Saturday, October 27, 2012

Getting On The Pet Health Insurance Wagon: Does Being Insured Equal Being Covered?

To get a pet health insurance or not to get pet health insurance, that is the question. 

It's been a dilemma for us for a very long time. The main reason? We don't like insurance companies and we don't trust them.

Insurance companies are not charity organizations.

They are businesses; they are in it to make money. And as they say in Vegas, “the house always wins.” So why would anybody ever pay for any insurance?

We were struggling with this dilemma when we got Jasmine.

We asked her vet at the time what the cost of some common mishaps and accidents could be. We then decided, that instead of paying insurance, we would put an equal amount into a savings account instead. Made perfect sense to us and it is an advice you'll often hear.

It was the advice we got from Jasmine's chiropractor when we mentioned we were considering getting pet health insurance for JD.

Logical, isn't it?

We had five thousand dollars put aside in a dedicated savings account for Jasmine's unexpected vet bills and we felt very good about it.

And then Jasmine injured her knee. Then a mass was found in her abdomen. Then she busted her other knee. Then she ended up spending a week in the ICU at the teaching hospital after her drug-induced hyperthermia …

Over sixty five thousand dollars of veterinary bills later (and that's just for the past four years) the five thousand dollars, we'd originally saved, turned out to be about as good a spit in the ocean.

Here is the question, though, how much of that would have actually been covered and paid had we had an insurance?

Jasmine's acupuncture vet adopted a dog who ended up with back-to-back health issues, similar to Jasmine. She did have an insurance. Guess what? After a number of claims, the insurance cut her off.

Getting pet health insurance is one thing. But what does it cover, how much does it pay up, and under what conditions? 

Does one actually need to get a lawyer in order to figure out all the different policies and conditions in order to get an insurance that will do them any good?

With Jasmine, it is what it is. But what about JD?

JD might of course remain perfectly healthy for his entire life. Not all dogs get sick and keep on getting sick. But short of having a crystal ball, there is no telling what might happen.

Every time I watch JD throw up bunch of wood chunks, run after a squirrel without any regard for the terrain and obstacles, or simply run into things expecting them to get out of the way, I get covered in cold sweat.

We don't have any more money or credit to draw from!

Frankly, we don't even have any extra money to spend on an insurance. Jasmine is an ongoing project and expense.

We discussed this over and over, time and time again. We looked at different policies from different pet health insurance companies. We looked at the premiums and the conditions. And we kept procrastinating. Stories we heard did very little to encourage us.

With JD, I mostly worry about intestinal obstruction, intestinal perforation, broken limbs, busted knees, bloat …

Many companies offer insurance at reasonable rates. But when you look at the policies, you'll find that the policy might cover only say up to $2,500 per accident/illness/year.

Well, that is all fine and dandy, but how much of veterinary care does that really buy?
  • Jasmine's hospitalization after her drug-induced hyperthermia, and to remove an abdominal abscess –   $13,000
  • Lilly's severe adverse reaction to a rabies vaccine – $16,000 (or more, I don't know the exact number; the insurance covered something around $3,500)
  • Ella's hospitalization and surgery after ingesting a string – $7,000
  • Diagnostics and treatment/surgery of cruciate ligament injury – $5,000
  • Ella's syringomyelia diagnostics and treatment – $10,000 plus
  • Cancer diagnostics and treatment – $10,000 - $20,000 plus
  • IVDD diagnostics and surgery – $8,000 plus

And for all that you'd get $2,500 minus your deductible. So that is not very helpful, is it?

A friend of mine had a coverage that included stem cell therapy. Awesome, right? So they did the treatment and the insurance paid. $150. (Stem cell therapy comes to $2,500 plus, depending on where you have it done) Their policy covered stem cell treatment but had a maximum of $150 for arthritis treatment per year! That wouldn't even cover the cost of NSAIDs!

Makes you wanna run out and get one [pet health insurance], doesn't it?

Some plans out there offer coverage up to $5,000 per accident/illness/year. That's better, but apart from the knee injury, doesn't really cover any real disasters either, does it?

If we were going to pay for an insurance, we wanted to be covered no matter what happens. You can't tell your dog to get hurt/sick only within the coverage you happen to have.

Our sentiment in that regard was clear. We're not going to waste our money on insurance just to get a consolation prize.

Then we found an insurance who has a premium plan that offers unlimited coverage per accident or illness. Sounds good, right? They even cover  things such as annual check-ups and dental cleaning. HOWEVER—and there always seems to be a however—they pay out only up to 80% of the actual cost (minus the deductible, of course). AND if you make too many claims they can lower it all the way down to 50%!

No wonder we kept abandoning the idea of getting pet health insurance.

Not to mention all the things that don't get covered anyways, such as pre-existing conditions, hereditary conditions ...

Is there actually ANY way to get insured AND covered?

On the other hand, as healthy as he is, JD is a disaster waiting to happen...

