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Last updated 5/2/10

Veterinary Pet Insurance:   Does My Dog Need It?

People ask me about pet insurance from time to time so I decided to do a little checking into it.  I have always recommended that all of my new German Shepherd owners should sign up for the free 60 day trial that AKC gives away with each new AKC registration but what about when the 60 days in up?  Is pet insurance worth it?  Should I continue the policy and if so, which policy should I choose?  Here is what I found out......

Pet health care insurance isn't a new idea -- it has been around for many years.  It has been offered for more than 25 years in the United States but many people haven't been aware of it until recently.  Additionally, the availability of pet insurance plans been limited and the policy restrictions have been prohibitive in many cases.  But, in the last few years, we have seen changes in this industry and pet owners with insurance are now able to provide levels of care that previously were cost prohibitive.

Veterinary medicine is one of the few health care professions that is not financially based on insurance.  Unlike most medical, surgical, dental, and pharmacy cases in human medicine, veterinary patients (owners) are responsible for veterinary costs incurred -- including preventive/routine care, emergency and disease conditions.

Pet health policies are similar to human insurance policies; annual premiums, deductibles, and different coverage plans based on what the owner chooses.  Plans are based on species, age, pre-existing conditions and in some cases, lifestyle of the pet (i.e. indoor vs. outdoor).  As for pre-existing conditions, some companies will cover conditions if the animal is stable or controlled (usually after a waiting period of 3 to 12 months), other companies will refuse animals with current conditions or terminal disease.  Some insurance plans will not cover breeds prone to developing diseases common to the breed (i.e. hip dysplasia in German Shepherds).

Many people's initial reaction is to think, "I have absolutely no interest in pet insurance".  But, let's take a closer look.



VETERINARY ECONOMICS

Last year, one of Dr. Robin Downing's clients brought in an older German shepherd with gastric dilatation and volvulus syndrome. Dr. Downing knew what she needed to do to save the dog: remove his spleen and keep him in the ICU for five days. This care came with a $5,000 price tag, which the client paid out of pocket.

Two months later, the client's other dog, a 3-year-old German shepherd, arrived at Dr. Downing's clinic in Windsor, Colo., with the same condition. The client couldn't afford to pay for the care a second time around, so she made the painful decision to euthanize her pet. "When this client first brought in this dog as a puppy, and at several following visits, we encouraged her to buy pet insurance—but she didn't," Dr. Downing says. "This was a fixable problem. What a horrifying way for the client to learn this lesson. That dog didn't have to die."

Dr. Mona Rosenberg, a veterinary oncologist at City of Angels Veterinary Specialty Center in Culver City, Calif., is currently treating a 1-year-old cat that had a severe upper-respiratory infection and developed pneumonia when the client adopted him. The client didn't expect the cat to live—but he did.

The client has an insurance policy for the cat, but the company won't cover anything associated with the upper-respiratory infection because it considers it a preexisting condition. "Now the cat has benign cancer of the jaw, which will become fatal if we don't treat it," Dr. Rosenberg says. "There's a clear date of diagnosis, so it's not a preexisting condition."  Still, the client's finances are limited, so she's waiting to proceed with treatment until her pet insurance company decides how much of the cat's care it will cover.  

These two cases outline the importance of pet insurance and how it can impact a pet's care.

 

THE FACTS:

  • Surveys and research by the American Veterinary Medical Association and the American Pet Products Association indicates that today, most pets are regarded as full-fledged members of the family.  More than 60 percent of North American households have at least one pet, and many have more than one. There are more than 75 million pet dogs in the U.S. and Canada.  Projected 2010 pet expenditures for North America are over $45 billion, of which $25 billion is earmarked for veterinary related care.
  • It has been estimated that over one million pets are now insured, and this trend is expected to continue.

  • Some fear that adding insurance to veterinary medicine we will follow the path of insurance red tape and problems found in human health care fields.  But, comparing pet insurance to human healthcare is like comparing apples to oranges. The pet insurance model isn't similar to managed care and it would take major changes in the profession to steer it that direction.  A big part of what has made human healthcare a mess is the contracts between three parties: the insurance company, the physician, and the patient.  The insurance company has influence on the doctor's decisions - It can even exert pressure on the physician to practice medicine a certain way.  On the other hand, it's hard for the pet insurance companies to put pressure on veterinarians because the companies don't have a contractual relationship with them.  No one wants the veterinary profession to suffer the nightmares that human doctors are going through with insurance and it's not likely to happen either because the insurance products are different and the relationship is between the insurance company and the pet owner—instead of with the veterinarian.  Pet insurance is more like car insurance -  It's insurance against accident and illness.  In essence, the insurance company is betting that your pet will never have an accident, and you're betting that at some point, your pet will. But, the goal is to never use it.

THE GOOD:

  • Many options now exist that make the cost of insuring your pet’s health quite affordable.  Policies range from less than $300 to over $600 per year.

