Mar Vista Animal Medical Center

3850 Grand View Blvd.
Los Angeles, CA 90066

(310)391-6741

www.marvistavet.com

PET INSURANCE BASICS


(Photocredit: Morguefile.com)
Imagine a world where expense is not a major factor in your pet’s health care decisions. The fact is that, thanks to pet insurance, you are probably already living in this world but do not how participate. There are many pet insurance companies and many options; navigating through all the choices can be tricky. Many people do not know where to start.

OPTIONS AND VOCABULARY: DECIDING WHAT YOU WANT

“Per Condition” versus “Annual”

Insurance pays according to an annual term which renews on the anniversary of the sign-up date or “per condition” meaning per disease condition. Per condition insurance is a better deal for on-going or recurrent conditions while the annual basis is better for finite single conditions.

For example: Allergy, Arthritis, Cancer, Kidney Insufficiency, Idiopathic Cystitis, Asthma, Tracheal Collapse are examples of on-going conditions. If you have “per condition” coverage you need only pay your deductible one time for each condition and then the insurance company pays for life. Each disease has its own deductible to meet.

Alternatively: A simple broken bone, bite wound, intestinal foreign body, or parvovirus infection are likely not to have implications for the long term after recovery. Further, a pet may have multiple incidents within a one year period. All the incidents add together to meet a single annual deductible and after the deductible is met, the insurance company pays for the rest of the year. When the year is up, the deductible starts over.

Per condition tends to be better for older pets or dog breeds with genetic issues as these pets tend to experience long term problems.

The Cap

The cap is the maximum paid by the insurance company. You either want no cap or a very high cap (at least $8000). Insurance with a low cap will not reliably cover a major illness in this city.

The Deductible (you typically pick from $0 to $1000)

This is what you pay before the insurance kicks in. If you have an annual deductible, this is the amount you pay per year for covered conditions before insurance kicks in and next year you have to pay it again before insurance kicks in. If you have per condition insurance, this is the amount you pay for a given disease/condition before insurance kicks in.

If you pick a very high deductible to get a lower premium, you will end up with insurance that only pays for very serious conditions.
If you have an annual policy and a high deductible, it may never pay out.

Percent Covered

After you pay your deductible, insurance kicks in and pays a percentage of what is the remaining charges are. It will likely be 100%, 90%, 80%, or 70%. Obviously, the higher the percent covered, the less you have to pay out of pocket. Some policies do not have options: they simply cover 90%. Others let you pick your percent covered so you have more control over your premium.

 

Waiting Period

When you sign up for insurance, there is likely to be a waiting period before coverage begins. This period differs between insurance companies or may differ for orthopedic illnesses vs. other illnesses. Some plans do not have a waiting period.

Wellness Coverage

Insurance is made for accident/illness situations but many companies offer “wellness coverage.” Wellness services include: vaccination, flea products, annual examination, teeth cleaning, microchipping, spay/neuter, routine lab testing and more. Since these are services that every pet needs, it is possible to budget for them on your own but it may be worthwhile to have them covered through your pet’s insurance.

If you choose to add Wellness coverage, be sure you are not restricted
to specific amounts for specific services (i.e. $50 for annual exam, $75 for vaccinations etc.).
Get either unrestricted wellness or a lump sum that you can mix and match depending on what Wellness services you want.

The premium (how much it costs)

The “premium” is your monthly payment. The more you want the insurance company to cover, the higher your premium will be. You can control your premium by changing the cap, deductible, and percent covered.

WHAT IS NOT COVERED BY PET INSURANCE

  • No pre-existing conditions are ever covered. Get your pet insured before something major happens.
  • Some policies will not cover ruptured cruciate ligaments in dogs. Some do not cover congenital disease even if it is inapparent at the time coverage starts. Some will not cover FIV+ or Feline Leukemia positive cats, Diabetic pets, or pets with Cushing’s disease (unless these conditions develop after the pet is already insured). Be aware of any limitations of a policy you are considering.
  • Some companies will only accept new patients if they are under age 14 or 15 years of age (though there are several companies that will insure pets of any age).
  • Some policies do not cover the office call fee for an accident/illness incident and consider this to be a “co-pay.”

SPECIAL SITUATIONS OTHER CONCERNS

There are special situations that you may want to check into before settling on coverage.

  • Discounts if you pay for the whole year at once or if you do not need your insurance for a year.
  • Will you be interested in coverage for alternative medicine or physical therapy? This may or may not be extra.
  • Are behavioral problems covered?
  • Are therapeutic diets covered?
  • Is there 24 hour customer service in case you have coverage questions during an emergency?
  • What is involved if you want to change your coverage? If you want to change your deductible, will you lose coverage of prior conditions?

There are currently about a dozen pet insurance companies. Each one will have a premium calculator on its web site so you can determine premium for the options you want. If you are looking for more help making insurance comparisons please visit:

petinsuranceuniversity.com

(an independent site put up by a veterinarian who sorted through it all and made an easy to follow format).