16. Can I afford the monthly premium, deductible, and required co-pay?

Don’t think this question needs much explaining..but, just make sure you think about the different costs and what the co-pay would mean to you.

17. Is there any penalty if I cancel my policy?

It’s my understanding that with insurance, you’re always owed back any premium that you’ve paid ahead of time. However, make sure to check with each company just in case you decide you don’t like the coverage. And, as in most pet insurance companies, if you decide to switch, any conditions that began with one company will likely not be covered by another.

I hope you have found these questions helpful. I’d love to take credit for them, but they did come from The American Animal Hospital Association, so you can thank them;)

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.

9. Do I understand exactly what the policy covers?

This is to reiterate the importance of understanding what you’re getting! Too many pet owners get into pet insurance without fully understanding, then get angry for not understanding! Now, true, there are some companies that try to take advantage of the unknowing consumer, but if you don’t do you research thoroughly, you can’t blame anyone but yourself!

10. How much coverage does this policy provide for chronic, hereditary, or pre-existing conditions?

This is a really important question to ask and be made aware of, especially if you own a breed that is prone to certain conditions. Most companies will not cover any pre-existing conditions, so if your pet has had a medical history make sure to ask how that will affect future coverage.

Chronic conditions is also a really important topic. Please read all the fine print. Many companies start a brand new policy upon renewal, making anything in the previous policy term pre-existing and NOT covered. For example, if your cat were to get diabetes and treatment was covered, then you renewed your policy 3 months later, there is the possibility that treatment would no longer be covered. This is a BIG one, so please, please ask the provider how they handle chronic conditions!

That brings me to my next question…

11. How does this provider handle renewals?

As mentioned above, some policies are annual policies, and therefore have to be renewed each year. Make sure to find out how renewal will affect your coverage. The last thing you’d want is to be paying into insurance for 4 years to have your dog develop skin allergies in the 4th year, only have them covered in that 4th year, but then being stuck with that insurance company because you’ve already put so much money into it and his skin allergies would be pre-existing anywhere else. Talk about frustration.

NOTE: There are companies that have continuous policies or that offer additional coverage for chronic or recurring ailments.

12. Are there certain types of accidents or health problems that aren’t covered?

Again, this goes back to making sure you know what is and isn’t covered. Specifically ask what incidents would be excluded for coverage. For example, most companies don’t cover accidents to working dogs (guard dogs, police dogs, etc.) or any complications from breeding or pregnancies. Since intact pets are more prone to certain cancers and other ailments, there are often exclusions if your pet isn’t spayed or neutered, so make sure to also inquire about that.

I would love to hear additional feedback: comments, suggestions, further questions, etc. Until next time…

7. Will this provider reimburse services provided by my veterinarian or am I required to use a veterinarian in this provider’s network?

I really only know of one or two companies that require you to use a veterinarian within their provider network. Since most pet insurance reimburses the pet owner, the pet owner can see whichever veterinarian they choose. However, make sure to double check when picking out a provider.

8. Does this provider have an appeals process I can use if my claim is denied?

Many pet insurance providers will offer you the opportunity for you and/or your veterinarian to appeal a denied claim. This usually gives the veterinarian (if they’re willing) the chance to further explain the pet’s history or chosen treatment. Some providers will then even send the claim and appeal to a third part group of veterinarians for review. I think this is a good system to have in place, and offers pet owners extra peace of mind.

Again, please feel free to ask questions or embellish on anything I have mentioned here.

As you might also be aware, treatment for ongoing conditions such as these are quite expensive! In some of my pet insurance research, I’m finding that while conditions such as these may be covered in the first year they appear, they become pre-existing (and therefore not covered) in years following. Take Charlee for example, if he had gotten insurance as a young pup, before any of these allergies were showing, then he might have had coverage for the first year.

I am finding, however, that some insurance companies require you to purchase a “continuing care” add-on. And even some of these add-ons have yearly or lifetime limits!
Have any of you had experience in getting ongoing treatment covered?

