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Should I Buy My Pet Health Insurance ?

Health Insurance For My Dog And Cat


Ron Hines DVM PhD

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Purchasing medical insurance for your pet might be a very good decision. You must be considering it if you are reading this article. There are a lot of articles on the internet regarding specific pet insurance policies. But only this one is written by a veterinarian who has no personal interest in these companies that are looking for your business.

The basic questions you have to answer are these “Do I consider my pet a family member and would I spare no cost to keep him/her well as long as is medically possible? “Would these costs cause me financial hardship or might I not be able to pay for them at all?”

Fifty years ago, the majority of Americans would have answered no to the first question. But today I suspect that the majority would answer yes. In the interim, our family size contracted, our relatives tend to live farther away, we are living longer, our disposable incomes have increased, the human/animal companion bond has grown closer and veterinary medicine has become enormously more sophisticated and able to offer life-saving but costly treatments.

Over the last four decades, companies have appeared that offered pet health Insurance. Few prospered and most did not stay in business for long. There were several reasons for this. The first, was that most of them underestimated the complexity of the task. Unlike humans, dogs and cats come in multiple sizes, shapes and pedigrees – each with it’s own set of problems. Second, acceptable standards of care varied greatly from location to location -making treatment decisions and cost of treatment highly variable. Third, few of these companies were owned by or employed specialists in veterinary medicine. They thought this would be something like offering car or vacation insurance, which are not nearly as complex. Fourth, most of these companies were under capitalized. They did not have deep enough pockets to pay claims. Fifth, some were fly-by-night operations that never intended to pay claims justly.

In many ways, pet health insurance policies are similar to the human health insurance policies you are acquainted with. They both have annual premiums, deductibles, and different coverage plans based on the types and limits of coverage you choose. Like private human insurance, pre-existing conditions are rarely covered for the first 3 - 12 months after you enroll, and age factors into the premium cost. But species, and lifestyle (indoor vs. outdoor cat) also are factored in. If they are not factored into the plan you are considering, it may signify a problem. Certain breeds suffer high incidence of certain diseases and plans may attempt to protect themselves from high costs by not insuring these breeds or the condition in question (such as hip dysplasia in German shepherds).

You must remember that all of these companies are in business to make a profit. They use actuarial tables to calculate their exact risk of having to pay your claim and then set a premium rate that earns them a profit when many pets are insured. They know how many pets will develop each specific problem. You buy their policy so you won’t have to worry that your pet is one of them.

Unlike human medical insurance, pet insurance usually reimburses the owner for a percentage of the pet’s treatment cost – not the veterinarian directly.

How Should I Choose A Plan?

There is little benefit in purchasing a policy to cover routine, treatment. The companies know the average fees that they will have to pay and that they will be paying these costs for virtually every pet they insure. So the cost of the insurance for these procedures will likely be the same as the fee you would pay for these services directly, plus whatever it costs the company to administer these plans. The exception would be when a company negotiates a lower fee with chosen providers in your area. Your regular veterinarian may or may not choose to participate in such a plan.

Regarding deductibles. I suggest you decide at what price a procedure would become a financial hardship to you and set your deductible at that level. That is a form of self-insurance that tends to be cost effective.

Which Are The Best Companies?

In choosing a specific company my main suggestion is to check on the company’s prior reputation, scope and length of time in business. My favorites are policies offered by branches of companies you are already familiar with. In order of preference, mine are Nationwide Insurance Corporation's /VPI, the more-recently-announced Aetna/Pet's Best alliance and Nestle/Purina's PurinaCare). The advantage of VPI is that they have been in business many years and have a proven record in paying claims. Aetna and Purina are new to the pet insurance market and we have only the reputations of the parent companies to evaluate. Other companies offer less expensive policies for a simple reason; they pay you less when you submit a claim.

Before you approach these insurance companies, obtain copies of all your pet’s health records. Read through them. If visit dates are missing or if examinations notes are unclear, ask that they be corrected or an explanation added. This will help the insurers understand your pet’s current health and their degree of risk.

If you choose another provider, be sure that they or their underwriters are well funded, have a
solid history of paying claims and, most importantly, are approved and regulated by your State Department of Insurance. These are called “admitted” companies.

Before you purchase a plan, take it by your veterinarian and see if he/she thinks the policy limits are realistic.

Here are the top medical reasons cats go to the vet:

Urinary tract infections, stomach problems and vomiting, kidney failure, intestinal upsets, diabetes, allergies, ear infections, respiratory infections and over-active thyroid gland.

Here are the top most expensive procedures your cat might need:

Eating a foreign object that must be surgically removed, boy-cat urinary problems requiring surgery (urethrostomy), kidney cancer, bladder stones, other cancer, radioactive treatment for over-active thyroid, malignant fibrosarcoma skin tumors,
Kidney cancer, intestinal cancer

Here are the top medical reasons dogs go to the vet:

Ear infection, skin allergies, hot spots, upset stomach with vomiting due to eating the wrong things, diarrhea, urinary tract infection in females, skin tumors on older dogs, eye inflammations in bug-eyed dogs, arthritis, sluggish thyroid gland.

Here are the top most expensive procedures your dog might need:

Intervertebal disc problems requiring surgery, lung tumors, gastric torsion, things eaten and lodged in the intestine or stomach requiring surgery, torn knee ligament, cataract removal, bone tumor, auto accidents causing broken bones, brain tumors

You can read more about each of these problems on this website when you visit ACC.