The pay schedules are not even close to realistic

Out of 10

my 13 year old cat was diagnosed with feline fibrosarcoma, malign and aggressive, the only treatment available and needed to be performed ASAP was extensive surgery to get rid of all the tumor. the entire thing cost us $2,500 including anestesia, one night in the hospital, lab work/biopsy, pain killers, the actual surgery... i just received the check from VPI... and i quote: "Total Amount submitted: 2,595.33" "Total ELIGIBLE Amount: 208.50" and just to give you an example of this "pay schedule", part of the "items" in the treatment was anesthesia... kind of critical, you can't operate without it... and i quote" "diagnosis code: 02 Anesthesia" "Submitted expense (what we pay): 555.00" "Eligible Amount: 60.00" "Reimbursement Amount: 54.00" the rest of the items in the list are equally ridiculous. i even called to ask about it, they said that the "60.00" allowed for anesthesia was compiled as a national average... and i obviously asked, in which country? Somalia?, certainly not here in the U.S... i have had cats for a long time, i clean their teeth every other year, and not one time, has a doctor charged 60 dollars (or anything close) for anesthesia... so, after paying for this insurance for 8 years... 1,700+ in payments... the reimbursed amount i get for a 2,500 surgery is just: 187.65! just not worth it... the people answering the phone may be very nice and attentive, they may have a nice website and they have been very quick to process my claim... but 187.65?? still not worth it...

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Posted: 07/27/2008

Sufficient information provided to understand that the diagnois and the percentage of reimbursement is based only on the Schedule of Benefits. In other words the benefit is a percentage not "up-to" the benefit amount. I did not understand that the basic Schedule of Benefits would only pay 80% of that amount until I had a claim. By the time one has a claim or the pet has a condition identified,it is difficult to change insurance companies.