT SURGERIES. Small print = “Outpatient Surgery” covered to a maximum of $1,500, period. We had to actually start negotiating with the hospitals, through the surgeon directly.
This is what the insurance industry is coming to. They’re not in the business to lose money. YOU HAVE BEEN WARNED.
Lol,
I represent Mega now and fully go over coverages with my clients. The policies do have max out of pocket limits and do have riders that should be put on every plan for cancer etc.
Quit dogging a great company that is kicking the wind out of the old Hmo’s. I know for a fact that this company does not rip off anyone and if people would expect to pay for what they get they might not have any problems. Many times people want the cheapest but expect the most and that doesnt happen in insurance.
Using this site to sell your crap plans is so whiny its laughable.
Best of luck…
Well Todd, if you had actually READ all the posts here, you’d see that I’m not “using this site to sell my crap plans…”.
I’m actually using http://www.oregonhealthinsurance.net for giving people no oblgation health insurance quotes, but I’m not doing it here.
This is actually a blog where real people are posting their real experiences and opinions, and some are “pro” and some are “anti” Mega.
I suspect you’re just someone hired to go out and dispute the stuff online about Mega. Good for them. That’s what they’ve got to do.
However, for you to write “if people would expect to pay for what they get they might not have any problems” is pretty funny.
Yes, if only people realized that there’s no free fide in life, and salesmen might lie to make a buck, then they’d be disappointed a lot less.
If anyone wants more real people talking about Mega, look to this forum and search for “Mega” - http://insurance-forums.com
Scott I find it both amazing and impossible all at the same time that you are such an expert in the field of Computers, Technology, Cell phones, More and now Insurance??
Do you even sell insurance? What is your base of expertise built upon? If so, how do you ever find the time to do all of the above and also run this Blog.
Jack-of-all-trades, but master of none!
What a sad existence.
The MEGA office that I happen to work out of happens to give us strict instruction that we are not to say all of the very things that you accuse us of. Maybe you or some of your cronies did experience such un-ethical tactics. However, this abuse is rampant and runs wild in all insurance companies. Why? Because you and those that follow are all out for the same thing that all sales agents are after. A SALE!!
Why is it that MANY of the companies, the ones you speak of as being so GREAT, are being sued in the local area I live by 2000 physicians for using things such as “Reasonable” and pre-admission requirements as a cost cutting measures.
Why is it that all of these so-called great companies have a whole staff of lawyers working for them? You know how many work for MEGA? Only (1). Email me and I will give you his number.
The sad truth is that health care in America sucks and so do all of the insurance companies that represent it.
I have heard sad story after sad story from people that have been on all of MEGA’s COMPETITOR plans. If MEGA is part of the problem fine, however YOU ALL STAND HAND IN HAND WITH US!
Maybe you and all of your followers should actually go out and sell your insurance plans to those that need them instead of wasting your time BLOGGING and Dogging MEGA.
If the plans you sell are so good you wouldn’t be wasting your time worrying about what MEGA is doing.
-Brent
Missouri
There’s no reason to insult me personally, or the legions of people who feel they’ve been screwed by Mega.
I’m glad your MEGA office is so ethical, and I’m sure that when people buy a policy from you, they know what their maximum out of pocket will be for any incident. That’s great, and I’m sure you sleep well at night.
If you actually read what I’d written here and elsewhere, you’d have seen the answers to your own “questions”…
1. No, I don’t sell insurance anymore.
2. My expertise is based upon the fact that I DID sell insurance for Mega and was “Rookie of the year” in 2002 for my disrict in Portland because I believed in the product.
3. Answering a few posts is not alot of work. Amazingly, you Mega agents seem to be giving it a life of it’s own, and all the activity keeps bringing to the top of the search engines. Thanks!
4. Yes I agree that the whole insurance industry stinks, and that lots of companies do lots of unethical things, and routinely deny claims as “unreasonable”, and use deceptive tactics for sales, etc. and that’s why I left the industry altogether.
Now I have one for you…
If they’re so good, then why, in 2004, was Mega ranked by the Oregon Insurance Commission as having the second highest “compaint index” in Oregon of all heath insurers? A flook? and in 2003, and 2002, they were ranked the third worst.
It’s easy to find Megas compaint record in your statem, and see how they stack up, or the record of any insurance company. Just go to Google, and search for “insurance compaints state name” then find the report.
If the reports are .pdf files on your State Insurance regulators website, then use the “search binoculars” inside Adobe Acrobat to find the company name. Oregon’s is here
Your own state (Missouri) says “A complaint index of 100 is considered average” while rating them a 551 for health insurance, and a whopping 3642 for life insurance! Wow, you must be really proud. Here’s a link to prove it
As far as me being so busy, that’s nothing compared to the ONE lawyer you claim to be in the employ of Mega and UICI. One attorney? Do you really believe that, or are you flat out making it up?
Here’s a link to the details of some of the multiple and class class action lawsuits that your SINGLE LAWYER agreed to settle in May of 2004. He must really be tired…
http://www.selfemployedweb.com/nase-2.htm
You say I’m “wasting my time”, but I think answering these Mega inquiries is my penance for all the inferior policies I unwittingly sold for Mega with no out of pocket maximums or stop losses.
Since I’m online all day anyway, I don’t mind. It also gives me a chance to refer people to my affiliate site where they can get anonymous quotes for insurance in any state, at http://www.oregonhealthinsurance.net*
*I am no longer an agent for any insurance companies in any state. The above website is merely a place to get quotes for health insurance.
By the way Brent, I deleted your other duplicate post. I’ll let you comment all you want, but no copy and pasting comments, please…
I appreciate this web site! I had a meeting today with a NASE/MegaHealth insurance salesman, completed the application but held off on writing the check. After reading through this web site, I sat down and carefully read through all of the fine print in the brochure. I am shocked at just how little they do cover. Even on the ‘riders’ for additional coverage, it’s just not much coverage. You are doing a good service!
This discussion thread makes for interesting reading and I googgled across it while seeing what the buzz on the Internet was these days regarding MEGA.
My reason for searching? I was contacted yesterday by an investigator for the Bureau of Insurance, State Corporation Commission, Commonwealth of Virginia. I haven’t had a chance to speak with him but the discussion should be interesting.