The most no-nonsense plan we could find is with Trupanion.

The core policy covers
  • Accidents
  • Illnesses
  • Hereditary conditions (other than hip dysplasia)
  • Congenital conditions
  • Diagnostic tests
  • Surgeries
  • Medications
  • Hospital stays
  • Veterinary supplements

There is no lifetime limit per claim, per incident, or per year and no lifetime payout limit. It pays 90% of the cost (minus deductible). It seems simple and sweet.

So JD is now officially a Trupanion insuree.

He is now insured—and, hopefully—covered. If we get disappointed, you'll hear about it.

Do you have a pet health insurance? Do you have misgivings with pet health insurance?


  1. Brilliant post! We've had that same circular discussion at our house, with the same result (setting aside $). Like you, we've had "surprises" that our little "vet pot" couldn't possibly cover. Definitely going to check out Trupanion. Thank you!

    1. Hi Sue, it IS a major dilemma, isn't it? Of course, the easiest solution would be being rich ... LOL Otherwise, one be pretty much screwed.

      This seems to be the best option out there, hopefully the best is good enough.

  2. We're a Trupanion client too. I actually spoke with the CEO of the company, because I had questions about the policies and it turns out that my questions didn't even cover it. Thank heavens I spoke with Trupanion or I would have ended up with a different company who would have dropped me after a claim or two or because our dogs got old or because they determined that their breed was a risk.

    I'm with you. I don't trust insurance companies. I've been screwed over in the past happily by insurance companies and had to listen to their lame reasons why I wasn't be covered although I made my payments faithfully and on time for years (talking about YOU American Family).

    Great post!

    1. That is quite reassuring in regard to our choice, glad to hear.

      So sorry about your insurance misgivings, things like that were the source of our great hesitation.

  3. Hi Jana,

    My family have had me covered with Trupanion since I was a puppy and so far we've made 2 claims - Trupanion have been excellent in our experience and Mum and Dad are so happy they don't have to worry when I go to the vet about the finances, as well as about me….

    They've had insurance in the past for Dogs (in the UK) and found it a relief when they got really sick that it was one less thing to stress about….

    I hope you have a great experience too with Trupanion :)

    Wags to all

    Your pal Snoopy :)

    1. Thank you, Snoopy, glad it's been working out for you.

      Pet health insurance is certainly awesome in theory; in real life, though it doesn't always seem to work out for the good of the dog. I'm hoping that the story is different with Trupanion, that's why we decided to go with them.

      Wanna share about your claims?

  4. Sure Jana,

    The first one was when I had a stomach problem last year and they surprisingly covered 50% of the cost of the special food I needed too….

    The second was when I recently had a sudden massive swelling in my throat - this was about $500 worth of investigation and medication, we have no deductible on ours, so they paid 90% of the cost (excluding the exam, which was about $50) - they give you progress info as they process the claim by email and they paid out really fast…

    I think they've just introduced an enhanced policy to cover alternative therapy, etc - but we haven't signed up for that - Mum's thinking about it


    Your pal Snoopy :)

  5. Great and informative post. It's been a long-time dilemma of mine too. And while I've never had pet insurance, I was thinking I'd look into it before Cosmo turned 10. Then right about the time I was considering it, Cosmo was diagnosed with cancer. The only consolation is I saved 10 years worth of premiums. But now I'm thinking insurance might be a good thing, if it's the right one. Thanks for sharing this info.

    1. Hi Diane, thank you for reading!

      How is Cosmo doing?

      Yeah, a little bit too late now to get an insurance ... Insurance most certainly is a good thing BUT only when it actually pays the bills which, unfortunately, isn't always so.

      So that's where the problem with insurance is - paying for years and then, when one needs it, instead of money getting excuses why you particular situation is not covered or get some ridiculously small amount on a huge bill. And, sadly, that happens often enough.

  6. After seeing several pals trying to raise money to pay huge vet bills for cancer and other extreme conditions, I decided to get insurance for "just in case". I have Trupanion, after the research, they seem to be the best choice. :) I chose a high deductible though, and the exam wasn't covered (er vet for gastritis), but the treatment and tests did count toward my deductible :) I chose them because they don't have annual or lifetime limits and cover hereditary. I didn't get the premium rider, so "behavioral" items like Valium are not covered, but Valium is cheap enough. :) So far I am happy with my choice. It is a great relief to know I can say "do what is required" without worrying about cost.
    No insurance will cover pre-existings. so I think with your first dog, you are out of luck, but would be great idea for your second dog.

    1. Hi PepperPom, yes, often the situation gets dire. Insurance is great when (see my above comment). Often people pay for insurance only to get nothing. That's when it is wrong and that's why people shy away from getting one.

      Trupanion doesn't cover ER vet either?

      Glad you're happy with your coverage. We picked average deductible, simply because that's all we can afford along Jasmine's constant vet bills.

