And, more often than not, this trouble that they get into means pricey veterinary bills. Last week Trupanion paid a claim for the expenses to repair a puppy’s broken leg. Cause of the fracture? The little bulldog was accidentally stepped on, running up a total of $2,906.64 in veterinary costs. Click here to view more Trupanion pet insurance claims and associated costs.

A number of pet owners feel that setting aside a pet emergency fund each month will do the trick, and for many, that may be true. However, take the case above, and assumed Pet Owner is putting $20 aside each month. We’ll also go ahead and assume that Puppy is 6 months old and has been with Pet Owner for 4 months. Leaving Pet Owner with $80 set aside. Maybe this puppy got lucky and only required $100 to treat, but what if the bill had been closer to $500? $1,000?

No one plans on accidents happening, and before you are faced with an unexpected surgery, medications, or veterinarian bills, it may be worth looking into pet insurance.

HMO. Managed care. Human healthcare system (US). Sound familiar?

As most of you are aware of, human health insurance companies in the US like to dictate to doctors/hospitals/clinics what they are allowed to charge and subsequently, what the insurance company will pay out.

For example, if you go see a shrink through your healthcare provider, and that shrink usually charges $250 an hour (hmm maybe I’m in the wrong line of business…nevermind.) but the health insurance company says “to get our clients, join our network, but we will only pay you $75 an hour”. The same goes for regular doctor check-ups, emergency room visits, hospital stays, etc.

Ok now that you know what I’m talking about; let’s touch on our veterinary healthcare system. Oh wait, there’s isn’t one…yet.

As pet insurance becomes more popular in the US, many veterinarians are becoming worried that pet insurance will start dictating their prices. That is, the more that people buy into pet insurance to cover their pets, then their pet insurance company says “we will only reimburse you up to $200 for that knee surgery because that is a ‘reasonable cost’”. Well, when you get your veterinary bill for $1,000, what would you do in that situation? I know what I would do “hey veterinarian, why are you overcharging me?” It turns into a debate over who should you trust, veterinarian or pet insurance company? Well, as a representative of a pet insurance company, let me give you what I think is the correct answer: YOUR VETERINARIAN.

There is a reason why they went to school for many years and decided to go into veterinary medicine. They truly like pets. They want to make them healthy. They want to take care of their clients (your pets) and their owners (you).

I’ve seen many comments over the past few months on this blog about benefit fee schedules and people getting upset that their pet insurance didn’t pay out enough, or didn’t pay as much as they were expecting.

By now you’re probably thinking “ok, Melissa, get to the point already”.

Here it is: make sure you understand what your pet insurance company is paying out on. Most pet insurance companies do have some sort of reimbursement schedule or fee guide, whether or not they clearly market it. If you’re okay with getting about 50% of your claim reimbursed, then maybe that’s ok with you. But for most of us, we’re expecting to get the advertised “90% of your costs” or “80% of your veterinary bill” back.

Be wary of things like “usual and customary fees” or “reasonable costs”. Ask the question “Do you pay out based on what my veterinarian actually charges?”

Now, for those readers who haven’t yet gotten pet insurance or ran into the problem above, could the rest of you please share your horror stories? Did you think you would get $700 back but actually ended up only getting $300?

However, some veterinarians still can get stuck in the middle. For those companies who reimburse based off “usual and customary fees” or fees that the company deems reasonable for a given procedure, the pet owner may then feel like they were over charged by their vet. From some veterinarians that we’ve heard from, they don’t want to get stuck in the middle so they don’t go out of their way to recommend companies, but they will do their best to honor their clients wishes and fill out necessary paperwork.

Of course there are veterinarians on the other end of the spectrum, who love pet insurance and have seen how it has helped save lives when the pet owner wouldn’t normally have been able to afford a given procedure.

As a pet owner, would you feel your vet was doing you a disservice if they weren’t informing you of pet insurance, if it turns out it could have helped you? Do you think it should be their job to help process paperwork? If I have any veterinarian followers out there, I’d love to hear your opinion as to why or why not you may tell your clients about pet insurance.

This forces you to go to an emergency clinic, which typically costs a lot more. While pet insurance would more than likely cover treatment of a broken leg, how much would they cover at an emergency clinic?

Some companies will cover the same amount as if you saw your normal veterinarian, while others will lower the coverage amount. The same goes for referral specialists. Say your cat developed some kind of skin allergy and had to visit an allergist. Often specialists end up costing much more. True, this is also something that most pet insurance companies would cover, but at what cost?