When I became self employed in 1994, I contacted the National Association of Self Employed, NASE, (I didn’t know any better at the time) regarding health insurance. A NASE “representative” (e.i. MEGA sales rep) came to my house and signed me up after a hard sell.
What I ended up with was an expensive policy and a bunch of worthless NASE benefits. Fortunately, I wised up and by 1995 had a far superior health plan for 1/3 the cost of the MEGA plan.
I’ll post again after my discussion with the investigator (I’m hoping to stick it to NASE).
I sell for MEGA in Illinois and we have a full portfolio of their products from the defined benefit Health Choice Plan that you seem to be making referance to here to the Signature Plan which is arguably the best plan in the US (and yes it has a calendar year deductible.) The fiduciary responsibility we as agents have is to fully explain what a given plan will and won’t do so the customer fully understands what they’re getting. There are no surprises if the agent does this however,(industry wide) not many do. MEGA is not immune to this. The problem is not the plans that are offered nor is it the company that offers them (whoever they are). The problem is the agent who either doesn’t know what they’re doing or doesn’t care. Either way, its a problem for the customer. It is patently unfair however to blame an entire company for the unethical practices of a few of its independantly contracted agents! Mega has some excellent policies and frankly has hurt no one, that’s right, no one. Unfortunately the Health Choice Plan can be built with very low limits and is designed to be flexible so the customer can select the benefits they want and set the limits they can afford to have, but they have to be guided by an ethical agent that knows what they’re doing and is looking out for the best interest of the client. Typically, there are better choices for the client in Mega’s portfolio. Only two products have a “period of confinement” deductible, all the rest are calendar year. Frankly, arguments can be made for both. Like I said before, Mega is not immune to bad agents, but let’s be fair and accurate, no company is. I’ll welcome all comments and/or rebuttals. But before you call, have your facts straight and be prepared to argue them, because when it comes to health insurance, and the facts, I’m the expert.
Lee Blair (630)215-3857
Lee, you sound honest, and if I lived in Illinois, I’d probably look you up and call you.
WHowever, wat I feel is inherently bad about Mega is that the “customization” ability allows agents to strip it down so far, and that can leave the coverage to be pretty poor.
That’s great for someone trying to hit a price point, but bad for someone (i.e. most people)unaware of all the exclusions and limitations in an insurance policy.
If you strip a car of the power windows, air conditioning, AM/FM/CD player, leather seats etc. to make it affordable, those shortcomings are readily apparent to a customer.
Doing the same thing to a health insurance policy seems unfair. It’s up to the consumer to investigate and know the difference.
Scott,
Its really up to the agent to explain what stripping down a policy could and probably will mean to them should they ever have to use it for anything serious. There are plenty of people out there who when left to their own devices bought a plan through another company based on price and what they read in a trifold brochure that was sent through the mail either directly from the company or from a broker, then found out the hard way what the plan was about when they used it. That is not good business practice on either side of the sale. It is true that some of Mega’s plans can and do lend themselves to being able to be “stripped down” (while there are others that are entirely comprehensive), and yes that’s a problem however, it comes down to the need to have agent’s with enough backbone and integrity to walk away from that business or explain it. First rule of business should always be: never put a customer in harms way, never leave them in harms way.
Second rule of business: always fulfill rule # 1
Third rule: can’t figure it out? dust off your resume
Lee Blair
Would anyone be willing to write or speak with me about the issue of agent training re the application for Mega Life and Health, I would sincerely appreciate it! The attorney I have is saying if we had a former “insider” we could consult, we might have a case. Mega’s attorneys are saying I had pre-existing conditions not listed on the application. I purchased the insurance 9 years ago. Any help would be most sincerely appreciated. I have researched the internet for months and have much information but need someone who was an agent for NASE/MEGA to help me. Thank you!
i am currently looking for Health insurance in the state of Massachusetts. I just recieved an apox quote form a Mega insurance agent. Now i am getting a little sceptical about Mega. Could anyone put me in the right direction for the State of Massachusetts?
http://www.mass.gov/doi/Consumer/Get_Smart/css_get_smart.html -
Write or phone and ask about Mega’s record in Massachusetts - the site says this -
“Massachusetts consumers are urged to call the toll-free Get Smart Hotline at 1-866-SMARTWEEK or visit http://www.naic.org/gsw to obtain free information about what they should expect from insurance coverage as well as tips for confirming whether a policy is legitimate before they buy.”
Get anonymous quotes for insurance in any state, at http://www.oregonhealthinsurance.net
Thank you for the information, looking at the Naic site. Is 12 complaints for 2003 and 11 for the year 2004 execcive for an insurance company? Here is the reasons for the complaints.
http://www.naic.org/cis/codeReport.do
and i apriciate your fast responce to my initial question. I wish i could buy insurance in Oregon with you all. Someone told me and i don’t know if it its true. Does this sound right? The Mass legislation passed a bill that allows anyone to get health insureance and cannot be turned own by any insurance company for an existing illness. And that is the reason why there are only a few carriors in the stae because of the risk they take and why are costs are so high?
i just looked at somemore reports on Mega, it seemed they were over the national median in 2004 but in 2005 they had a 15% drop in complaints and in 2006 they are currently at 92% drop but the year is not over yet.
12 complaints sounds like hardly any. In Oregon, they post a “complaint ratio” number(Meaning a company with 12 compaints and 24 customers has a 50% ratio) and then they rank them that way.
It’s easy to tell at a glance which ones have the highest percentage of unhappy customers, but if you don’t know how many people are insured, you can’t tell.
If Mega was down 15% in complaint RATIO over 2004, then that’s a nice improvement and that’s something to be proud of. However, I wonder if they just have 15% less members? Someone should find out.
A 94% drop reported in February though is not really indicative of much, but it does sound better.
Yes, you’re right. The same thing happened north of me, in Washington. Mandatory coverage means many of the insurers want to get out. Who can blame them?
As an insurance company, in business for a profit, would you want to be forced to sell insurance to someone that’s confirmed to be dying right now? Amazing how some states try to “help” you…
Again, just to clarify - I do not sell insurance in Oregon or anywhere else. I’m an internet consultant and marketer, and you gan get a free quote here at http://www.oregonhealthinsurance.net
This Mega post has taken on a life of it’s own! I even got a “Cease and Desist” letter from UICI / Mega attorneys a couple of days ago!