    2. Trupanion does cover ER visits. I believe what he was referring to, was that the exam fee from the ER wasn't covered. Trupanion does not reimburse exam fees. I work with Trupanion as a Territory Partner. They are a great company filled with animal lovers and really do want what is best for the pet. It is a business and as a business, they certainly want to be profitable. Insurance of any kind is a gamble, maybe you'll need it, maybe you won't. But unless you are in the financial position to "self-insure" it certainly helps you sleep at night! I'm very glad to hear that you all have been happy so far and I believe you will stay that way.

  7. I have similar (or the same!) trust issues with insurance, and after a ton of research I narrowed it down to Trupanion and PetPlan. I was looking at both what was covered, and reviews about what people were saying regarding reimbursements. Ended up going with PetPlan as at the time Trupanion didn't cover hip dysplasia and I wanted to be covered for that (I notice they now cover it). I'm wondering if any of the limitations you noticed involved PetPlan? It has been a couple years since my research.

    So far PetPlan has reimbursed for the only accident/claim we've had (knock on wood!), which will cover the next 5 years of premiums. Good, but I still have the trust issues! And like you I won't be quiet about any problems I run into (although to be fair I will of course share the positive too).

    I'm sorry to hear about your health difficulities and expenses. I ran into a 10K-in-3-days cost (then my dog passed) that led me to the insurance for our future guys. I too had done the savings thing, and was pretty blown away by how quickly it can rack up with certain diseases and specialist care. Particularly when we only had that dog for 8 months... if we had only been putting away some money each month, that wouldn't have covered much!

    Thanks for the great post!

    1. Yeah, the pet health savings account sounds good on paper, doesn't it? Probably plenty for most dogs, but ...

      The problem is one never knows what's coming. We certainly did not.

      I did consider PetPlan, sounds pretty good except that they cover up to 80% of the claim, More over, what hinds behind the "UP TO" is that if one makes "too many claims" they can lower it all the way down to 50%

      This is what I got from them directly:
      "Upon enrollment, your veterinary services will be covered at 80%. Depending on your claiming activity, this may be adjusted. Adjustment are made in accordance with our Claims Risk Management process. This process involves a semi-annual review. The review considers the past two years of claiming history for all members. Should your claiming history be above the average of all policy holders, you may experience a co-insurance adjustment. Adjustments are completed in 10% increments to a maximum of 50%. This change, on average affects approximately 3% of all policy holders. Should the claiming history fall back within the average of all policy holders, the co-insurance would be adjusted positively. The maximum percentage of coverage is 80%."

      So that just didn't work for me. I know how much we spent on Jasmine. And I know that her acupuncture vet has a dog who's sick a lot and they got "kicked out" of their insurance.

      What is the average claiming activity? I don't know but I do know that I was getting insurance for "non-average" expenses.

      So that's why I sent with Trupanion instead.

    2. We'll switch to Trupanion for future dogs, sounds like - especially with their recent changes for hip dysplasia and holistic care. I'm worried about preexisting conditions to switch our current dogs over, at least for Mort (who was hit by a car - we had costs reimbursed at least). We insured them directly out of the shelter, to reduce/eliminate preexisting conditions under our care. Tigger, our other dog, hasn't had a single issue so perhaps it would be safe to switch her as she's still fairly young too (just under 4yrs old). Do you have any data about Trupanion and preexisting conditions? This was something that came up regularly for all the companies when I was researching a few years back, but it has been awhile now so details are fuzzy.

    3. I think you won't find an insurance that covers pre-existing conditions, for obvious reasons.

      If your other dog has no history of illnesses, than you should be fine. JD is 5 but has a clean bill of health, that's why it was safe to enroll him.

    4. Yeah, not looking for one to cover any (both dogs don't have any - just the one that was in an accident but fully healed) - what I'm concerned about is the insurance company claiming the issue as the cause of whatever the claim is in for. I've heard many very ridiculous things happening in this area, like an ear infection two years ago being a pre-existing condition for cancer sort of things. Or even ones that don't make sense... the ear infection negating a claim for being hit by a car, for example. So that's why I was sure to immediately insure after adoption, and my concern about switching, whether anyone with Trupanion has run into problems like that.

    5. Trupanion policy is quite clear on their rules, check it out. I don't think they would do what you're saying, though with insurance companies one never knows

    6. Yeah, with all the reading did I became very skeptical (they never say they will and everything sounds terrific on the marketing material, so I went for anecdotal evidence). Anyway, will start drudging through the forums and blogs again :)

    7. I was extremely skeptical too. Trupanion seems to be reasonably fair and square, so we decided to give them a try.

  8. So glad I found your post! I have been procrastinating getting insurance forever. I did not know of this company so I am on my way to check it out. Thanks! Love Dolly (and Sandra)

    1. Hi Dolly, we researched really hard, most of them have a snag, this one does not. They even upgraded their coverage now, so they cover more things.