Loopholes in Coverage

1
Out of 10

Apologies for the lengthy post, just want to make sure that I am documenting adequately:
I have been with Healthy Paws since early 2013 for my first dog and have since added another dog to my policy. The dogs are still young, quite healthy, and have only been covered by Healthy Paws for the most routine and run-of-the-mill problems. I could afford deductibles and cover preventative care, including regular teeth cleanings at a low-cost clinic without problem. As such, I remained faithful in Healthy Paws's services to think I could afford caring for a cat, and I adopted a young sweet rescue in January of 2017, signing him up for insurance shortly thereafter. In late April of 2017, my cat Baxter (just celebrating his one year birthday) was diagnosed with a rare auto-immune disorder, juvenile-onset gingivostomatitis, which means his gums are allergic to what is otherwise ordinary plaque build-up on his teeth. This results in painful sores as well as inflammation throughout the body and other general symptoms like fatigue and low appetite. The doctor informed me that it was 'going to be a long road to treatment,' and despite the devastating news, I was confident that at least my sweet pet's costs would be covered.

In early May I saw a dental specialist to discuss forms of treatment--there are usually two approaches, the first for extreme cases and the second for cases caught early: 1) full dental extractions to remove the source of allergic reaction (plaque) or 2) partial extractions, paired with home care (daily brushing, oral rinses, and water additives) AND regular (as in, every 3 months) professional dental cleanings. Having discussed Baxter's options, the specialist advised beginning with the less aggressive option. Young cats, especially, have been known to make a full recovery if owners are diligent with their treatments. Before agreeing to the second option, which will involve more costs but could potentially save his teeth and lead to a longer and better quality of life, I called Healthy Paws to double-check that Baxter would be covered and was assured that he would be. Because the roots of the condition are not well known, I also contacted my rescue to see if they had any information about Baxter's early life that could be illuminating and was told that his brother was just diagnosed with the same disease and that it was likely a mix of environmental and hereditary factors because they were both rescued under-nourished and in a squalid, hording

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Injury/illness
autoimmune disorder
Claim Amount
$500 - $1000
Breed

Mixed Breed

Age of Pet
1 - 8

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Posted: 08/04/2017
By: Tim

Sara - We're sorry to hear that Baxter and you are dealing with a case of stomatitis. We understand your veterinarian is using the dental cleaning as part of the treatment for stomatitis. Per our policy we do not cover dental health care including dental cleaning or prophylaxis. Healthy Paws Pet Insurance is regulated by the Dept. of Insurance and is bound to be consistent in the application of our policy. It would be discriminatory to cover the dental cleaning for one pet and not for other pets. We do not cover dental cleaning for any policy holders as a form of treatment or preventative.
We do our best to be transparent throughout our website, during the enrollment process and in the policy documents available to each client in their online Healthy Paws account regarding the limited exclusions of our policy. Anyone visiting our website can see this information on our “Benefits, Coverage and Exclusions” page. These limited exclusions allow us to offer a complete accident and illness plan at an affordable monthly premium. Our policyholders value comprehensive coverage and unlimited benefits at reasonable rates.

The Healthy Paws Team

Posted: 08/08/2017
By: Tim

Sara,
We're sorry to hear that Baxter and you are dealing with a case of stomatitis. We understand your veterinarian is using the dental cleaning as part of the treatment for stomatitis. Per our policy we do not cover dental health care including dental cleaning or prophylaxis. Healthy Paws Pet Insurance is regulated by the Dept. of Insurance and is bound to be consistent in the application of our policy. It would be discriminatory to cover the dental cleaning for one pet and not for other pets. We do not cover dental cleaning for any policy holders as a form of treatment or preventative.

We do our best to be transparent throughout our website, during the enrollment process and in the policy documents available to each client in their online Healthy Paws account regarding the limited exclusions of our policy. Anyone visiting our website can see this information on our “Benefits, Coverage and Exclusions” page. These limited exclusions allow us to offer a complete accident and illness plan at an affordable monthly premium. Our policyholders value comprehensive coverage and unlimited benefits at reasonable rates.

The Healthy Paws Team