In response to that, I DID change the unfair verbage in my posts that they cited specifically. I guess I was in acertain mood when I wrote them.
thanks scott,
i did try to use http://www.oregonhealthinsurance.net but for my zip code 02019 i am not eligable
hehe, well if i was Mega or any company that didnt like what i read i would try the scare tactic too.
well good luck and thank you for your opinions and everyone else’s
Reading some of these postings, I can relate. We just had a baby and had some complications right after he was born. He ended up being taken to the ICU, was there for about a week. I figured I was going to have to pay the deductable, then 20%. I was already cringing. Now I’m looking at an additional 10,000 in medical bills! This insurance will only pay $80 a day for a physician visit - one specialist alone charged $2500! I assumed that the difference would be applied to my deductable. I could go on and on. I can’t believe what a scam this company has pulled on me. This is the first time we’ve really had to use the insurance and we’re being ripped off. Is there any way to go after these guys? I can’t believe that this is legal. Would it do any good to call the guy who sold me the plan? -
Wow, Jay! That’s awful -
Yes I’d call the guy that sold it to you, but more to beinterested in knowing if he still works there, or if he left. Show him this post and get his opinion.
Unfortunately for you, the company probably paid exactly as the policy states it will.
I have only two Mega posts on my blog.
Hhowever, on this one -
http://www.pdxtc.com/wpblog/archives/31
there’s a post from an attorney offering to help Mega dissatisfied customers.
I obviously cannot vouch for anything someone posts here, but my opinion is that you should email him.
I hope everything with your child is fine now, and plese come back and update with any new info…
Good Luck Jay, hope you and your family are all well, and btw i didnt go Mega. I thought about it and after every thing i read i desided not too.
Thanks for all your help
Just received my membership and insurance documents from NASE. A little confused, and a lot pissed-off. Received a thank you memo for opting to have my association fee directly withdrawn from my account. Nothing signed to that effect. I was told that my first year was free and 199.00 thereafter, small print seems to indicate around 400.00 per year. Can’t even begin to understand the policy benefits. Not even sure whether the membership fees are included in the monthly premium or in addition.
Couldn’t understand why, since I am the small business owner, had to hire my husband and establish policy in his name, given that everything I read from IRS website indicates that in order to deduct premium policy needed to be established in trade name?
just received policy today. seriously need advise.
I would appreciate any input.
Thanks
If it were me, I’d call my sales rep before the 5 day free cancellation period (In Oregon it was 5 ) and get them to make me understand it all clearly.
Sounds like you were told something that was not true. They never gave away the first year of membership that I heard of. It was always $35 added per month on auto withdrawal.
It’s easier to learn and understand it right now than it will be after an expensive hospital stay. Get your rep on the phone asap!
We have a Mega Rep. coming to our home tomorrow night. After reading some of the comments I am having second thoughts about this company. How can I find a good hlth. insurance plan for the self employed in Virginia? By the way is this a common thing for them to come to our home?
Thanks for any help.
If it were me, I’d talk to a local insurance agent in Virginia about an HSA plan - (That’s a Health Savings Account)
follow this link - http://tinyurl.com/7ofeo
on the left side - 4th link down - you can get a quote for a Health Savings Account.
I’m not an agent anymore, and can’t offer legal advice, but I’m self employed and real glad I have an HSA!
Hey,
Im an insurance agent with United American Insurance Company. I have replaced a lot of clients’ Megalife/NASE policies with United because they were not offering the products and benefits like we offer-ie guaranteed renewable, same in every state, local agents, lower rates, and no association fees (because we are the insurance company).
Why are the strongest defenders of Mega almost always anonymous, but people like Mario tend put their names?
This guy is full of hotair, too bad you have to steep to low blows to sell your plans. I represent Mega and do so proudly. Your marketing is slanderous and sad. Mega’s plans are highly rated and will protect you, just wait till you see our new line. Dont be selling off fear and misinformation, you should be ashamed.
Todd
My mother bought a Mega policy and the coverage it provided for her battle with colon cancer was horrible.
She trusted the “NASE” rep when he told her that her new “group” policy would protect her. When she went for chemo, we found out exactly how bad the policy was. For a $7500 treatment, it paid $1000. How many treatments can most people afford like that?
Any major illness will leave mega ploicy holders bankrupt! People, always ask your agent about the maximum out of pocket!!
Todd - If you could read, you’d see that I’m not marketing ANYTHING or selling insurance at all. I’m a former Mega agent that grew a conscience and quit, thna a couple of years later I made a blog post. Now taken on a life of it’s own.
Tony - Yes, EXACTLY correct - the Mega insurance in Oregon that I sold offered people an ADDITIONAL rider at extra cost, that paid for up to a whopping $1000 a day chemo treatment. Woefully inadequate. You’re lucky to have bought that rider though… See why I couldn’t sleep well selling Mega?
Scott- I can read and your insurance quote site isnt selling insurance? Your idea of honesty is far from mine. To all those people misled off this site please contact your states insurance commission. Your lies and propaganda are sad scott. I would lay money on the fact your fixing to get your tail sued off. To all others the Nase with Mega insurance is a great deal. We have HSA’s, Catastrophic, and basic Plans that let you chose what is best for you. Dont be misled by people who have to resort to unethical marketing, which is illegal by the way scott.
Todd - a proud Mega Agent
That site of mine is for EHealthinsurance, giving anonymous insurance quotes. I’m not a licensed agent, and not marketing anything beyond information.
If there’s anything I’ve written that’s not true, feel free to point it out and I’ll correct it, or more likely, back it up with facts. Lies and propaganda? Please, point out a specific untrue fact.
I do agree with you Todd that all people SHOULD contact their state insurance agencies and find out where any company ranks for customer complaints before they buy. they should also know their out of pocket maximums, and be aware of the exclusions and limitations of ALL insurance, not just Mega.
