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Emergency Vet Exams not covered, and Co-Insurance is! READ the FINE PRINT!!!
Two weeks ago, my dog was attacked by a large unleashed dog while being walked. She was bit, and had several serious lacerations on her neck, requiring the insertion of a drain, several stitches, medications and a 2-day hospital stay. The cost of it all came to $787.64. My plan provides for a $500 deductible, with an 80% reimbursement percentage, so I assumed my reimbursement would be $230.11 (80% of the $287. 64 allowed after subtracting my deductible.). To my utter shock, I received a completed claim notice advising me that I would receive a total of $17.32 on my $787.64 claim! I immediately called and was told that the $141 “emergency exam” charge was not covered. The policy exclusion does in fact list “veterinary exams,” although it does not state “emergency veterinary exams,” which this one was listed as by my vet. I interpreted the exam exclusion to mean routine examinations, as I’m guessing most people would. After all, how can a veterinarian be expected to treat a badly injured dog brought in as an emergency without first ascertaining the type and degree of its injuries? Would it have been preferable for her to take xrays, or do a CAT scan, or even surgery without examining my dog to insure there was nothing more serious going on? Of course not…yet these more invasive diagnostic procedures would have been covered. Then to add insult to injury, I was advised that of the $646.64 allowable charges ($787.64 minus the $141 emergency exam), I had a co-insurance obligation and was required to pay 20%, or $129.32 before subtracting the $500 deductible. In other words, $129.32 would be subtracted from the $646.64, giving me $517.32. After subtracting my $500 deductible from this amount, the reimbursement for my $787.64 fee would be $17.32. I am not challenging this later charge, as I clearly did not pay attention to this little bit of very expensive and confusing fine-print in the policy! But I find it interesting that none of the so-called pet insurance review sites ever mention it under the list of policy “cons.” And, by the way, this is not a standard requirement of all pet insurance companies (see Embrace, for instance), so I encourage pet owners to read the fine print more carefully than I did before deciding on a plan. And to take Healthy Pets off the list of “one of the best.”
Insurer: Healthy Paws
By: Laura
Latest 1 comments
Laura, We’re so sorry that you baby was attacked and injured by another dog. We do our best to be transparent regarding the limited exclusions of your Healthy Paws plan. Those exclusions are pre-existing conditions, preventative/routine care, and the office visit fee (vet exam, emergency exam, recheck or consultation).By making these limited exclusions part of the pet parent's financial responsibility, it allows us to offer a complete accident and illness plan at an affordable monthly premium. We also make every effort to inform our clients on how our reimbursement calculations work. We include this information (including examples) on our website within our "Frequent Asked Questions" page. Our process for calculating reimbursements is approved by each state's Department of Insurance and are based upon the deductible/reimbursement level a client chooses at enrollment. As with any policy with a deductible, that deductible must be met before any claim reimbursement.
I sent claims for my dog Pedro and…
I did notice today the claim I was talking about did appear as being processed. Thank you for your immediate response and help! Kathleen Rhodes
Insurer: ASPCA
By: Kathleen Ann Rhodes
Avoid petsplusus
Pay for asong as you like once you make your first claim then they ask for your let's medical history since birth... Fine but should have asked me from the moment I started paying. I provide all medical history and now again they tell me I need proof that from my previous insurance that I have left them... I left them a year ago. This has been just a circle of heada he's and extremely slow response. I highly do not recommend.
Insurer: Pets Plus Us
By: Gino
was not too difficult to do
was not too difficult to do
Insurer: ASPCA
By: customer
It’s too early to give any stars
It’s too early to give any stars. Just got the policy. As usual getting the policy was easy, five stars. The real test will be when submitting a claim, will write another review at that time
Insurer: Spot
By: A Nair
I took out insurance on my pet
I took out insurance on my pet. The rates were great. It was easy to peruse the website. Now I have peace of mind in case my pet should get sick or have an accident.
Insurer: ASPCA
By: ROSALIE
I haven’t used Rain’s insurance yet but…
I haven’t used Rain’s insurance yet but what I like about it is any emergencies will be covered and I can pay for coverage yearly versus monthly.
Insurer: Spot
By: Kathy Vitaris
I am very pleased with Pumpkin Pet…
I am very pleased with Pumpkin Pet Insurance. I signed up for direct deposit. I have had multiple claims and after review, Pumpkin has deposited the money into my account. Great pet insurance! Thank you Pumpkin!!!
Insurer: Pumpkin
By: Polly
Easy and affordable enrollment
It was very simple and easy to enroll my dog! Its also much more affordable then other companies, insurance for my Rottweiler has been a ongoing struggle for me the past year. Finding this company and registering with a affordable price with the option of hopefully getting GoFetch Pay makes my heart happy and be at ease.
Insurer: ASPCA
By: Shelby Hart