Stella

Stella

Monday, February 27, 2012

I Never Talked About Pet Insurance

It occurred to me today that I never talked about our experience with pet insurance. 

We do not have pet insurance on our current pets but we did have it for other pets in the past.  We had policies on 2 cats and 2 dogs. 

The policies we carried at that time were for catastrophic issues only; not for routine care or yearly check-ups.  In fact as I recall they did not even offer those years ago.  I do recall however that their care plans (with the specific company we were involved with) were offered in different levels; something like silver, gold and platinum levels.  We had the middle level.  The cost was around $30 per pet, per month.  We carried these policies for approximately 4 years and never used them even once for the cats (thankfully).

Incidentally, the coverage from the insurance company was around 35% to 40% reimbursement.  Not great but better than paying 100% out-of-pocket.

One of our dogs at that time was our Pug, Mugsy (he is also mentioned in an earlier post).  Mugsy had spinal surgery for ruptured discs in his lower back.  Prior to surgery the surgeon warned us that Mugsy may develop bladder issues as result of this surgery and healing - 10 months later, Mugsy had bladder surgery.

The insurance claim forms were about the size of a half sheet of paper; approximately 4”x6”.  Each form had 4 lines with boxes - we were supposed to fill in specific data in the boxes such as date, pet’s name, diagnosis, veterinarian’s signature and cost. We were required to list EACH cost separately – for example:


1/2/01 / Mugsy Smith / Pre-op for Spinal Surg / John Jones, DVM / $100
1/3/01 / Mugsy Smith / Spinal Herniation Repair / John Jones, DVM / $1000
1/3/01 / Mugsy Smith / Pain Meds Post Surgery / John Jones, DVM / $30
1/9/01 / Musgy Smith / Stitch Removal Post Surg / John Jones, DVM / $15
*This is just an example not actual cost or diagnosis description.


The instructions on the claim form stated that if we needed extra space (and of course we did since everything had to be itemized separately and there were only 4 lines to do so) we were to fill out an additional form.  The instructions were very explicit that we could not write on the back of the form nor could we use a blank sheet of paper – it had to be additional claim forms with the pre-printed boxes; but we were allowed to use as many as needed.  So we followed the instructions for both surgeries and all the costs involved; pre-op exams, surgeries, medications, post-op care, follow-up care, etc.

We received partial reimbursement for Mugsy’s spinal surgery and as we awaited reimbursement for the bladder surgery we received a notice that Mugsy’s annual premium had been bumped up 40% but without explanation.  I called the insurance company and was told that we had submitted too many claims for him.  They stated we were entitled to submit 2 claims per year (per pet) and every claim after that would trigger the premium to increase 20% per additional claim.  They stated we had already submitted 4 claims for the spinal surgery which is why the premium was now 40% higher and that they were denying coverage for Mugsy’s bladder surgery unless we were willing to pay an even higher premium.  Confused, I explained to the customer service rep that we had submitted only TWO claims in one calendar year for Mugsy; ONE for the spinal surgery and ONE for the bladder surgery.  The rep stated 4 claims were submitted for the spinal surgery alone.  I explained to her that we did submit multiple forms for ONE surgery but that was because they required itemization and only allowed 4 lines per form.  It did not matter that the multiple forms submitted together in one envelope obviously contained the information for the ONE surgery (as filled out by the veterinarian) – the rep stated EACH PIECE OF PAPER was considered a separate claim regardless what is was for; they counted the number of papers in the envelope period.   I canceled all 4 policies on the spot.

If pet insurance companies still operate in this same manner I can’t imagine what Stella’s premium would be today given that she had 2 major surgeries in one day followed by 20 separate radiation treatments in addition to the all the follow-up care and check-ups she’s had to date - and it hasn't even been a year yet.

Although we had a negative experience with pet insurance please keep in mind that this was 10 to 12 years ago and things may have changed and/or may be different for your pets depending on their healthcare needs.  If you choose to obtain pet insurance please read all the fine print, ask detailed questions about claims and ask about their cancellation policy. 


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