Great pet insurance but know what you're getting

1
Out of 10

Petplan USA offers great coverage. There are a few very important factors that helped me decide on this plan over many others. They do not have a per incident max and the yearly max is $20,000, both of which are better than found in most other plans. They also cover hereditary, congenital and chronic conditions which most plans don't. I know from experience that those are the kinds of conditions that will cost you a lot of money over time. It also covers some alternative therapies which many people choose to use as a complement to traditional veterinary medicine. Now for my complaints about the plan. The one thing I didn't realize when I bought the plan was that the deductible was per incident. However, after much research I found that many plans are like that and you can't have everything in any insurance plan, you have to give and take. There are deductible and coinsurance choices, I have the $200 deductible with 0% coinsurance. Had I known the deductible was per incident I would have gone with a lower one. The biggest problem I have with the plan is something that you could only find on their website by clicking on the word coinsurance to look at it's definition, something I never did because I know what coinsurance is. If you take your pet to a specialist, emergency care, after hours veterinary facility or accredited school/college of veterinary medicine, you will pay 30% coinsurance no matter which coinsurance you have chosen. This is a big problem for me because I know that where you really spend your money is when you seek emergency or specialized treatment. When I read this in the policy I was very upset and contacted them because I never saw this on their website, since it was hidden under the definition of coinsurance. I was told that as long as I went to a specialist on my own, not with a referral by my veterinarian, it would be covered with my standard deductible and coinsurance. The person I spoke with also told me that they were removing that provision and all policyholders would be notified when that happens, something I haven't seen yet in the 11 months I've had the policy. This would have been a reason for me not to purchase the policy. I was looking for coverage for the major and chronic conditions and would never select a plan where I had to pay 30% coinsurance for that care. As a matter of fact, I had a claim where my dog went to a specialist and they denied to cover it. When I contacted them and explained what I had been told by one of their staff and that it was not on a referral basis, they paid the claim. Just like with any insurance company, you really do have to question them if a claim has not been paid when you think it should have been.

Did you find this review helpful?
Injury/illness
Claim Amount
Breed
Age of Pet

Leave a comment

Image CAPTCHA
Enter the characters shown in the image.
Posted: 05/22/2009
By: Ron

As I commented before, the co-payment is invoked by the *facility* not the vet per se. They know that MRIs, kidney transplants, advanced cancer treatment etc tend to be available only at the most technologically up to date *facilities* and/or teaching hospitals, where like human hospitals the cost on paper is sky high. If you choose that route you will have a hefty co-payment.
I hope I never need $20,000 a year worth of care but if I do and I choose to spend it at one of the co-payment *facilities* then I will just have to come up with the few thousand it costs me out of pocket.

Frankly this is not an issue unless you as an owner choose to make heroic efforts to save an animal. If you do Petplan will be your partner but if they gave the $20,000 away without conditions everyone else's policy would be more expensive.

BTW, the co-payment for specialty care in New York state with a normal 100% reimbursement after deductible is 20% not 30%. Some of Petplan's literature is contradictory on this point but I called to ask.

NCI. Current Petplan policy holder who has not used specialty (not specialist) care yet.

Posted: 02/11/2010
By: Melanie

I am still confused by this issue. We have used specialist *facilities* for three of our pets over time - for nothing as extreme as a organ transplant (basically if it is anything non-routine, you get referred to the teaching hospital). Two dogs with cancer treatment and one horse for colic surgery. Honestly, this is the stuff I am worried about and what insurance for. I am not going to be > $ to have < co-pay if it is just going to be set at 30% for the scary stuff.

Posted: 10/15/2009
By: ROBIN L

IT DOES NOT MAKE SENSE THEY WOULD COVER A SPECIALIST VISIT @A HIGHER RATE FOR SELF REFERRAL. USUALLY ONE NEEDS TO BE REFRRRED BY THE FAMILY VET TO BE SURE A SPECIALIST VISIT IS NECESSARY. THE HIGHER CO-INS. FOR GOING(LIKE AN HMO)TO A SPECIALIST ACTS AS A GATE KEEPER OR DETERRANT SO A CLIENT WILL NOT SELF REFER..SINCE MOST SPECIALIST CARE IS IMMEDIATELY MORE EXPENSIVE. IF INDEED PETPLAN PUSHES OFF THE 30%CO-INS. FOR A VET REFERRED SPECIALIST....PRETTY CRUMMY! mOST PET OWNERS DO NOT HAVE THE EDUCATION TO DX WHEN OUR PET NEEDS SPECIALIST CARE..THATS WHY WE GO TO OUR VET FIRST. THE 30% PENALTY SHOULD BE THE OTHERWAY AROUND.