Preparing to Buy Pet Health Insurance

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You’ve just made the plunge!  You went out and spent $1,500 on your darling little Fifi, the registered, purebred Yorkshire Terrier that you’ve always wanted.  She is just the cutest little thing, with all of her playful wiggles, kisses and spontaneous abounding energy.    Of course, being a responsible pet owner and animal lover, a major concern is keeping Fifi as healthy as possible for an anticipated very long time.   So, how do you ensure she gets the best care possible for those unforeseen maladies that are just part of life? 

Before You Sign

Before you sign on the dotted line for pet insurance, it is vital for you to do your homework.  Health insurance for you is one thing but, if you think it works similarly for your little Fifi, think again!    As if understanding insurance isn’t a challenge under the best of conditions, it is important to understand that not all pet insurance plans are created equal and you need to be aware of how the various types of policies work, how much are the copays, deductibles and its limitations, just to name a few things to consider.  

  • What will the plan cost you? 

The cost of the plan should include considerations in regard not only to the monthly premium /annual cost and how that fits into your family budget but also your costs as they apply to coinsurances, copays and deductibles.  These amounts can vary from policy to policy and from company to company.  Also, ascertain if any deductibles are based on an annual deductible amount or are they per-event based (a specified amount due for each event or a specified amount calculated annually).  These costs can add up pretty rapidly.  

For example, if Fifi gets sick and her vet bill is $600; let’s say your pet insurance policy has a deductible of $200 per event and you have a coinsurance percentage of 30%.  In this scenario, you would have to pay the first $200 (event deductible) then your coinsurance would be calculated on the balance of $400 x .30 = $120.00.  So, your out of pocket for Fifi’s $600 vet bill would be $320.00.  This is in addition to the monthly premium payment for the pet insurance plan you purchased.  

In this scenario, each time Fifi needs medical care for an accident or illness, the event deductible of $200 would be due again before the insurance company pays their portion of any covered expense.   If your plan has an annual deductible, that deductible will need to be met each year before the insurance company would pay their portion of the covered expenses, in this scenario 70%.  In this scenario, once the annual deductible is met, you would only be responsible for 30% of the vet bill each time Fifi needs medical care for the rest of the year. 

  • Ask about what they consider pre-existing, congenital or hereditary and chronic health conditions

 It is unlikely that you will find a pet insurance company who will cover any pre-existing health condition but it is important for you to know just exactly what they consider to be pre-existing.  For example, if Fifi sees her vet and she is diagnosed with an ear infection, for example, early in the policy period or even before the policy period begins, and then needs to have a surgical procedure because of the ear infection later, then many companies will consider the ear infection to be a pre-existing or even chronic health condition and they’ll pay nothing.  

Congenital or hereditary health issues are sometimes breed related and you need to know how the insurance company will handle these conditions.  Some insurance companies can also be vague about what is considered chronic as well.  These are areas in which you could assume you have coverage when in fact you do not and you won’t find out until you file a claim only to have it denied.  Asking before you sign up will eliminate unpleasant “surprises” in the future.

  • How are reimbursements handled? 

 Pet insurance companies generally expect you to pay the initial costs and complete a claim form for submission to them for your reimbursement.  So, basically, it comes out of your pocket up front and they pay you back according to the parameters of the policy.  If you had to scrape together the costs to treat Fifi for her illness initially, or even worse, literally robbed from Peter to pay Paul, you need to know how long you could be operating your family budget in deficit before the insurance company’s check is received.  This would be particularly bad if they denied the claim or didn’t pay what you expected them to pay.  Checking with the Better Business Bureau for their rating and registered complaints can sometimes help to fill in the blanks in this area. 

  • Is there a special network of veterinary providers that you must utilize?

 There are many pet insurance companies who require that only veterinary professionals who are registered with the American Veterinary Medical Association (AVMA) be utilized for patient care.  Not all vets are registered with AVMA but have chosen, instead, to register with the Humane Society Veterinary Medical Association (HSVMA), and their services would not be covered in policies requiring AVMA registration.  This also applies to other ancillary services like laboratories, radiological services, imaging services, emergency facilities and even surgical facilities.  It is possible that this type of policy requirement would necessitate your changing from your trusted vet to someone unknown to you.

Some Additional Suggestions

The purchase of pet insurance is certainly an important decision and it is not an easily understood process for most of us.  We love our pets like family and it is our desire to protect and care for them as we would our human family members. It is for this reason that we have listed just a few of the more important points to consider when you are contemplating the purchase of pet insurance. Here are some additional suggestions offered to help you as your make your decision:

  • Do your homework and comparison shop as you would for other items you want to purchase.  List your policy options side by side to compare.
  • Don’t be afraid to ask questions.  Call the agent and ask the questions of him or of a customer service person.  If they don’t give you the answers you seek or are vague, flag it as a caution to be looked at later.  If they truly are interested in providing the best care for your beloved Fifi, the person to whom you are directing your questions should be able to answer openly and courteously or direct you to someone who can.