If I get sued, I suppose they’ll also sue Business Week magazine, who wrote this article called “It’s enough to make you sick” -
Or maybe Mega should sue this law firm in Oklahoma called Richardson, Stoops, Richardson & Ward who makes their money representing clients who have purchased fraudulent health insurance from Mega Life & Health Insurance Company and Midwest National Insurance Company, both owned by UICI in Dallas. I suppose that’s unethical too?
And maybe they should also sue the Wall Street Journal, who wrote an article claiming “Several states are examining what they believe are sales abuses and deceptive practices in the growing market for health insurance sold through associations” and the star of the article is your pal, Mega and UICI -
Here’s the text of that article on another attorney’s website that ALSO apparently likes to sue Mega / UICI- http://www.jameshoyer.com/problem_association_wsj.html
And I hope they don’t forget to sue ConsumerWatchdog.org, who posted this article from the Saramento Bee, August 29 2005 where they quote the California Foundation of Taxpayer and Consumer Rights -
“No other policy sells patients health care coverage that promises so much yet delivers so little,” spokeswoman Carmen Balber said.
And while they’re at it, those lawyers should be sure to sue AM Best too, because they just had the GALL to revise UICI’s rating downward again -
AM best was established in 1899, is the world’s oldest and most authoritative insurance rating and information source - Click here for story
Why don’t the Mega agents that are so “proud” ever put their Mega website address, or link to policy details so people can investigate for themselves and decide?
Scott,
Here is the website so you can educate yourself.
http://www.naseweb.com/raymondphillips .
Mega products on this site are available in NC,WV & VA.
Todd
Todd, when I worked for Mega, they did not allow their agents to sell competing products, like you seem to be doing here with Benicard, GTL Life insurance, and Drug Card America…
http://www.affordablehealthandlife.net
But maybe their employment policies AND their insurance policies have changed, and I should be more open minded…
I also apologize for doubting your authenticity.
Scott, I too sold for MEGA and finished in the top 10 of my class and was selling a ton of insurance. One day I sat down and really read the policy and discoverd how little it actually covered. I became sick to my stomach knowing that I had sold this policy to people who trusted in me. I still pray to God everynight that my customers either dont’t ever have to use the insurance or that they have gotten rid of it. People please ask questions and really know what you’re getting into.
After I left the insurance business, I actually phoned many of my customers and recommended departure, pointing out the holes I’d found. At least I slept better after that…
When I left Mega, they wanted to collect nearly $13,000 in “unearned advances” from me, and then offered to settle on just over $4000.
It definitely hurt me to pay, but it gave me peace of mind and avoided a collection battle.
I sold for Mega for just over a year and couldn’t do it to people once I realized that I wasn’t selling what I thought I was. I too are being chased by the credit dogs for payment of “advances” How did you get them to settle for less?
Actually, it was them who offerred me the settlement. Immediately upon my resignation, I got a letter where they said I owed them a little over $12,000, and claimed they would take me to collections if I didn’t pay.
It then offered to settle for $4000 something if I paid within 30 days, which I did, wanting to avoid collections.
If I were you, I’d make the collections people an offer t omatch the 30 cents on the dollar. Can’t hurt to try!
We had a NASE agent visit us last week. After reading all the comments i am surprised why he was showing us the MAMSI Life and Health provider’s directory as a list of all the doctors who accept their “Group Policy”? I am just so glad i cam accross your blog and have found several other links to confirm that NASE offerings and benefits are nothing but a scam.
I wouldn’t say it’s really a scam. Some of the NASE membership benefits are really very good.
The health insurance is not the worst available either, although once you dig int othe details, you find that it’s really not what it’s cracked up to be, and there are other alternatives that offer more protection and less risk.
I emailed the representative who was selling me MEGA insurance to ask him what he knows about them having max out of pocket. He said that the premiere PPO covers $1,000,000 and $7,000 max out of pocket. I was wondering how long ago you worked there and if maybe things had changed.
Thanks
It was 2002, and it was only in Oregon, so yes, it’s possible that it’s changed. In fact, agents have posted here saying that is the case. so…rather than take the agen’t word for it, I’d phone Mega and verify that you have a worst case scenario OOP max of $7k (including?) your plan deductible. And ask if that is for an individual, or your whole family…
Lori-Ann, I was a Mega Agent in the state of Florida from March until July of this year so I am a little more up to speed. The policies may vary slightly from state to state, but from what I have gathered through research I have done, the stop loss from state to state is the same–there isn’t one.
When that agent told you there is a max of $7000 out of pocket, that is very deceptive. If you have the $2500 deductible that is true PER CONFINEMENT PERIOD. What that person failed to explain to you is the fact that they do not have annual deductibles like most insurance companies, it is per period of confinement. So if you go in for a heart attack tomorrow, your paying your deductible plus $4500 and if they find a brain tumor in November, you are paying again. BE CAREFUL and be aware of what you are buying.
I quit Mega in July because I realized how terrible the products are. I am now a non-captive, independent agent. I have no allegiance for one company over another, although I can honestly say I would never sell someone a Mega or Mid-west policy even if I could. There are much better products out there for you. If you want my full story go to this link. I’ve posted a couple times about my experience with Mega.
http://www.ripoffreport.com/reports/ripoff131154.htm
I hope this helped. Scott, thanks for the great forum.
Amy, I read your story at Ripoff Report…
Congratulations on keeping your integrity. There’s always a way to justify a sale, but the bottom line is that you have to live with yourself.
I still keep up my interest in Mega because I have two friends (at least they used to be friends!) that are a district manager and a top salesperson.
Its truly amazing to me how Mega Life/Midwest agents across the country can log on here, read the terrible stories that there own fellow agents
are responsible for and justify in their minds that what they are selling and being told to say to people is okay!!
They are blinded by the $$.
Mega Life/ Mid West Life and Health are greedy souless companies.
One of the same. Outragous premiums, deny all claims.
Pres, VP’s, executives get fat and rich
with rediculous salaries, bonuses, and stock options, all the while the little agents and employess do the dirty work their instructed to do. All for the golden carrot there never going to get.
Can you say ENRON!
All mega life and midwest agents lie about the coverage they selling because its substandard compared to what the “real insurance companies” offer.
They are trained to lie and mislead by their managers. It all starts at the top.
I worked for them for 9 years, I was a manager.
I have lived the lie. not any more. life is too short.
