As time has progressed, I have become a fan of pet health insurance. More clients are asking about the benefits and limitations of policies and we have seen a number of clients’ pets receive care that the client would otherwise have not have been to provide without an insurance plan. It is not a panacea for health care, and there are limitations, but understanding the available programs may assist you in keeping you dog or cat healthy for years to come.
Nearly every insurance plan works in a reimbursement basis: the client receives a bill for the veterinary services and pays the bill on a credit card or via another means. The client then processes the claim with the insurance company, which then reimburses the client either through a deposit into their checking account or via mailing the client a check. In special cases, the insurance company may be able to reimburse a veterinary hospital directly, but such an arrangement must be made with the veterinarian and the insurance company in advance.
What’s covered? it depends upon the insurance carrier selected and the plans that they offer. Most plans cover accidents and illnesses that occur after the insurance is purchased and several have wellness components. When evaluating the plans, check to see if pre-existing conditions are covered, whether there are breed / hereditary condition restrictions, and age of enrollment maximums. Then assess if there are waiting periods. Several plans have a two week waiting period before coverage is effective, and most have a restriction on coverage for hip dysplasia or knee problems. Remember, this is insurance and the companies want you to enroll before there are problems.
There may be a maximum age in which you can enroll your pet. If over this age, they may not write a new policy, but if your pet was enrolled before said age, your pet may have the policy renewed for life. This helps keep the pool of healthier pets larger, pushing down overall costs of the insurance plans.
Reimbursement for accidents / illnesses will generally include the exam fee, necessary bloodwork, X-rays, medications, necessary treatments, hospitalization, and surgery. Many plans even include rehabilitation services and alternative medicine modalities, such as acupuncture, laser treatment, and others.
One must navigate pre-existing conditions carefully. Read your pet’s full medical chart carefully for any prior findings of abnormalities. If your pet has had a knee problem in the past or has had skin disease or upper respiratory infections, you may not be reimbursed for like problems in the future. Some companies will review your pet’s medical records in advance for you and detail any problems with coverage at no cost to you. I highly recommend such a service, especially if your pet is older or has had issues in the past.
Most plans have an annual deductible and possibly an annual or lifetime limit that is paid by the insurer. Ask what the deductibles are and if there is a per-incident or per-disease / condition deducible or reimbursement. It is usually best to avoid per-incident deductibles as these can limit the amount paid out to you, even if you meet your standard deductible. For example, the company may only pay $2000 for a condition, but the actual bill was $3000. You are left paying the difference. It is also important to be certain that, so long as you keep the policy in good standing, chronic conditions that develop while insured will continue to be covered every year.
Several companies offer wellness endorsements to their policies. There are detractors to wellness plans, but if you know how to navigate them, you can save yourself a few dollars. They pay up to a certain amount for routine vaccinations, heartworm testing, preventives and dental procedures. Wellness plans work similar to a health savings plan – you put money in and the payout when used is larger than that put in, usually by 20%.
Differences exist between plans – some are comprehensive and cover everything, others only illness. Although we don’t endorse a specific company or plan, we are happy to chat with you about insurance and you pet. Please research what plan is best for you and your friend and feel free to ask us anytime for help.
dt,dvm – (C) 2016