Living With Animals: Pet Health Insurance

By Hope Bidegainberry on August 24, 2018

Seems like every month I get asked about pet health insurance: Do I recommend a particular plan? Do I have insurance for my own animals? Will I offer one plan or another through PHS/SPCA? The answer to all three questions is “no.” Opinions certainly vary even among those who claim expertise in the cost-benefit analysis of health care (I don’t!) but nothing currently available has convinced me to jump into this still relatively new arena.

To my knowledge, all pet insurance works through reimbursement: you pay the veterinarian’s bill and then get reimbursed for those services and for the amounts covered. Although not an unreasonable method, that model leads to some of the obvious plusses and minuses of the current offerings. On the negative side, I routinely hear from owners who feel they were not reimbursed as anticipated. This does not necessarily indicate a bait-and-switch scam; instead, it may simply mean the owner was ill-informed about coverage (what was covered and to what degree). But the complaints are so routine it sure seems at least some of the fault lies with how policies are marketed. On the plus side, there’s no limits placed on which doctor you can see, how many second opinions you can get, and when to see a specialist. That’s because all of the doctors know they’ll be paid (since you’re paying them, remember?) leaving the risk on you. In addition to fighting for reimbursement, other common complaints include claims rejected because of pre-existing conditions when that explanation is debatable. Or that the medical problem is inherited and, as such, excluded.

Part of the problem may be that as we all struggle to understand our own complicated medical insurance we assume, incorrectly, that regulations and practices for our pets’ health coverage mirrors human health insurance. They do not. I’ve little doubt that there will continue to be new offerings and new options for what’s clearly a potentially massive market. Perhaps it’s for these reasons that only one percent of U.S. pets are enrolled.