Posted: April 13, 2011

Pet Health Insurance

As the cost of quality veterinary care increases many clients are investigating the value of pet insurance plans for their dogs and cats. The staff of MercyVet is continually asked if we recommend pet insurance. The short answer is a resounding "yes!". The long answer is, "yes, but choose carefully, ask questions and speak to a cross-section of representatives from different companies to get a good match for you and your pets' needs".

There are many considerations when choosing a pet health insurance plan. We have listed a few below, including feedback from colleagues and clients.

 Cost

Cost is determined by your deductible and your co-pay, decreasing with a higher deductable and co-pay.

 Well pet care vs. sick pet care

Well-pet care may include annual exams, puppy/kitten exams, vaccinations, spay/neuter surgery, dental work and routine blood testing. It is our understanding that for the price of the higher premium for well-pet plans, it is often not cost-effective for the client. On the other hand, injured or sick pet care can be very cost-effective.
For example, a cruciate-ligament repair these days can exceed $2500.00. An emergency splenectomy with blood transfusions can reach $10,000.00. Cancer therapy can reach $8,000.00.

 Deductibles

This is the amount that will be subtracted from your claim payment until the designated deductable is met. Deductibles vary greatly depending on the company.

 Co-pay

This is a percentage of the amount that you will pay for each incident. Some companies will reimburse you for a straight percent of what the vet charges you; others will reimburse you on the agreed percent of their allowance for that particular problem.
For example, if you are traveling to another city and your dog slips her collar and is hit by a car (heaven forbid!), emergency care including hospitalization, anesthesia, radiographs, IV fluids, monitoring, medication, etc. might exceed $3000.00 at an emergency clinic. One insurance company might reimburse you for 90% of that cost; another might have a 'ceiling' for this incident, allowing only $1500.00, and then reimbursing 90% of that cost.

 Limits per occurrence

Select a dollar amount that is realistic. A dollar limit of $1200.00 per occurrence is no longer realistic for emergent medical care and most surgeries. A more realistic amount might be $7500.00 or more if you can afford the premiums.

 Lifetime and annual limits

In most instances, if your pet were to incur a large bill, ($100,000.00 or higher) chances are, you may be unable to afford the co-pays and deductibles.

 Office Visits/Examinations

Most major pet insurance plans cover at least part of these, but it pays to ask. By not covering routine examinations, companies are able to keep their premium costs lower.

 Prescription Coverage

Medications, for large dogs in particular, can be extremely expensive. It's a good idea to ask the company if medications are covered.

 Pre-existing Conditions

Most pet insurance plans do not cover pre-existing conditions, (but it never hurts to ask). For this reason we recommend doing the research, choosing a plan and enrolling as soon as possible after you adopt your pet. If the veterinarian finds anything abnormal during the exam, the insurance plan will likely not cover it, but most companies will not enroll your pet without a physical exam.

 Selecting your Veterinarian

It's important to choose a plan which allows you to see whichever veterinarian you want. The majority of plans allow this, but we are beginning to see HMO-type plans in the veterinary insurance business.

 Hereditary/Genetic 'Glitches'

These conditions are congenital. The pet may or may not show initial signs of the problem, but eventually, treatment for the problem can be extremely expensive. An example of this would be canine hip dysplasia. The puppy might present healthy with sound mobility, but later in life this condition might result in an $8,000.00 surgery to correct both hips. There is a tremendous range in coverage of congenital problems-- with no coverage at one end of the spectrum, and complete coverage at the other. Most insurance companies fall somewhere in between.

 Orthopedic Surgeries

There are insurance companies with exclusion periods for conditions like anterior cruciate ligament (ACL) ruptures. If your pet is enrolled in one of these plans, and he injured himself during a 12-month waiting period, the pet will not be covered for the surgical repair or other treatments for this condition.

 Cancer

Some insurance companies include cancer treatments, others offer a rider at extra expense.

 Complementary/Alternative Treatments

If you prefer treating your pet with natural medicine, you will want to ask if the company covers acupuncture, chiropractic, homeopathy, and other alternative therapies. Some companies cover all of them.

 Premium Increases

Factors which could increase the cost of your premium include increasing age, previous claims and inflation.

 Age Limits

Different companies have different coverage for aging pets. Some will discontinue coverage after the pet reaches a certain age; others will continue coverage if you have been a loyal customer for years.

 Research the Company

Don't be afraid to ask questions. How long have they been in business? How long does it take for a claim to be processed? Be specific about your pets' needs and if they are covered. A good website which compares the companies services is: www.petinsurancereview.com

In summary, the best way to decide if it will be an advantage to your pet (and your wallet) to purchase pet insurance is to consider the age and health of your pet, research the differences between the pet insurance companies and choose wisely.

The above information was compiled from an article by Shelley Epstein, VMD,

Wilmington Animal Hospital, Wilmington, Delaware