Budgeting for Pet Health Insurance Now Can Save You Heartache — and Wallet Ache — Later
“I think at the end of the day it will probably be a wash,” says Stacy Toczylowski, referring to the amount she pays on health insurance for her Jack Russell terrier, Bella, and the amount her dog’s medical care actually costs. In other words, she believes that all told, the money the pet health insurance company reimburses her for Bella’s care will essentially equal the amount she will have shelled out on the monthly premium. Still, she is not sorry that she bought a healthcare policy for her beloved dog. Why not?
“I find it easier to pay the little bit per month than to pay larger bills all in one chunk,” she says. “It spreads the cost of Bella’s treatment over time. If she didn’t have health insurance, I could end up with a $500 bill for which I wouldn’t get reimbursed versus paying just $80 a month. (Bella’s premium just rose to $80 a month from $67 and change. She is 11 years old now and has had a couple of ongoing health problems.)
Ms. Toczylowski originally signed up for pet health insurance in 2013 because Bella had been licking her vulva and the surrounding tissue so persistently that she was “licking herself raw.
“I knew they weren’t going to cover that because it was a pre-existing condition,” she says. “But I knew that she could potentially have other issues down the line, which would be covered by the policy because they’d have nothing to do with her vulvar area, and she was getting up there in age.”
It turned out Bella had a condition called vulvar dermatitis — an autoimmune inflammation in that area finally diagnosed by Tufts veterinary dermatologist Lluis Ferrer, DVM, PhD, DECVD, when her primary care vet referred her to him. Between office visits, diagnostic tests (including a $718 biopsy and a $381 allergy panel), and the various medications prescribed by her local vet before the right one was identified by Dr. Ferrer, Ms. Toczylowski has spent “about $6,500” to date.
“I was disappointed that the insurance didn’t cover it,” she comments, “but I understand.”
What Ms. Toczylowski did not understand was why the insurance carrier denied a claim made on Bella’s behalf for a new disease diagnosed last year: atopic dermatitis, an inflammatory and chronic skin condition brought about by allergies to such environmental irritants as grass and dust mites. It has nothing to do with the vulvar condition, yet between tests, antibiotics prescribed to vanquish a secondary infection brought about by the problem, and drugs to control the allergic reaction, she has already spent in the $2,000 range.
To the credit of the insurance carrier, Trupanion, when the claim was denied and Ms. Toczylowski called, the representative advised her to ask her veterinarian to fill out an appeals form to explain why the two conditions were not related. Dr. Ferrer did just that, and “a couple of days later,” she says, “I ended up getting an e-mail saying that the claim was approved — 90 percent reimbursement minus the office visit because the policy doesn’t pay for that. The appeals process was seamless, and I received reimbursement within two weeks of when the claim was filed.
“So it works,” she says. The insurance has paid for itself this year. There are a few hiccups — sometimes they’ll start asking for stuff that you sent them 20 times. It’s not a smooth, clean operation all the time. But I’m not sorry that I pay for it.” And who knows, Ms. Toczylowski adds: while her monthly premiums currently cost about the same amount as Bella’s monthly care, “down the line it may work in her favor,” especially since at her age, other health conditions might very well spring up.
A less mixed review
For Meghan Antonangeli, health insurance for her dogs has been nothing short of a godsend. Her dog Bruno didn’t get diagnosed with heart disease until the condition had progressed very far. “I spent, like, $20,000 when it was all said and done,” she says
That was back in 1999, and for her next dog, and all her dogs since, she has purchased insurance to pay for their medical care because she knew she couldn’t keep spending $20,000.
First came Ms. Antonangeli’s boxer, Major. She took him home as a puppy and bought a health insurance policy right away. Then she rescued a second boxer, Sammy, who was one year old at the time, and bought insurance for him, too.
It worked out, if you can call anything having to do with a dog’s getting sick working out. Insurance “actually saved me,” Ms. Antonangeli says, “because Major needed a major surgery. He had cancer by his adrenal glands, in front of his kidney. The bill was $3,394, and they [VPI, a well-known insurance company] paid $1,344.60. That’s a lot of cost savings.”
In addition, when Major was first admitted to the hospital, “he needed a transfusion. It was $290,” she reports. “They paid $261. A $130 blood test — they paid $117. And that was more than one time. You see what I’m saying? It’s not crazy to have this. Really, you’re doing yourself a disservice if you don’t.”
Ms. Antonangeli has a similar story of saving money by having pet health insurance for Sammy. “Sammy had the canine version of ALS [Lou Gherig’s disease],” she says. He had to have MRIs. He needed a cart [to get around], and they even paid for part of that.”
Pet health insurance has been a life saver,” she says, “a life saver. I would go into debt for my animals before putting them down. But what if you’re faced with a $10,000 surgery and you can’t afford it? If you’re going to be a responsible pet owner — and medical issues are going to come up in your pet’s life, just like in your own life; they get hurt, they get sick — the health insurance keeps you from having to make a gut-wrenching decision. If you have it, you don’t have to decide” whether you need to put your animal down because you can’t afford the cost of care. “You’re responsible for this creature in your life,” she says. “And you have no idea what’s going to happen. So an ounce of prevention is worth a pound of cure — it could really be a cost savings. And some of the plans, like mine, cover regular checkups. I have saved so much money by paying the premiums.”