After 6 months TRYING to sell Mega I finally got out because I realized that most people can’t afford the “best” that Mega has to offer. I always told the truth about the more affordable plan terms and therefore was unable to make many sales.
Mega requires that “uninsurables” sign up with the Health Choice plan and be officially declined coverage before they become eligible to enroll in the “state mandated” program. With so many people not making it through the underwriting process, I was left with quite a large back-end debt.
Does anyone have any advice on how I can negotiate with Mega? Mega will gladly eat up all of my residuals on good business written indefinitely but will only pay out residuals against my account balance for 12 months. Now they are demanding payment in full. Any suggestions?
Just call them and try to settle. I got them to take 30 cents on the dollar… Explain your situation, and ask politely ifsomething can be worked out.
keep us posted!
Shea, You must have a very compelling story. It is brave of you to finally leave after 9 years. I wish you would share some details. What was the final straw for you?
Let’s get to the truth of the matter. All health insurance companies are created equal. They all have armies of claims adjusters paid to find loopholes and reasons not to have to pay claims. It is ridiculous to make statements that MEGA does not pay any claims. If that were the case how do they stay licensed in 40+ states for the last 25 years? It all comes down to the integrity of the agent and the memory of the customer. I have seen agents lie through their teeth to get the customer to buy. It is not limited to any one company. However, I can see how it would be in a “broker’s” best interest to say disparaging things about MEGA since they can not sell the products. And if they are ex-MEGA agents they probably said terrible things about the companies that they sell for today. I am a MEGA customer and I care too much about my family to go with a company that won’t pay its claims or raise rates exponentially from one year to the next. I sleep very well at night because my customers know exactly what they have purchased. Whether it is one of our limited indemnity plans or one of our catastrophic plans that do have maximum out of pockets comparable to other plans in the market. To all you brokers out there I say, stick to selling on the strength of your product instead of trying to beat down a company that has been paying claims and meeting the needs of its customers for over 25 years while still keeping the same company name.
Heard about the katest lawsuit against Mega?
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=40664
Is there a current class action law suit against Mega Life Health Insurance. They have devastated me finacially with the medical bills that they would not cover or put their low caps “not mentioned by sales person” on all of what they do pay. I found that their 80 - 20 policy turned out to be I paid the 80% they sometimes paid the 20%.
I’m not aware of any, but then I’m not in that industry at all any more and hgaven’t been for some time.
I know there WERE in Alabama -
http://www.selfemployedweb.com/mega-al.htm
and something in mississippi and California
http://www.selfemployedweb.com/nase-2.htm
and here’s Texas and Oklahoma this year (2006
http://tinyurl.com/yj94uh
I’d recommend contacting an attorney near you, since I believe these are individual state matters…
Again, I’m NOT an insurance agent any longer, nor am I an attorney.
I’m just a former employee of Mega that had a guilty conscience for selling their product for several months.
I merely made this blog post on a whim after someone sent me an email from a very old bulletin board post they saw, and I’m simply stunned at the number of people that have commented here.
The forum mentioned above was hacked. They have moved to http://www.insurance-forums.net and there is an extensive discussion there about Mega, and some of their shoddy practices, complete with bills that they refused to pay.
I have been reading some of the above comments and see that they mostly are from Oregon. I am from South Carolina and am looking for new insurance and have run accross the MEGA ins. Do you know if it is any different in this state or is is pretty much the same all over??? I really need some help finding affordable insurance for a small company and my family. I know that is probably impossible…
Jessica, I can’t speak for health insurance in any state, but I would encourage you to check with your state insurance regulators -
https://www.doi.sc.gov
Has anyone got Mega experience in SC that can help her out?
Well, this is all very interesting reading and as and ex-agent for mega life and health i completly understand and that is the reason I had to make a change. But my reason for this message is about the repayment of advances, last month i recieved a letter requesting that i pay advances of $5500 over a period of time or a smaller lump sum now. Well i was told by a current agent to not worry about it that my back end would clear the debt. Now a few days ago i recieved a letter once again saying that i did not take the lump sum payment that now i had to pay the $5500 asap. I need some advice and guidance as to how to handle this situation with my former company.
Well Chris, you’re likely out of luck. The reason that your back end never cleared was because so many people roll off of it so fast.
I’m not sure what to tell you… I owed 13k and settled for 30 cents on the dollar, but that was at my initial departure, when I took them up on their offer. Perhaps they’ll still go for a settlement if you contact them.
At least you have a clear conscience about what you do for a living… congrats on that.
Chris, I also settled my account for pennies on the dollar. Call them up. The letter that they sent me said I would owed them over $2000 if my business didn’t stay on the books–which I knew wasn’t going to happen because I already had clients that were calling me up to cancel. They offered me to settle it immediately for $790. When I called them to get clarification, I was amazed that the person I spoke to said I could actually settle it for $300. DONE. I paid them off and washed my hands of MEGA forever. Call them and find out if they will still give you a smaller settlement.
Thanks to all who have posted on this site, and to Scott for your perspective on MegaLife. My husband is self-employed and joined up with NASE (and therefore MegaLife), believing it would be more secure for our family. Unfortunately this has been an expensive mistake. Early on I got poor information from a MegaLife rep about maternity benefits, (reassuring me that prenatal care/birth was 100% covered after our deductible). Turns out that we will have to pay all lab work/testing/ultrasounds, which is looking to be 1500-2K alone. Then, in addition to our 2K dollar deductible, MegaLife is now telling me that our INFANT, (upon admission to the world, I guess) will also have to pay a 2K deductible. And since we’ll have to pay 20% of the cost of the birth, plus everything else which MegaLife has assigned a max to (example: they’ll pay 500 per night for hospital stay, and I fear it’s going to be a lot higher than that) this so-called “100% covered” birth is going to be a lot more expensive than we thought, like maybe 8-12K. Any advice out there for how I might challenge some of this stuff, or am I out of luck? I still can’t find anything in the MegaLife “benefits” that indicates a newborn also has a deductible…I’m also looking for new insurance as soon as the baby’s born (in Oregon) so I’m open to good recommendations there. Thanks a lot.
If I remember correctly, there’s no separate deductible for the infant for the initial birth. hospital stay etc. However, yes, ultimately, the baby becomes another family member, and has their own deductible, increasing your rates too.