Make sure that when you’re looking into insurance, that you find out if you are covered for treatments outside of your normal veterinarian.

What started off as any old day, get up, get ready, make coffee, let Goldie out, drive in to work, sit at desk, start working…you get the picture, turned out to be a little crazy. Goldie, my lucky lucky dog, gets to accompany me into the office every day where she is always greeted by her other canine office companions and they run around all day. If we could only all be so lucky.

I know that she has a tendency to follow her nose and wander away if left to her own devices, so when I couldn’t find her around the office I didn’t think too much of it at first. After all, she’s always somewhere. I started asking around and got a response that someone saw her outside and assumed I had been with her and that we went somewhere. And so set in a little bit of panic.

…And it kept building as I realized that she had somehow gotten outside (and I won’t point fingers, but I still don’t understand how someone would let her out WITHOUT knowing about it…). Of course a million horrific images popped into my head at once as I ran to get my car keys to go start driving around.

“What if she ran into the woods somewhere and doesn’t know how to get back?”

“What if she gets hit by a car”

“What if someone takes her”

And worst of all “What if I have to go home tonight without Goldie?”

You know, basic ‘mama with lost dog’ panic. My heart dropped even further as I noticed that her collar was sitting on my desk (her and Charlie tend to get rough when they play, so we remove their collars in the morning).

Slowly people in the office started hearing about the story and were starting to gather and heading outside. My first instinct was the jump in my car and head left – call it mother’s intuition, but I found her ‘taking herself for a walk’ about a block down the road on the sidewalk. As soon as she saw me and my car she went crazy, as I think she had followed her nose a little too far and got turned around.

PHEW!

Well that was my first (and hopefully last) near dog loss experience. And did I mention I’ll never take Goldie’s collar off again? And yes, she is microchipped, but you never know, right?

Anyway, I’d love to hear similar stories…and how you stayed sane!!!

13. How are claims submitted? How long do I have to submit a claim? Will my costs change based on the number of claims I submit?

This is an important process to understand, since, duh, this is how you get your money back! Make sure you understand what you have to do, what your veterinarians has to do, and exactly how long you have to do it. Some companies require you submit your claim within 30 days of the treatment, some 3 months, some a year, but make sure you understand that time line. The last thing you’d want is a denied claim simply because you exceeded the amount of time you have to submit!

14. How long does it take, on average, to be reimbursed?

This is a little trickier to get a straight answer. There aren’t many rules regulating how long a company has to reimburse a client. Some companies will advertise their average turnaround time, while others will dance around the question. Either way, do your best and see what you can get out of them.

15. Does this policy use a list of “usual and customary fees” to determine how much I will be reimbursed? Is that list up-to-date? Are the fees consistent with what my veterinarian expects to charge?”

For this I would recommend getting this answer in writing. Find out exactly how much you will get reimbursed on an approved claim, and even think about taking those costs/fees into your veterinarian to see if they make sense. If your veterinarian says “no way, these prices are way too low” then you might want to consider another company.

The over-encompassing term amongst pet insurance providers states that they will not cover conditions which existed before the policy term. Ok. I can live with that. Or can I? Sure, if my cat gets diabetes tomorrow and then I got to get insurance the next day, I wouldn’t expect them to cover any of the medications. However, if she’s covered when she develops the diabetes, then my policy renews in 6 months from now and suddenly they won’t cover the diabetes anymore, that’s not cool!

Let me pull out my common sense really quick and say that that doesn’t make sense! If there was no lapse in coverage, and the condition was covered, how the heck could it *magically* become pre-existing?! Now, don’t be fooled by the companies who will claim to give you the option to have these things covered. Oh, I hear my common sense again, “They should be covered in the first place! Why would I want to pay more to have something covered that should already be covered?”

As fellow pet owners, I would love to hear your take on the situation and share your stories. How do you think pre-existing conditions should be define? Keep in mind here, pet insurance companies have to place limits somewhere or they’d have to charge ridiculous premiums or go out of business.

Companies may boast about “we pay out up to $30,000 a year!” and then in the fine print or in fast paced radio voice “each incident only pays $1000”. So, what you’re telling me is that my pet would have to have 30 separate incidents for me to receive the full ‘benefit’?! Wait a minute, something doesn’t add up. Not to mention, what most pet owners aren’t aware of ahead of the incident, is that cancer treatments and knee and hip surgeries, for example, can cost an upwards of $10,000. How many of you have been tricked by limits? What do you suggest to others looking for insurance?

You can learn more about pet insurance limits by visiting here.