  • Pet Insurance allows you to budget for any unplanned veterinary costs that might come up.  That can be very helpful in today's economic situation.  Experts think that the recent spike in interest is secondary to more owners wanting to control the high cost for unexpected accidents and illness.  Also, treatments once reserved exclusively for humans (or only available at top veterinary schools) are now commonly offered in most metropolitan areas and demand for veterinary specialists (ophthalmology, dermatology, neurology, internal medicine, dentistry, oncology) has increased and is growing faster than any other area of the practice of veterinary medicine. These advanced treatments are often expensive but can be covered by a comprehensive pet insurance policy.

  • At this time, pet health insurance companies don’t restrict your choice of veterinarians or try to dictate what you can spend on services.

  • You don’t have to shop around for a veterinarian who “accepts” your policy.  Virtually any national company will cover you for service done by any licensed veterinarian.  (Plus, most veterinarians don’t charge for helping submit your claim.)

  • Having the right policy could make the difference in a life-and-death decision.  If you enroll your pet at a young age, it’s possible to have coverage that lasts your pet’s entire life.

  • Many veterinarians who were once skeptical about the value of pet health insurance are now recommending that pet owners consider subscribing on behalf of their dogs.  Sharing pet health insurance information with owners is becoming an important part of client education in many vet offices.

  • The current overall average for annual deductibles is around $100.00.  The policy costs vary widely, depending on the animal and the different packages that the owner can choose.  Some packages are comprehensive, including such things as: annual checkups and vaccinations, routine care, preventive medications (like Heartworm preventive) and spay/neuter surgeries.  Other plans cover only accident and illness.  Most plans offer immediate coverage for accident claims, and 30 days for illness claims on new policies.  Additional pets are usually covered at a reduced rate after the first policy-holding pet.

 
THE BAD

  • You usually get what you pay for!  Policies that promise the world for peanuts and seem too good to be true almost certainly are.  Insurance companies are in business to make money, not to help pets.
  • Many companies severely limit what conditions they cover or how much they will reimburse.  First example: One major company won’t cover any condition it deems genetic or congenital in nature. Second example: Another company will pay for a lifelong condition the year it is diagnosed, but excludes it the following years. Third example: Another company another limits the payment per illness to only $500.  READ THE FINE PRINT!
  • You have to pay the veterinary and hospital fees up front and then seek reimbursement from your insurer. 
  • If you wait until a condition is already diagnosed, or “forget” to renew on time, you probably won’t be covered.

THE UGLY

  • Insurance companies are in business to make money.  Many companies have come and gone over the years – emphasis on “gone.”  Those that make it are the ones that make the most money.  Those that offer the best “deal” may mean well, but not be able to live up to their promises when you really need them.  As in every contract, read the fine print and research the company before you send money!

 

Each pet owner will have to evaluate pet health insurance and decide if it is right for their pet(s), but it is definitely becoming something to consider.  And while it’s not right for every owner or breed, insurance does — in the case of trauma or disease —  ease financial stress.  When you are trying to decide between paying your electric bill or paying for a needed surgery for your dog, it’s not an easy decision, but if you can take the money out of the equation, you can then decide what is in the best interest of your dog.

Comparing pet insurance companies and policies can be very confusing.  Here are some comparisons of some of the most popular pet insurance companies.  Not all policies are created equal.  You always need to make sure you read the policy thoroughly and ask questions until you understand.  There are some policies that exclude problems with a certain breed.  If you’re considering insurance, the North American Pet Health Insurance Association (www.naphia.org) can provide guidelines for shopping for the best plan.  And, don't forget to find out things like: How long does it take to be reimbursed?  How's the company's customer service? What does the plan absolutely not cover?  

Please note that company insurance policies can change at any time, so only use this information as one tool for choosing a pet insurance company and make sure you contact the company you are interested in to confirm costs and coverage's for your individual pet.  Also, these are general policy offerings and most companies offer special packages such as for older pets, so if you are looking for variations in the below coverage's you will want to contact the company to see if they offer what you are looking for.

Check out Pet Insurance Review.