Hip dysplasia is defined as: an abnormal development of hips where head of femur does not fit snugly into pelvic socket.

Treatment often requires extensive surgery, which can range in cost from $5,000-$10,000!

So then, would pet insurance cover such a thing? Well, (and you know how I hate being vague), it really depends on the company. Some do cover this condition up to a certain amount (even if only $300), some offer additional coverage for this condition, and some do not cover any congenital or hereditary conditions (which this would fall under).

Has anyone been forced to fork out the dough for this ginomrous surgery? Or has anyone had any experience in trying to get a pet insurance company to cover the condition?

“Is there something similar to this with pet insurance?” “What would happen if my insured dog bit another dog?” I actually received these questions a few days ago when chatting with someone about pet insurance.

Fortunately, pet insurance is a little more straightforward. Pet insurance companies won’t necessarily duke it out. And it’s true, your dog could hurt another dog, but this isn’t something that most pet insurance companies would cover. However, if your dog is injured in a fight (or gets bitten by another dog), then pet insurance would likely cover the injury.

Well, the answer is (and I hate being so vague): it depends.

The answer I got from one company was that if your pet got sick due to the contamination, it would be covered. However, if you know that your pet eats one of the recalled foods, so you decide to get a liver panel done just to make sure (even though they weren’t showing any signs of being sick), and it turns out that he or she is not sick, then this would not be covered.

Essentially with this company, if the pet is sick from the contaminated food, it’s covered.

Other companies I’ve heard of will only reimburse pet owners if the pet owners could prove that they had not received any type of reimbursement for damages from the pet food company itself.

My best advice, if you’re curious or hunting around for pet insurance, is to include the question in your research: if my pet gets sick from contaminated, recalled pet food, would their illness be covered?

Well, it’s quite simple actually (at least in most cases). Most companies have a claim form where you’re asked to fill out your contact information, the amount of the claim, what it’s for and then your veterinarian is usually asked to fill out a portion and sign the form as well. Typically the insurance company will ask you to fax or mail in the form along with the invoice from your veterinarian. The company may or may not ask for medical records, depending on the situation. For example, if your dog or cat fell from the deck and hurt his or her paw, they wouldn’t need medical records because there is nothing in the pet’s history that would relate to this claim.

Why then, can a claim take so long? I often wonder that myself. If the pet insurance company does need further medical records, they will often ask your veterinarian directly and if there is a delay in that process, well it adds time. In fact, I would imagine that getting complete medical records is one of the biggest reasons why there would be a delay in the process. Fortunately, in the past many companies might have taken weeks to get your reimbursement, but now that competition is stiffening, it’s not rare to receive payment within a few days to a week.

I have heard horror stories as mentioned in my post about It’s going to take how long to receive reimbursement?! where people are having to wait longer than a month with some companies. But, like I mentioned, I think you can expect to see this waiting time diminish.

And let me clarify as to what each of those are. An annual deductible is one that is required per year before any condition is covered. So if you have 5 incidents in one year, you would only be required to pay one deductible once.

A per incident deductible is one that would be required each time your pet has a different incident. For example, if your dog fell and broke his leg in march you would be required to pay a deductible, then if he got sick and needed medication in June, you would have to pay another deductible, then a year later if he got sick again you would have to pay another deductible.

And lastly, a per condition deductible is one that pertains to a single condition or accident. For example, if you have to see your veterinarian 3 times over the course of a year because your cat keeps throwing up, you would only have to pay the deductible the first time (given that these incidents were related). Or, more importantly, if you dog were to develop diabetes (something he’ll have the rest of his life) then you would only have to pay the per incident deductible once.

Deductibles with pet insurance can range anywhere from $0 to $1,000 and, in fact, the American Animal Hospital Association recommends that pet owners choose deductibles from $500-$1,000. But, what do you think, as a pet owner, is most reasonable? Would you want the option of a high deductible to use the insurance for only the rare, expensive incidents? Or would you want a $0 deductible knowing that you’d be covered for just about everything?