Yes, I’m afraid you’re probably out of luck and out of pocket a few thousand, but you should definitely call the agent that sold you the policy, assuming they are still employed by Mega. If your claim is that you were told one thing, that turned out to be another then ultimately you should contact the Oregon Insurance department.
Laura, since you’re stuck on Mega, look into the “Association 105″ NASE benefit. This (used to) allows a self employed family to write off 100% of the cost of the health care, premiums, hospital stays, deductibles etc.
After the baby is born healthy etc. then you can look at other Oregon health insurance options.
For healthy non-smokers, you likely won’t find anything better than Assurant (Formerly Fortis). That’s how it was when I was a licensed agent years ago, and I’ll bet it’s still the same.
To this day, my family uses a Fortis/Assurant Medical Savings Account plan for our insurance…
Thanks a lot for the feedback, Scott. We’ll slog through Mega and then investigate new options once the baby’s here. Appreciate your insights.
Scott and all included in this blog…
I do agree with you that the old plans that most agents have been selling with mega are very limited policies.
Honestly it is the fault of the agent for not disclosing to the client the limits. I am working for the company in Florida.
They have changed around the company tremendously lately. We now have plans (they are not the cheapest) but an agent can feel comfortable leaving the brochure with a client.
There is a maximum out of pocket. From my experience in Florida this is the best individual policy out there in the area for the price.
We still do have those not so wonderful policies with many holes in them. I believe these policies are really meant for people that can’t afford much.
Things had to change within the company, and I can honestly say I am very pleased with the changes. The company has let go many agents that were hiding, lying and deceiving clients.
I do think you will see great changes in the response from clients with these new plans. If anyone in the South Florida area would like for me to explain the plans, options and limits of these new policies please send me an email lk765@aol.com.
These new plans are no longer the limited plans of the past. They are true catastrophic plans, and I believe that is what most of us want and need.
Scott thanks for having this web site. It is very informative and helpful for clients.
Insurance is a very tricky and scary thing. As always, it is always best to have the most information to make an informed decision.
Thank you,
Lori West Palm Beach Florida
Scott - the data you are referancing is out of date - do all a favor and sit down with an agent and do a fine tooth comb on the PPO plans, which have been out for years. There are clear limits to expenses.
My previous plan left a family member holding large bills, because the critical care provider that they were flown to did not accept it as payment in full.
I’m sure you’d want to steer people to the best plan for them, so current data would help all.
Yes John, the post is old. You can see the date of August 2005 at the top.
So you claim Mega is no longer out to deceive people? Great, a couple of other agents have commented the same thing, and I’m glad to hear it.
However, I’d also recommend reading the comment on this post http://www.pdxtc.com/wpblog/archives/31
from Erin on Feb 1 2007… last week.
>>>begin Erin>>>
I am currently reviewing a PPO policy issued by Mega that excludes lab work and diagnostic testing unless performed during a hospitalization.
The exclusions are not clearly listed in the policy. The policy does not say “excluding CAT scan, x-rays, lab work…â€
Instead it has language that is buried in the Exclusion and Limitation section that says “charges for which benefits are not specifically provided for in this Certificate†are not covered.
>>>End Erin>>>
Tn my ears as a consumer, that sounds sort of important, doesn’t it?
* Re: Any blog post you ever read *
Erin, unfortunately, does not tell readers the state she’s in, so people can research this for themselves and determine her legitimacy. So, she might actually be a competitor of Mega that’s lying.
That’s part of the age we live in. Anyone can say anything, but you the reader have to decide what and who to believe. The same thing goes for CNN and Fox.
*My thoughts as an informed consumer on health insurance*
The internet is a wonderful thing. You can get an insurance quote from nearly every company in your area and every company will show many price ranges. No agent will ever even call you unless you choose to allow it.
Choose something there, review the whole contract before signing anything, and pay special attention to the exclusions and limitations, and the maximum out of pocket in a year. Demand to read the policy you get before signing anything, otherwise you have no right to complain.
Finally, for the umpteenth time, I’m an Internet marketer that tried selling insurance for Mega for nearly a year. I have not sold or even recommended any particular insurance since 2003, but I do make a couple of bucks when you get an instant quote for your zip code at Ehealthinsurance.
Dear Sir:
There are some very important facts you need to add to your website; almost all of the older Mega plans are no longer available or almost completely fazed out.
There are now three plans and in training we are trained to explain the Value plan has no cap on coinsurance while the other (standard & premium plans) do have caps on coinsurance. Obviously for the family trying to just get insurance coverage - the value plan may be their only choice because of cost - but I have been trained to make sure they understand the plan in detail.
Also too, I suppose you should note that the recent happenings with Goldman Sachs / The Blackstone Group / DLJ Direct - these suggest the parent company Health Markets (who now owns Mega) are backed by pretty serious money and are committed to maintaining and strengthening the integrity of the new product offerings form Mega. I suggest you visit their website and stop sharing negative information without current facts. Thank you.
from:
Fan of your website!
Well CJ, i’m afraid it’s not my job to tell people that Mega’s not a ripoff anymore… it’s yours.
I wrote this in 2005, and Mega agents and clients alike are free to post here and say what they want.
Sounds like you’ve attempted to set the record straight, and I’m sure some people will want to check it out.
Hey CJ - Did you ever get to see a Mega policy during training when you’re combing line by line through the competitor policies?
I thought so… I didn’t either, despite asking three separate times.
The best thing to do is to call the company directly and ask them how much you would be liable for on a $100,000 claim.
An agent may not truly understand the policy benefits … or in some cases be willing to lie … in order make a sale.
Also, be sure your agent writes down ALL your pertinent health information. Don’t believe them if they say a past health problem is unimportant or doesn’t need to be listed on the application.
I used to be Mega agent… my thing is to everyone stay away from Mega!!!!!!!!!!
Why doesn’t anyone acknowledge there are insurance agents that care and have been able to help people get covered when they couldn’t any other way? I know for a fact some true stories that no one seems to talk about. The young woman with three children that passed away THREE DAYS after her policy was effective, and they paid every penny of her benefit, and they paid for the children for a year, AND they gave her an Accidental Death and Dismemberment benefit.
