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Veterinarian Technician February 2009 (Vol 30, No 2)

Management Matters — Answers About Pet Insurance

by Katherine Dobbs, RVT, CVPM, PHR

    Although fewer than 1% of pets in the United States are insured, the numbers are rising.

    The number of companies offering pet insurance continues to rise, and although competition among providers can be good for the market, it also can become confusing for pet owners who are trying to make an informed decision.

    Veterinary practices have a responsibility to inform their clients about pet insurance options, and the role of veterinary staff in this information chain is important. Although companies offering pet insurance have a common goal — to make pet care more affordable — they differ in their policies, processes and prices.

    The veterinary team should be there at every stage of the pet's life to answer client questions and help clients make the best decision for their family. When a new puppy or kitten arrives, the option of pet insurance should be introduced. When the veterinary team begins to discuss the future, the option of pet insurance also can be included as a way to help cushion possible expenses. A crisis, an unexpected injury or an illness may force a pet owner to make difficult decisions, and the option of pet insurance may protect their finances so the owner is not facing potential hardship.

    First, however, the practice team needs to be informed about the practice owner's stance on pet insurance and which policies he or she endorses or recommends. The practice owner may choose one company or be a conduit of information for several different plans and let the client research the options and select a provider. It is important for the entire team to know the practice's policy regarding client education about pet insurance. Although most answers to client questions depend on the practice's policy and the insurance plan, the following general questions are not affected by either.

    Q: What is pet insurance?

    A: Pet insurance is an option to help a pet owner afford medical care for his or her pet. Most policies are considered indemnity, or property insurance, which differs from human health insurance. It is important that clients understand that pet health insurance is not modeled after human health insurance. They are likely familiar with their own health insurance and how it works, so this distinction needs to be made early in the discussion.

    Q: How does it differ?

    A: Unlike the case with human health insurance, the pet owner is typically responsible for submitting the pet insurance claim. The veterinary practice can assist clients in preparing the forms by signing each claim and providing any medical information requested or required by the insurance company. Most insurance claims require only the signature of the veterinarian, and the diagnosis and treatment costs can be completed by a team member. Veterinarians are often requested to submit copies of medical records or write a medical summary of the case so the insurance company can make a decision about a claim.

    Q: How does the payment take place?

    A: This also typically differs from human health insurance. The fees for veterinary care are paid by the client to the hospital at the time services are rendered by the veterinarian. The insurance company then reimburses the pet owner after the submitted claim is approved.

    The practice's complete financial policies should be clearly outlined in client education materials, including a discussion on how pet insurance payments are handled. The owner needs to understand that he or she may receive financial assistance from the pet insurance company after the fact, but the pet's medical care is still paid up front. Misunderstandings on this point can alienate the pet owner.

    Q: Does pet insurance cover routine wellness?

    A: Some policies do, and typically there is an option to purchase this additional coverage. If your practice offers a wellness program that bundles certain products and/or services together for different stages of a pet's life, it is important to discuss these programs with pet owners before they choose a pet insurance plan. The programs and services you provide may affect the owners' decision on what type of policy or plan they purchase.

    Q: Are there limits to what insurance will cover?

    A: This depends on the plan and policy. There are often limitations on genetic, hereditary or preexisting conditions. Chronic conditions also may require special coverage, and certain types of accidents and health problems may be excluded from coverage.

    Many breeds are susceptible to conditions that can be considered genetic or hereditary, and these could represent the type of expenses that the pet owner is trying to insure against.

    It also is important to note that there can be a waiting period before a policy becomes active. This limits the possibility that an owner can obtain pet insurance when the pet becomes ill or activate a policy when an accident occurs.

    Q: My pet has experienced a crisis. Can pet insurance help?

    A: If the owner has an existing policy, then most likely yes. However, after a pet has been diagnosed with a problem, it is considered a preexisting condition by most pet insurance companies and as such may not be eligible for coverage. That is why it is important to consider pet insurance before a crisis occurs.

    Staff members in emergency and specialty referral practices are often in the unfortunate position of explaining this limitation to owners. This is a time when pet owners may consider pet insurance for the first time, so the specialty or emergency staff can suggest that the owners discuss options with their primary care veterinarian.

    Pet insurance is an important decision owners make, so be prepared to help your clients make this decision for the future well-being of their beloved family member.

    For More Information:

    American Animal Hospital Association (AAHA); www.healthypet.com.

    National Commission on Veterinary Economic Issues; www.ncvei.org.

    North American Pet Health Insurance Association (NAPHIA); www.naphia.org.

    NEXT: More CE credits now available from Veterinary Technician journal

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