kinds of drugs and its side effects

Pet Insurance, Part 2: Jasmine’s story

Today I’m turning my blog over to Susanne Fritz, my Aussie pal who takes care of the lovely Jasmine. I’ve introduced Jasmine before; she’s the pup who is “diabetic and loving it.

The lovely Miss Jasmine

The lovely Miss Jasmine

As I’ve mentioned, with 20-20 hindsight, I wish I had insured Frankie when he was young and before he was diagnosed with diabetes. You’ve seen my vet bill in my first post on this topic. And if you’re thinking you would have  set aside money each month for such emergencies as occurred with Frankie — well, you’re a better (or perhaps richer) person than I am.

Just so you know: I compared my own research in the U.S. with Susanne’s and policies/circumstances are very similar. I’ll add a few of my own things to look for at the end, based on the research I did for my new book, Am I Boring My Dog.

Susanne’s story

“Should I get pet insurance?” you may be wondering. Everyone’s circumstances are different, but from my experience I say YES! It is absolutely worth it. You see my dog Jasmine, like Frankie, has diabetes, but fortunately my insurance covers a large portion of the ongoing costs for her treatment. In the last two years since Jasmine’s diagnosis, I have definitely come out ahead.

I originally decided to insure Jasmine as a puppy because I knew she would grow into a very large dog (currently she weighs in at over 100 lbs), and realized if something went wrong it would be costly. I did not want to find myself in a position where I could not provide her with treatment she may need in an emergency due to expense.

When deciding if pet insurance is worth it, consider that the recent advances in veterinary medicine have been huge. Many treatments available in human medicine are also available to pets; in fact, they are often first developed using animal models. Your pet can get chemotherapy, MRIs, even kidney transplants, but these technologies are not cheap.

If your pet falls ill or has an accident and needs to go to an emergency vet hospital after hours, you could be up for over $1000 a night for intensive emergency care and monitoring. Could you afford this?

Vets would love it if more of their patients were insured, even though it creates additional paperwork for them filling in claim forms. They want to do what is best for an ill animal, but all too often they are limited in their treatment options, or have to euthanize a treatable patient due to the financial situation of the owner.

When I first insured Jasmine nine years ago, the pet insurance industry was relatively new and policies were generous, offering a lot for your money. Over the years the industry has evolved, and in the name of profitability companies have added deductibles and exclusions to their policies. This makes it important to carefully read the policy to understand what is and isn’t covered before signing up.

All policies will have good and bad points, so you will need to weigh these up, decide what you expect from the policy, and see if it meets your expectations.

Most companies offer various levels of insurance, such as accidental injury only, or accident and illness, or accident, illness and routine care. Routine care options provide some cover for routine veterinary expenses, like vaccinations, parasite control, microchipping, and neutering.

Among the questions you should consider when researching pet health insurance:

Does the policy have a deductible?

Most policies have a “condition deductible.” For example, my policy has a condition deductible of $50, so I cannot claim on the first $50 in vet fees for a condition. This is only payable once per condition, so if it recurs or is ongoing I do not have to pay the deductible again for the rest of the policy year. I do have to pay it again for any new conditions, and when I renew the policy each year the deductible is payable again. Often companies will offer lower premiums if you agree to a higher deductible; conversely, you can pay higher premiums to lower the deductible.

Are there exclusions?

Invariably the answer will be yes, and factors like the age and breed of your dog may determine what these are. Some policies do not cover breed specific hereditary diseases, and you will need to get more information from the company website or speak to an agent to find out exactly what this will mean for your breed of dog. For example, hip dysplasia may be covered for some breeds, but excluded in others, such as German shepherds, who are at high risk of developing the disorder. No insurer will cover you for a condition that existed prior to you taking out an insurance policy.

Other exclusions may include preventable diseases, that is, those for which routine vaccines are available. Pregnancy-related expenses and nonessential procedures are other common exclusions. An exclusion on my own policy is they will not cover stem cell therapy. This did not concern me a few years ago, but there is now a new stem cell treatment available here in Australia for treating arthritic dogs which looks promising. If it was something I thought Jasmine might benefit from in the future I would not be able to make a claim on it unless the insurance company changes its stance.

I can’t stress enough to be aware of exclusions; they will vary between companies and between breeds, so make sure you are not paying good money for a policy that covers your particular breed for very little.

Does the policy cover all or part of the vet bill?

Most insurers only cover part of the vet fees, say 70 or 80%. This is in addition to the deductible, and again you can often make this amount higher or lower by increasing or decreasing your premium.

What are the age restrictions?

Most insurers have age limits on new policies, and will not accept older animals — usually over 9 years old — as new clients. A pet insured continuously from a younger age, however, should be eligible to remain insured for its entire life. The company I have Jasmine’s insurance with has just changed its policy for illness claims: For dogs over 7 years old they will only reimburse 70% of vet expenses. For dogs younger than 7 they will continue paying 80%.