What about the five claims that I know of personally that Mega paid even more than what the policy says they are responsible for?
AND, no one talks about other companies, like Assurant and even Blue Cross when their coverage is less than what it says it is.
A friend said they were covered for testing 50% for his sons thousands of dollars of tests. They say in their policy, and agents represent their policy as covering 50%. What they don’t let you know, and I am sure it is in the fine print, is that it is 50% of what they think the procedure is worth! So, out of a series of 6 tests, $800 each, Blue cross covered 50% of $300, not the $800. Just because a company like Blue Cross or any other company has a household name doesn’t mean that is the right plan for a certain individual.
No matter what company they represent, the agents need to be trained. People need to read what they are getting. Mega Agents go through training and testing on a regular basis to assure that the product is represented. I know we have helped hundreds of thousands get benefits that would go without insurance otherwise, and indirectly raise the cost of health care for everyone in this country! That is why it is important that they work with a person, not buy on-line, and not buy over the phone. They should see things in writing in front of them.
To Lita in August of 2006:
FYI: There is no way that MEGA could require a person to apply for coverage knowing they would be declined, just so they will qualify for state medical assistance. If MEGA had that kind of power over the state assistance programs, the government agencies would be totally different. Do you really think state governments would give them that power?
I am not sure where you got that idea, but obviously, you don’t have the intelligence to figure that out. If someone does not have coverage, and meets the prerequisites for the government plans, whether income based subsidized private held plans, or actual state assistance, they can get coverage, although in most cases there is a great waiting line for the subsidized plans.
Now that I have read a number of posts and arguments on here, I guess it is my turn to crack back a little bit. Currently I am a licensed health and life insurance agent in Wisconsin and also happen to sell for the NASE & Mega, and have been doing so for over a year now.
My first comment would be to those of you that have tried working for us and were not successful. This business of selling life and health insurance isn’t for everyone. So get over it. Just because you failed at selling a certain product doesn’t make it a bad one. So don’t sit here and make claims about a product that you don’t understand at all. My advice to you is do what I did. While your out in the field go over people’s current policies with them, and show them the difference between theirs and ours. Pros and cons. I have no problem what-so-ever about walking away from a sale if someone is better off with the current plan they have. That way you both will have a better understanding of what is out there. But to sit there and say, oohhh MEGA sucks, don’t buy them. When it pretty much comes down to the fact that you couldn’t sell ketchup to a hot dog.
Second, I see that Scott’s first post was in August of 2005 which might I remind you, those products are no longer sold here in Wisconsin to my knowledge. And I will agree with you that our old products did have some holes in the policy’s, and if they were not built correctly, they could cause some major financial strain on the consumer.
The one thing I will say that I dislike the most while representing this group is “The Moneyâ€. It seems that a lot of agents get fixated on that aspect of this business, and will do anything to score a sale. They will strip a policy down to its bare bones so they can look good when it comes to business turn in time, and not even think about what could happen to the customer. I know in our meetings we have, I feel as if our managers are contradicting themselves by first talking about how much money were making, and then try and tell us that were doing it all for the customer. My guess would be, that we’re not doing it all for the customer for this reason right here. I would bet that if we could cut say, a few thousand dollars off of these ridiculous bonus checks that some people get, we could offer a much more, sound plan to the consumer.
Also Scott, and I’m not 100% sure on this, but for you to still leave a post up on what our plans “Use†to offer, I’m not real sure how legal that is. I know in WI, we can’t make claims on insurance we’re not authorized to sell. And FYI, there is now $4000 dollar co-insurance max and quite a few other things that have changed since 2005 for the better.
Now another post in here that I found quite interesting is the one claiming how most insurance companies cover you on the job. If I were a consumer or an agent who believes that, I have a bridge to sell you. please read the following e-mail from the WI commissioner of insurance that I have.
—–Original Message—–
From: Kevin
Sent: Thursday, March 01, 2007 5:50 PM
To: information@oci.state.wi.us
Subject: Self-Employed workers comp. question
I have a question regarding insurance coverage for people who are self-employed by themselves, and that their spouse is the one providing insurance coverage through her job for the family.
The question I have is, is it mandatory for a family insurance plan that is provided by a spouse’s place of employment, to provide “on the job” coverage for someone who is self-employed and with no employee’s.
For example, if my wife carries insurance, and me “the husband” is covered under that policy, does that policy have to provide coverage for me on the job, if I am self-employed with no employee’s? Or is it the insurance companies decision whether or not that is part of the policy rules and regulations?
Good afternoon:
Most policies that provide health insurance coverage have an exclusion in them that says they will not provide coverage for any injuries that are a work related injury. I recommend that you check with the insurer to make certain that you are covered. If you are not, then you will need to get a policy that will cover you if you suffer a work injury.
Annette Byrnes
Complaints Supervisor
Office of the Commissioner of Insurance
(608) 266-9893
Annette.Byrnes@Wisconsin.gov
Now if you read carefully, you will se that I had asked about family plans through and employer, and she went ahead and said that “most policies†in the state have that exclusion. So people please get your facts straight before you start your rants.
Last, I think we can all collectivly agree that health insurance for the most part sucks all over. Now, there are some good plans our there, and in order to get them you need to be quite healthy and pay an even better premium. Now are Mega’s the best, absolutly not, but we do offer prett solid plans,”if” sold correctly, and from what I am reading and finding out, “NOT FROM MEGA MIND YOU”, is that are products are going to be getting even stronger.
Mega life and Death sucks I AM WARNING YOU IF YOU HAVE A POLICY WITH THEM GET OUT NOW!!!!!! do not wait until it is to late, my wife was recently stricken with cancer, there policy will not cover a major medical event, there maximum benefits are adjusted for medical costs in the 1960s. we didnt get the chemotherapy rider which is a joke in its self because it would only cover 1000.00 max per session, well let me tell you its about 20000.00 per session. more over, the maximum life time amount and the aggregate amount are deceptive at the least. We are filling a complaint with our state insurance commission on the deceptive manner in which the policy was sold at the coverage it offers. Mega death and it’s constituents are getting rich at sick and dying peoples expense. I would love to either start or join a class action suit against these CLOWNS to expose them for who they are. Do your homework, there is far better coverage for same or less do not make the mistake I made. I will be watching for following responses for contact info.