Company Pets Best ShelterCare PetCare Embrace Pet Insurance Veterinary Pet Insurance  (VPI) PurinaCare Trupanion AKC - Wellnes Plus Plan
Enrollment 7wks-no limit 8wks-8yrs 8wks-8yrs 8 wks - 8 yrs (dogs) up to 10yrs(applies to new enrollments only) 8 wks-no limit 8 wks-14 yrs  
Benefit Limit Lifetime limit of $99,750 No Annual No Annual $2,000, $5,000 or $10,000 per year $14,000/year $20,000/year No limits  
Deductible $75 per incident average (Annual deductible 0-$1000) No $50 per incident $100, $200 or $500 per year $50 per incident, $100 annual then covers 90% Yes Optional $0 to $1000 $125 with a 20% co-pay
Discounts Multiple Pet Multi-pet, Medical Service, Micro-chip Multi-Pet, Medical Service Multi-Pet, Service Dog, Microchip, Employee Benefit, Veterinary Worker Muiti-Pet, Employee Benefit   Employee benefit  
Cover Pre-Existing Conditions? No No No Only if completely cured -- *this company also covers genetic conditions yes if considered cured No Yes if completely cured & occurred more than 18 months ago No
Cover Hereditary? Some       Yes Yes - but not if conditions shows up within first 12 months Yes NO
Cover Cancer? Yes Yes Yes Yes Yes    Yes  
Cover Sterilization? Yes, with wellness plan addition No No No Yes     Yes - some policies
Cover Chronic & On-going conditions? Chronic conditions will continue to be covered each year as long as you don't go over your annual and lifetime payout limits       Yes Yes   Yes - however, the following chronic conditions do not qualify - eye conditions, chronic renal failure, diabetes, osteoarthritis, and spondylosis.
Cover Preventative Care? For Additional Fee         Yes - with Wellness Plan and no wellness deductible   Yes - some
Cover Non-Traditional Medicine? Yes - some coverage for chiropractic and acupuncture.         Yes   No
Monthly Cost $23.00 (approx.) $29.95 (approx.) $29.95 (approx.) $35.00 (approx.) $30.00 (approx.) $37.00 (approx.) $30.00 (approx.)  
Website www.petsbest.com www.sheltercare.com www.petcareinsurance.com www.embracepetinsurance.com www.petinsurance.com    

 

 

There is also AKC Insurance for those of you that have an AKC registered dog.  I have not had a chance to review it thoroughly yet but it does seem that it bares checking into.  They have several different available policies.

My conclusion from my research is this:  the experts and practitioners agree that pet insurance is a good thing.  It gives clients the option to seek care for their pets that they might not otherwise.  While each pet owner will have to evaluate pet health insurance for themselves and decide if it is right for their pet(s), it is definitely worth checking into.  And it may not be right for every owner or breed, but it will definitely ease financial stress should the occasion arise that you should need it.

 

Do You Need Pet Insurance?

 
Pet surgeon at work
CC-BY-SA 3.0 Kalumet at the German Language Wikipedia

As veterinary medicine becomes more technologically advanced, the cost of care increases because of the higher costs associated with the equipment, facilities and training required to provide these higher-quality services. For some, the cost of care can cause some anxiety. Pet insurance can help by offsetting some or most of the costs of diagnosing, treating and managing your pet's illness or injury.

But pet insurance isn't for everyone, and there's no magic formula that will tell you if it's right for you and your pet. If you're considering pet insurance, talk to your veterinarian and do some research on your options. Here are some basic considerations:

  • Regardless of the insurance provider, your veterinarian should be monitoring the health of your pet as part of a valid Veterinary-Client-Patient Relationship (VCPR; for more information, check out our VCPR FAQs).
  • The insurance provider should clearly spell out to you the details, including the limitations and exclusions, of coverage for routine and/or wellness care as well as emergency treatments and conditions that require extensive care. Find out how your premiums will be increased as your pet ages or if you make any claims.
  • See if they have add-on options to provide any specific coverage (e.g., dental care, travel insurance, etc.) you may want.
  • Find out how they define and handle pre-existing conditions (diseases or conditions your pet already has – or has had – prior to purchasing the insurance plan).
  • In some cases, insurance providers will not insure a specific pet or breed of pet, or may limit the number of pets you can insure, if they consider them "high risk."
  • Some providers will give multiple pet discounts.
  • All of the charges, including co-pays, deductibles, add-on charges and other fees, should be clearly explained to you so you fully understand the policy and its limitations.
  • You should be allowed to choose the veterinarian who will provide veterinary care for your pet.
  • Pet insurance plans are generally reimbursement plans – you pay the bills up front and are reimbursed by the insurance provider. Ask the insurance provider how claims are processed as well as the timeframe for reimbursement of your expenses so you know what to expect. If you're concerned about covering the expenses up front, ask your veterinarian about payment options that will work for you in case you need to make arrangements. (It's best to find out your options ahead of time so you don't have the added stress of trying to make payment arrangements on an emergency basis.)

For more information, see the AVMA's Guidelines on Pet Health Insurance and Other Third Party Health Plans.

Your veterinarian may be able to provide you with a recommended pet insurance company based on their experience, but it's ultimately your decision whether or not to purchase pet insurance (and what coverage and from what company you purchase). Below is an alphabetical list of companies that provide pet insurance. The list may not be complete and is intended to provide information and links to help you investigate and decide if pet insurance is right for your pet. The AVMA does not endorse or recommend any one provider over others.

24PetWatch

AKC Pet Insurance​

ASPCA Pet Health Insurance

Best Friends Pet Insurance

Embrace Pet Insurance

Figo Pet Insurance

Healthy Paws

PetFirst Healthcare

Pets Best

Petplan

PurinaCare

Trupanion

VPI