What are the annual limits and sub-limits?

Insurers have an annual limit on what they will pay out on a policy, and within this limit there may be sub-limits, such as condition limits – where they will pay up to a set amount for a single condition; and medication sub-limits – only a set maximum amount will be paid each year for medications.

Do they pay the vet directly, or are you expected to pay the vet and then the insurance company reimburses you?

What are the payment options?

Usually you will have flexible options allowing you to pay annually, 6 monthly, or monthly to make the premium costs more manageable depending on your circumstances.

There may be other extras included in policies, and these will differ between companies. i.e. Jasmine’s policy will pay for her to stay at a boarding kennel for up to two weeks if I am hospitalized.

My additions

Other things you should look for in a policy include:

Choice of veterinarian

Most plans let you see anyone you like; others are similar to HMOs, limiting you to certain health-care providers.

Waiting period

There’s usually at least a 10-day wait so that people don’t sign up immediately after their dog leaps off a precipice. Check and see when a policy will take effect–and watch your pup like a hawk until then.

Prescriptions

You often end up spending far more money on medicines than on office visits and services, so be sure your plan offers good coverage.

Specificity

You’ll find plans that say they reimburse you for “reasonable and customary fees.” That’s way too much wiggle room. You’re far better off with an insurer that provides a chart detailing what you can expect to get back for what you pay out.

Rate guarantee

Some companies adjust their premiums on a quarterly basis; that means if they pay a claim they can raise your rates in the next period. Make sure the company you choose offers contracts for at least one year, with no fee-rise adjustments if you submit a claim.

Renewability

You want a plan that doesn’t consider a condition diagnosed after you first contracted with the company as pre-existing, and thus as a reason for not renewing your insurance.

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7 Comments

  1. Posted September 8, 2009 at 9:07 am | Permalink

    Which insurance program do you use?

    • admin
      Posted September 8, 2009 at 9:34 am | Permalink

      I’m assuming you’re asking Susanne, my guest blogger, since I don’t have insurance (sigh). She is probably sleeping right now — or in the middle of her work day; I can never figure out what time it is in Australia! — and I’m not sure if her insurance is available in the U.S.

  2. Clare
    Posted September 8, 2009 at 5:15 pm | Permalink

    Excellent coverage of the subject from both of you. Thanks. But what if you adopt a dog whose age and pedigree are unknown? What do insurers say about that?

  3. Susanne
    Posted September 9, 2009 at 12:05 am | Permalink

    In response to Clare: Generally exclusions for hereditary conditions are applied to purebreds, but check with the insurer before signing on. Crossbreeds tend to have the benefit of what is called hybrid vigor, which lessens their risk of genetically inherited problems that can arise in some breeds from years of unscrupulous breeding (i.e. using inferior breeding stock or inbreeding – that’s a whole other issue, don’t get me started!).

    If age is unknown, a vet should be able to determine if the dog is young, middle aged, or an older animal, although obviously they would not be able to tell the exact age. My thinking is that if a vet were to give you a written estimation of the dog’s age range, the insurance company should be okay with this, but it is not something I have looked into myself. I am sure that a quick call or email to a potential insurance company’s customer service center would let you know for sure what their requirements are in these types of situations.

    • admin
      Posted September 9, 2009 at 7:31 am | Permalink

      Well, Blondie — as Jasmine is fond of calling you on Twitter — you’re too darn smart and helpful for your own good. I’m going to have to enlist you to do more blog posts for me while I sit back and eat chocolate bon bons (to Frankie’s great disgust and envy).

      Seriously, thanks again for your great info, both in the post itself and your answer to Clare. I was about to answer myself, honest, when a lightening storm forced me to shut down my computer, but I’ve got to admit your answer was far more thorough than mine might have been!

  4. Clare
    Posted September 9, 2009 at 6:32 pm | Permalink

    Yes, Susanne, excellent response. Purely academic for me at this point, as my dog is geriatric and beyond insurance beyond a doubt. Wish I’d known this when he was much younger. Thank you.

  5. Susanne
    Posted September 11, 2009 at 3:09 am | Permalink

    What’s that about chocolate bon bons? Are you holding out on me and Frankie? No wonder he’s giving you the stink eye, nobody likes a bon bon hog! (& by the way flattery will get you everywhere 😉 )

3 Trackbacks

  1. […] that's what Tom (and Edie Jarolim – a speaker for the BlogPaws 2010 conference, which PurinaCare is helping to sponsor) said in […]

  2. […] that's what Tom (and Edie Jarolim – a speaker for the BlogPaws 2010 conference, which PurinaCare is helping to sponsor) said in […]

  3. […] pet health insurance, as I discussed in two earlier posts, Health Insurance for Pets? Hell Yes! and Pet Insurance, Part 2: Jasmine’s Story. But Frankie isn’t insured because, by the time I discovered it was an option, he was a senior […]

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