Pet Health Insurance Considerations

The doctors and staff of Wilmington Animal Hospital recommend that you purchase pet health insurance for your dogs and cats. Because of the high quality of care available to your pets, costs may be prohibitive if your pet has an accident or severe illness. For example, orthopedic care for a broken leg or anterior cruciate ligament tear can cost $3000-5000. A splenectomy with transfusions can cost $10,000. Cancer therapy can cost $7000 or more.

There are many points to consider when selecting pet health insurance. We have listed a few below, with comments based on our experience. We highly encourage you to search the Internet for websites that compare plans, and call the top two or three companies that seem to fit your needs.

1. Cost. In general, this will be related to your deductible and co-pay, decreasing with a higher deductible and co-pay.

2. Well-pet care versus sick pet care. This includes annual and puppy/kitten exams, vaccinations, heartworm testing and preventative, flea and tick preventative, spaying/neutering, and possibly dental work and routine blood testing. At this time, we do not recommend purchasing additional coverage for well-pet care, unless it is already included in a sick-pet care plan that you like. We have found (by running the numbers) that you’ll put a certain amount of dollars into a premium for the well-pet care and get that exact amount out of it. Better to keep your money and spend it yourself.

3. Deductibles. This is the amount that you will pay first before services are rendered. Note that in some plans, because of other terms of the plan, you may not see a decrease in your premiums unless you set a very high deductible, like $500.

4. Co-pay. This is the amount, usually expressed in a percent, that you will pay for each occurrence.  Be careful here. Some companies will reimburse you for a straight percent of what the veterinarian charges you; others will reimburse you on the agreed percent of their allowance for that problem. For example, if you are traveling to Los Angeles and your dog gets food poisoning, a night in the ER with IV fluids and medications, X-rays, ultrasound, etc. might cost $3000, and one company might reimburse you a straight 90% of that. But another company might have a “cap” for this condition, allowing only $1500, and then will reimburse you 90% of that amount.

5. Limits per occurrence. Make sure you select a number that is realistic. For example, a limit of $1200 per occurrence is no longer a realistic number for serious medical and most surgical conditions. We recommend at least $7500, preferably more if you can afford the premiums.

6. Lifetime and annual limits. These might not be as critical. In most cases, if your pet were to incur a lifetime bill of $100,000 for you, the condition might have been such that you would not have wanted to continue putting your pet through this or you would not have been able to afford the co-pays and deductibles.

7. Office visits/examinations. See if this is covered. Most companies cover some portion of the sick patient visit, but other companies do not, which is one way of keeping the premiums affordable and minimizing the deductibles.

8. Prescription coverage. Find out if the company covers prescription drugs. Medications, especially for large dogs, can be very expensive.

9. Pre-existing conditions. Most plans will not cover these, so we recommend enrolling right after your first vet visit. Yes, anything abnormal found on this visit will be considered a pre-existing condition, but most companies will not enroll your pet without a physical exam.

10. Selecting your vet. Make sure your plan allows you to select whichever vet you want. Most plans allow this, although HMO-like plans are springing up.

11. Congenital and hereditary disorders. These are conditions present at birth (whether or not they show symptoms or signs) and can result in very expensive treatment. Most pet insurance providers exclude or severely limit coverage for hereditary and congenital disorders while others cover many or most of these conditions. This can include something as common as hip dysplasia (in which surgery can cost $8000 or more to repair both hips) or less common like cherry eye.

12. ACL tears: Some companies have exclusion periods for conditions like anterior cruciate ligament (ACL) tears. For example, if your pet is enrolled in a plan with one of these terms, and your pet tears his ACL during a 12-month waiting period, he will never be covered for the surgical repair or other treatments of this condition.

13. Cancer coverage. This is included with some companies but exists as an additional rider with other companies.

14. Complementary/alternative therapies. Find out if the company covers acupuncture, chiropractic, homeopathy, and other complementary/alternative therapies. All of these services are offered at WAH.

15. Premium increases. Check to see what makes the premium increase. These factors could include increasing age of your pet, previous claims, and inflation.

16. Age limits. Some companies discontinue coverage when your pet reaches a certain age, while others will continue your coverage if your pet has been enrolled for a certain number of years.

17. The company itself. Find out how long they’ve been in business and what the turnover time is for a claim.

Search the Internet for pet health insurance companies and do your own comparisons. Once you think you’ve settled on a company, (and you’ve spoken to them on the phone to ascertain how helpful they are), contact a competing company to get the other side of the story.