Today, Ms. Antonangeli has Lulu, also a boxer, who broke her leg and needed surgery to stabilize it with a plate after she ran into her son while he was sledding. The insurance company “paid at least half, if not more,” she says. “And Lulu just had eye surgery, $830. But they’re going to pay $550 of that. So I’m here to tell you that people are crazy if they don’t get it. If you broke it down, if you go to Starbuck’s two or three times a week, that’s what it costs you.”
How veterinarians see it
The veterinarians at Tufts have found that those who buy health insurance for their dogs are often in a much better position to take care of their pets when they fall ill and make decisions based on what’s best for the animal rather than on their financial circumstances. It’s not that they think negatively of pet owners who, because they don’t have the financial resources in an emergency, must make the decision to put a dog down in order to spare her a prolonged ordeal absent medical intervention. In the Tufts view, as long as you love your dog from the moment she comes into your life until the moment she leaves this world, you have fulfilled your responsibility.
But they have seen so many people have to make the decision to say good-bye to a pet, not because there is no life-saving treatment for the animal but because they can’t afford it. And they have seen so many people unnecessarily wracked by guilt because of the decision they have had to make for the good of themselves and the rest of their human family due to finite monetary capacity.
At least as often, they have had to take a pass on testing/screenings that would help pinpoint the cause of a dog’s health problems, thereby forcing some medical guesswork into diagnoses and treatment that could have been avoided with the financial help afforded by health insurance. It’s for that reason that the vets at Tufts say that while about 95 percent of dog owners who walk through their doors with sick dogs don’t have health insurance for their canine loved ones, they wish 95 percent of them did.
The nuts and bolts of choosing a health insurance plan
Like health insurance for people, health insurance for pets is not perfect, as Stacy Toczylowski can attest. Copays and deductibles and various other limitations mean you can’t recoup every last dollar should your dog fall ill. There are also benefits schedules with maximums on various treatments that might not match what veterinarians typically charge. But a decent policy often reduces the cost of unanticipated (read: emergency) care by at least half, and sometimes much more than that.
The lion’s share of pet health insurance policies used to be written by two companies: Veterinary Pet Insurance, or VPI (the company Meghan Antonangeli uses), and PetCare Insurance. But the field has grown considerably, with Trupanion, PetPlan USA, Nationwide, and other companies entering the market.
All offer policies that differ in the following ways from health insurance for people:
Policies are considerably less expensive, sometimes as low as $40 a month or even lower (especially if you buy a policy when your dog is still a puppy without any diagnosed diseases). The cost depends, in part, on how comprehensive the plan is. Some cover wellness visits in addition to emergency events.
There are no HMOs, with “in network” and “out of network” vets. You can bring your dog to any veterinarian you wish.
This one’s important — you have to pay the veterinarian for the dog’s care and then get reimbursed, unlike a physician who treats people and is often willing to wait for her or his fee from the insurance company. So that means you have to have enough money up front, or at least enough unspent money on your credit card limit. In addition, you fill out and send in the claim yourself (with the doctor’s signature and any applicable receipts). The vet’s office staff does not handle it; you need to follow through. The good news here: the forms are not onerous, tending to be only about a page long or so.
Policies for pets have a lower lifetime cap than policies for people, maybe a couple hundred thousand dollars rather than millions. But it’s virtually always high enough to cover your needs.
Note that some breeds cost more to insure than others because they tend to get sick more often, or earlier in life. Ms. Toczylwski found this out when checking into insurance not only for her Jack Russell terrier Bella but also for another of her pets, a French bulldog named Chloe. While Bella’s policy started out as $67 a month, “if I were to get the same policy for Chloe,” she says, “it would have cost $150 a month, if not more.” French bulldogs are relatively prone to skin and ear diseases, respiratory problems, exercise intolerance, and spinal diseases, among other issues, and pet insurance companies are well aware of their higher risk for incurring serious medical bills. (Ms. Toczylowski opted against coverage for Chloe but “probably should have” opted for it,” she says. The dog began bleeding internally and “went pretty quickly but because nobody could definitively say why, we ended up with almost a $5,000 vet bill. She was in intensive care, and they had to use an IV and provide round-the-clock care.”)
What also affects the monthly price of a policy, not surprisingly, is how high you are willing to go on your deductible: $100? $500? More? Just like for people, the higher the deductible, the lower the cost of the premium. Often, the companies have online tools that “you can work with to find your comfort zone,” Ms. Toczylowski says.
When shopping around, don’t worry too much about purchasing a policy that covers wellness exams and routine shots; they’re not what wreak havoc on a budget. It’s emergency care that you can’t anticipate. Too many people don’t factor in emergencies, but it’s wishful thinking to expect that in the 10 to 15 years or more of a dog’s life, there’s never going to be a financially burdensome medical emergency, especially as your dog ages.
This article originally appeared in the February 2017 issue of Tufts Your Dog
A monthly nationally-circulated newsletter for caring dog owners presenting canine medical and behavioral information. All published articles are reviewed by board members who are affiliated with Cummings School of Veterinary Medicine at Tufts University and its hospitals. Read more and subscribe at tuftsyourdog.com