“That’s surgery waiting to happen,” warned the vet tech. Moments earlier, my husband and I were making our way to the exam room with our newly adopted retriever, Oscar, when he paused to vomit up the pound of pea gravel he’d stealthily swallowed from our backyard walkway. And over the next 10 minutes, as the veterinarian looked over our otherwise-fit 8-week-old pup, he discussed the dangers of foreign-body ingestion. That afternoon found us digging out the gravel path before digging up online resources for pet insurance.
Since the famous collie Lassie fetched the first U.S. pet insurance policy in 1982, the health of our furred, feathered and finned friends has become big business in this country. In 2014, U.S. pet owners spent some $15 billion on veterinary care, including $660.5 million in insurance premiums, according to the American Pet Products Association. The pea gravel incident was nine years ago, and though Oscar has never quite learned not to “ingest foreign bodies,” we’ve been lucky enough to stay clear of the surgical suite. But owners never know what health complications may arise.
“Pet insurance helps defray medical care costs,” said Marie Queen, executive director of the South Carolina Association of Veterinarians.
Charleston Animal Society’s director of community engagement, Kay Hyman, agreed. “Pet insurance can soften the financial blow of an emergency that could otherwise lead to a pet being returned,” she said, noting that the shelter offers new adopters a 30-day gift of insurance coverage.
Commonly claimed conditions in dogs and cats can cost hundreds to thousands of dollars in medical treatment, reports Veterinary Pet Insurance Co. Having the right insurance plan can unburden pet owners of disastrous financial hardship as well as alleviate the risk of losing a beloved animal.
The North American Pet Health Insurance Association boasts more than 30 member providers, so how can pet people be sure they’re buying the pick of the litter when it comes to plans?
“I recommend that folks do their research to get a policy that will truly benefit them,” Hyman said. Policies range from à la carte options covering solely medical (labs, X-rays, hospitalizations, medications and more) or wellness (check-ups, flea/heartworm prevention and vaccinations) to complete care plans covering all of the above. When vetting pet health insurers, chew on these five questions:
1. How is reimbursement determined? Rarely does an insurance plan pay veterinary costs directly. Most often, policies reimburse holders a portion of time-of-service payments to the animal’s health provider. Some rely on a benefit schedule, which lists diagnoses with a corresponding payout maximum. If those fixed amounts are significantly less than treatment costs, owners could be responsible for a large portion of the bill. Other programs simply reimburse policyholders a flat percentage of the vet bills — just beware that some such plans limit refunds by excluding common items like exam fees. Understand how reimbursements are determined and how quickly they will be paid.
2. What types of coverage are included? To maintain a pet’s health, look for a plan that includes wellness and routine care coverage, such as office visits, exam fees, spay/neuter surgery, vaccinations and tick/heartworm preventatives. The top dogs also cover behavioral care and alternative therapies like acupuncture and chiropractic.
3. Are pre-existing and genetic conditions excluded? The rules around pre-existing conditions can be hairy — some plans deny coverage on all previously recorded conditions while others may reinstate coverage of a “curable” complication (think respiratory infections and gastrointestinal disorders) if the pet goes symptom-free for a set period. Be wary of plans that refuse to throw you a bone for costly genetic conditions commonly seen in purebred dogs and cats, such as hip dysplasia in retrievers and progressive retinal atrophy in poodles, as these are what pets will most likely develop. Experts recommend engaging a policy before any health concerns arise. In order to fetch coverage, most policies require a documented vet visit within the year prior to enrollment.
4. Is there a deductible? If so, how is it determined? Annual deductibles must be met during each 12-month term before full coverage begins. Per-incident deductibles apply to every new claim filed. Per-condition deductibles can be beneficial for chronic conditions.
5. Will limitations or increases be imposed? Just as with deductibles, insurance plans may have annual, per-incident and per-conditions reimbursement limitations. Some call for lifetime limitations, meaning payouts stop just when your aging animal needs the most care. Be cautious of premium increases that penalize for the pet’s age, veterinary inflation and excessive claims.
Other factors to consider include: Can you select any veterinarians, including specialists and emergency clinics? Does the plan have a waiting period before coverage applies? Is the policy transferable/cancelable?
When sniffing out the best deal (multi-pet discount, anyone?), identify exactly what’s involved before committing paw to paper. As much as the monthly cost, consider deductibles, co-pays, caps and service gaps. Understand how a pet’s age and breed influence coverage. And consult a trusted veterinarian for advice on selecting a clear and comprehensive plan that works for your companion.