Mitigating the Unexpected, Expensive and Undesirable events for our pets
As with third-party payment plans, you need to understand the insurance plans available and the companies providing them in order to make intelligent and useful recommendations. In the past, when veterinarians or clients have become unhappy or frustrated with pet insurance, it’s usually because they’ve had unreasonable expectations of pet insurance in general or incomplete understanding of specific policy terms. Here are a couple of pointers that will help both you and clients better understand their options:
- Pet insurance isn’t right for all pet owners. Several factors for clients to consider when deciding whether to insure a pet include their bond with the pet, how much they’re willing to pay for its care (both over its lifetime and at any given point in time), their level of risk tolerance, and the nature of their financial situation. Pet owners need to think about their ability to cover not only basic wellness care but also nonroutine and catastrophic accidents and illnesses.
- All companies limit coverage in some way. If they didn’t, they’d pay out more in claims than they received in premiums and be bankrupt in months. Limitations include deductibles, co-pays, annual or lifetime limits, the use of benefit schedules, and coverage exclusions. When recommending plans, practice teams need to understand the coverage of the policy as a whole. You can’t just say, “Well, this policy has a 20 percent co-pay so it’s not as good,” or, “This policy uses a benefit schedule instead of a percentage pay so it’s not as good.” Look at the coverage as a whole (claim payment amounts, deductibles, co-pays, limits, and exclusions) compared to the premium. Pet owners also need to consider any breed-specific conditions that apply to their pets or any particular types of procedures they might want covered (for example, dentistry or acupuncture) and see whether their pet insurance policy includes those items.
- Some pet owners will pay more in premiums than they receive back in benefits. For pet owners or veterinary team members to expect that all policyholders will receive claims payments equal to or exceeding what they pay in premiums is unrealistic. How many people have been reimbursed for homeowner insurance claims that exceeded the cost of the premium? The nature of the insurance industry is such that some policyholders will pay more in premiums than they receive back in benefits. For pet owners, you could say these folks were unlucky with their pet insurance—but you could also make the case that they were lucky with their pet’s health. Other policyholders will pay much less in premiums than they receive in benefits—these individuals were unlucky healthwise but fortunate enough to have insured their pets. And most pet owners will be somewhere in the middle.
Pet Insurance Questions20 Questions to help you choose a pet insurance provider
It can be tough to sift through the legal jargon included in many pet insurance informational packets. After you do some research online and find a few companies you might like to work with, it’s time to dig a little deeper. Use this list of questions to find the level of care that’s just right for you and your pet.
- Is the company licensed in your state? Which of their policies are available in your state?
- Does the company have a good reputation? What do the Better Business Bureau or other independent organizations have to say about it? How long has the company been around?
- Are the policies and information provided reasonably easy to understand? Are the people you talk to knowledgeable and helpful?
- Does the company offer customer service during reasonable hours?
- Can you see any veterinarian you want?
- Have premiums increased over the past few years? If so, by how much?
- What happens to coverage and premiums as your pet gets older?
- Are there any reasons you wouldn’t be able to renew your policy?
- What type of coverage and co-insurance does the policy require?
- Is there a “usual and customary charges” clause? How are those limits determined?
- What kinds of care are excluded or limited? Are congenital or hereditary diseases covered? What about cancer? Is dental care covered?
- Are conditions diagnosed within one year excluded as preexisting conditions the next?
- Are benefits available for wellness or preventive care for your pet?
- Can you choose a deductible? Can you change the deductible from year to year? Is the deductible annual or is it applied to each medical incident?
- Are the waiting periods before coverage begins reasonable?
- Is there a maximum age for enrollment?
- Are there limits per incident, per year, per lifetime, or per body system? What are those limits?
- Is a physical examination required for enrollment or renewal?
- How quickly are claims processed and paid?
- Are there any billing fees or discounts?