Problem With Mega Life Health Insurance

[mega2008]

My question involves insurance law for the state of: MA

I bought a policy from Mega Life Health Insurance in Sep 07 for my wife with a Deductible of $10K as I already had an insurance but that would for up to $10K for pregnancy. The idea was that expenses up to $10K would be covered by Insurance A and the rest would be covered by Mega Life.This was clearly explained to the Agent before buying.

Now that we are expecting in Feb 09 and we have already reached the deductible limit of $10K, we are being told that this Deductible is applicable per Calender Year and hence from Jan 09 we will again have to reach the deductible limit of $10K for Mega to start paying, which is not possible now.

I had clearly asked the Agent that will we have an issue like this when I bought the policy and also again in June when we knew about the Pregnancy.He categorically said that it would not impact us as it will be the same Illness/Sickness and we should be OK. But on contacting the Customer Support at Mega Life recently, after multiple answers from different people they are now saying that the deductible will restart from Zero in Jan 09.

The Agent still mentioned that we should be OK till last week but is now saying that I may need to buy an additional policy or Mega will pay only if she is admitted to hospital by Dec 31 for Delivery...which is Ridiculous.

I feel I am clearly cheated here and we both are mentally stressed and also feel depressed at a time when we should be Very Happy and and will end up having to pay a lot of Money due to this, which I shouldn't be and I may not be able to afford it anyways.

What are my options?

[lwpat]

Deductibles are yearly. That is the way all health insurance works.

[kist]

Yes. IWPat is right. I have Blue cross/Blue Shield which is both a traditional insurance plan plus an HMO from Health Advantage and our deductibles all restart in January. But you'll think of something.

[lealea1005]

The above poster are correct, unless different deductible start/end dates are specifically noted in a policy.

I suggest you file a complaint with your state's Insurance Commission. Include copies of all communication with this agent/Insurance company in your complaint.