Friday, January 10, 2014

Pet Insurance

Ever since Maya's allergy outbreak at 10 months old, I've been regretting for not purchasing pet insurance the day we got her, especially after the broken tooth incident. Then it was the long debate of whether it's worth getting an insurance anymore, as there are already so many pre-existing conditions that won't be covered.

About a month ago, after learning the cost of surgery after accidents from a few fellow pet owners, I decided it's time to seriously consider pet insurance again. With some research and survey, I picked PetPlan (referral link), and here's why:

  • Recommendations from other pet owners
  • No lifetime claims limit
  • No per illness limit
  • Includes alternative and holistic therapies
  • Includes diagnostic testing

Like most insurance, they have a few different options to choose from.
  • Annual limit: bronze ($10,000), sliver ($14,000), or gold ($22,000).
  • Per illness deductible: $50, $100, or $200.
  • Reimbursement level: 80%, 90%, 100%. 

I choose gold plan with $200 deducible and 100% reimbursement. With some discounts, I paid $580 for the first year. It is the strategy for my own insurance as well, to have higher deducible, but better coverage. (However, after reading the fine print and realized that specialized treatment caps at 80% reimbursement, I'm wondering if I should lower to 80%.)

After signing up, I started the underwriting process, because I want to know for sure what are considered pre-existing conditions, so I won't have any surprises in the future. I downloaded a "medical record release form" from the website and faxed it to all 5 of Maya's vets that had treated her in the past 2 years. The vets were all pretty responsive and sent in Maya's records within a day or two. 

Once I was notified by all the vets that the records are in, I wrote an email to PetPlan to confirm. Well, that wasn't a happy conversation, according to the representative, "I searched our records for the medical records, and haven’t had any luck locating them. It is possible that the fax transmissions were unsuccessful; I apologize for the inconvenience." Are you serious? How could 5 different fax transmission all fail? Fortunately, a day later, I got an email from their underwriting department asking for my request in writing to start the process, so I guess they found the documents. 

About two weeks later, I got the "policy exclusion letter":
  • Dental disease - Dental tartar was noted prior to the policy. Dental disease is excluded from coverage for a period of 12 months once the teeth are cleaned and any recommended treatments are provided. This includes, but is not limited to treatments related to progressive dental disease.
  • Upper right premolar - Lifetime exclusion. Maya had a root canal and crown of her upper right premolar. This exclusion includes, but is not limited to; fracture of this tooth, and infection or complications related to the root canal or crown.
  • Atopy or Allergic skin disease - Lifetime exclusion. This exclusion includes, but is not limited to; pruritis, dermatitis, pyoderma, otitis and any other skin conditions that occur secondary to allergic skin disease.
  • According to the records we have received Maya is not up to date on heartworm testing and heartworm and flea and tick preventative. Any conditions that occur as a result of the lack of preventative care are excluded. If Maya's heartworm and flea and tick prevention are given, or if documentation is provided showing that she is up to date, this exclusion may be open to review.

The allergy and broken premolar lifetime exclusion were as expected. The dental disease was kind of surprising, as the tartar was minor and never really a concern from the vets. I wrote to ask if I was able to clear the tartar on my own and my vet verified her teeth is clean, can the exclusion be removed. They agreed that they can "review" the exclusion in that case. 

The heartworm/flea/tick prevention also caught me out of the blue. I followed up with Maya's heartworm test results from Hemopet last May as well as a bunch of receipts from ordering prevention meds online. I even sent a picture with her next to her meds. Hopefully, that'll be significant enough to lift the exclusion. Regardless, I'm not too concerned, as we have been careful.

Aside from the list, they also have a 6 month exclusionary period for knee related diseases, unless a vet noted both knees are healthy within 30 days of enrollment. I was stupid and totally forgot to ask the vet to check her knees during our last visit, which was perfectly timed within the period. Sigh.

The last thing I'm really worried about, is the premium increase as Maya ages. According to some online reviews, lots of owners have experienced about 25% increase per year. We've got a pretty good discount when we signed up, but I guess that'll just be for the first year, so the jump will be even more significant. We'll have to wait and see.

For those who are interested in pet insurance, here are some references: 

And for those interested in PetPlan, you may be able to get some discounts from the following links:

[Edit 1/14/2014]
After providing prove of purchase of Heartgard and Comfortis, they removed the exclusion for heartworm and fleas. Tick is still not covered, since Comfortis does not prevent ticks.

  • According to the records we have received Maya is not up to date on tick preventative. Any conditions that occur as a result of the lack of preventative care are excluded. If Maya's tick prevention is given, or if documentation is provided showing that she is up to date, this exclusion may be open to review. 
  • Edit: 01/13/2014: Removed exclusion for heartworm testing, heartworm prevention and flea prevention.

[Edit 4/14/2014]
Adding in a comment I made on a dog forum about the price being high comparing to other pet insurances: 
"Yes, it was higher than what I expected to pay. They have cheaper options too, but after some calculations, we decided that an extra $200 per year is something we can afford, while an extra $10,000 in surgery is not. I used "$20,000 for a surgery" as a guideline when I researched each insurance company, because that's what a friend spent when his dog got into an accident in our area. 
Each company do lots of "tricks" on their websites to make themselves look like the best. For example, on VPI website, they did a comparison for Pancreatitis treatment,
Bill Amount: $1,075.49
VPI: Paid $912.44 (85% Reimbursed)
PetPlan: Paid $759.46 (71% Reimbursed) 
However, they didn't mention that they had a limit of $1160, so if the bill goes up to $3,000 PetPlan will have much higher reimbursement. Something more like,
Bill Amount: $3000
VPI: Paid $1160 (39%)
PetPlan: $2320 (77%) 
For me, I don't really care when the difference is in the hundreds, but it really matters when it's in the thousands.

At the end of the day, insurance companies are not charity and they are here to make money. It's important to really read the fine print and know what you are looking for."

[Edit 6/10/2015]
My follow-up post about the 2nd year of using PetPlan: Pet Insurance - Year 2

[Edit 8/16/2015]
A good article about pet insurance. Exactly how I view insurance for both humans and pets.
It's about how much you can and willing to spend on your pets. 


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  2. Finally, a good and honest pet insurance review. Most reviews it seems like are either completely good or just downright terrible. Pet insurance is definitely one of those things that has its good sides and its bad ones!