Lets face it there are some horror stories for all insurance companys and it’s unfortunate that the consumer has suffered because of poor practices. In most states there is insurance complaint information as well as rating agencies across the nation, it is my recommendation that all prospective clients do some research before purchasing coverage. However, Mega’s plans are some of the best on the market today. I can only attest to the new plans that are available now (2007) I have no knowledge of what was offered in the past, but, I say to all of you naysayers to take a look at the new Mega products then update this site to tell the current story.
I worked there for 3 months (in late 2006) with no insurance back ground. I could not believe they had me selling insurance 3 days into training. I had no idea what I was doing. They recruit as many people as possible (whom pay $250.00 to UICI) run them through 3 days of training then start calling old, old leads. What a scam. No wonder they get a bad rap. Honest people like me want to start a new career and get no training. How could I possibly give someone looking for insurance correct information. Out of the 30 people in my training class, maybe 3 made it a month like I did. Once I realized what was going on I left. I guess the insurance is much better then 2005 but you have to fine an agent who understands it. I also they make you neighborhood look like crap with all the pole signs.
In response to LUKE.
Luke if your interested, I would like you to respond to my e-mail (kevincleary@charter.net) to see if you are still in the insurance business, and would like to do it the “proper way”.
What I mean by that is, actually put the clients needs before padding your wallet like they do at MEGA and UGA. I use to be an agent with them for a little over 1 year, and let me tell you. Now that I am on the outside looking in, WOW what scam that compnay is.
Talk about a legal “mafia” if you will. It is the shadiest group I have ever seen. Everything in that orginization stems from money. All the rah rah meetings, even the district meetings, or the 1 on 1 meetings. They would always tell us. “You could sell this to make more money and get higher bonus checks.” What a joke.
Health care is at an all time high, and you want me to sell more crap they will never use. My boss got 2 bonus checks a year, in the amount of $21,000. Let me remind you that, that is 2 of the 16 or so bonuses he gets a year. And the other 14 bonus checks are quite large also.
Like I said, its like the mob with kick backs up to the top, but minus the “wacking”. LOL. Also if any of you are reading this, and are still interested in running your own business, but providing good products to our consumers, let me know and I can help you out. The insurance business can be a great business, if it’s done the right way.
Don’t bother e-mailing me, if you are just in this to make money. If you are, get out of the insurance business all together. If you are honest with yourself, and more importantly with your clients, you are going to be doing quite well for yourself anyway.
I am very curious about everything I have read. I started working for Mega a few months back. I am reading alot of negative hype, however, our office has only had 1 complaint in 3 years. I am getting a lot of satisfied customers refering other customers. Yes, I am wondering if I made the right choice and I do want to sincerely help others not cause a train wreck for them. Advice is appreciated if it will allow me to help people out.
I am a former MidWest/Mega agent in Georgia, now selling Assurant. I left Mega because I was so ashamed of what I was selling and couldn’t face my friends and neighbors whom I had sold it to. I was new to the industry when I first joined MidWest, who later merged sales forces with Mega. As a natural sales person, I did well with the products but it was tough. The smart consumer would not buy and those that did, eventually cancelled as soon as they used it one time. Several months in to my employment, I began to see how horrible the product was and like the writer of this page, I too just quit selling and went without any income for several months. I didn’t know what I was going to do but if it meant that I was going to starve to death, I still wouldn’t have sold another MEGA policy. Luckily after 2 months of no income, someone shared Assurant with me. I was impressed but spent a good week trying to find holes in the coverage. I couldn’t find any so I decided to start selling it. I cannot tell you the number of times that I come across a MEGA policy owner who is furious with what they had been sold by another agent and are looking to switch. I put them in Assurant. I have not met a MEGA policy owner yet who has been happy. Today I met with a man who had been on MEGA for 4 years now and had not used it until last month. I sat with disbelief as he pulled one hospital bill after another out of a pile and the corresponding EOB from MEGA and it wasn’t good. MEGA found an excuse to exclude almost everything related to his ER visit and subsequent followup visits and testing. The man was furious to say the least and I felt so thankful that I was not the MEGA agent who had done this to this man. The sad thing is, that this man came to MEGA healthy with no pre-existing conditions but has developed a few issues over the past few years. He put in an application today with Assurant but he may be denied. How sad would that be if he was sold a crappy policy and could now be stuck in it because of pre-existing. Sadly enough, he has figured out that even if Assurant places several waivers on him to exclude treatments for these pre-existing conditions, it will still provide better coverage than his current Mega Plan. I, as a former MEGA agent, with a conscience, make it my duty now to seek out MEGA and MidWest insurers and get them off it as soon as possible before they are financially ruined. I tell people that while I would hope that they would purchase an Assurant policy from me because I truly believe it is one of the best products on the market, I will have done my job if they cancel their MEGA policy and move to a true Major Medical plan that protects them financially, as insurance is suppose to do. For anyone who is reading this and considering purchasing a MEGA policy, take warning. As someone mentioned above, most MEGA agents are new to the business and don’t know any better. Take the MEGA policy (or booklet) to an experience agent who has access to real major medical plans and ask him/her to compare any of them to MEGA and provide you with feedback. I promise you that you won’t buy the MEGA policy.
MEGA.
What’s getting me is what I’m reading in the “Prescription Drug Rider Exclutions and Limitations”…”we will no provide any benefits for: Contraceptives, oral or other, whether medication or device, regardless of inteded use.”! ha! freakin’ crazy christians i bet (and i’m catholic) “any medication, legend or not, which is consumed or administered at the place where it is dispensed.”…sounds like chemo to me.
WTF!
My husband and I are desperately trying to find insurance to bridge the gap to Medicare. We live in Jackson County, Oregon, and most policies in Oregon are set at Portland rates, which are lower. We currently have a union plan that is nearly bankrupting us and covers maybe 50% of the costs disallowing most of the charges above 50% of the cost. Thus we pay both nearly $1,000 a month in premium and out of pocket a lot more for those services not covered at the cost at which they are billed.
My husband has preexisting conditions that neeed to be covered and I am overweight. What can we do for 4 more years? We cannot continue as is. We were so desperate I nearl