Episode 7: Paws and Policies: Navigating Pet Insurance for Better Care

In this episode of Ted the Vet, Dr. Ted Burghardt discusses the intricacies of pet insurance, including how it differs from human insurance, its value for pet owners, and the rising costs associated with veterinary care. He emphasizes the importance of understanding policy details, the implications of pre-existing conditions, and the potential benefits of new legislation aimed at easing financial burdens for pet owners.

Takeaways

• Pet insurance requires upfront payment and reimbursement submission.
• It does not cover pre-existing conditions unlike human insurance.
• Veterinarians recommend pet insurance for better care decisions.
• Wellness plans are not the same as pet insurance.
• Pre-approval for surgeries can help with reimbursement issues.
• Insurance costs vary based on breed, age, and location.
• Veterinary costs are rising due to inflation and corporate consolidation.
• New legislation could help offset veterinary costs for pet owners.
• Reading the fine print of insurance policies is crucial.
• Veterinary practices can provide recommendations for pet insurance.

Transcript

Ted The Vet (00:02.53)
Welcome to Ted the Vet podcast where pet owners are empowered with insightful tips and advice to give the best care to their furry companion. Hi, I'm Dr. Ted Burghardt, owner of Companion Pet Care in Encinitas, California. Today I want to briefly address pet insurance. I'm frequently asked about how it works, whether it's worth it, and what's included. New puppy and kitten owners are usually the ones asking about it.

but it could be relevant for pets of any age. Pet insurance is available for horses and exotic pets as well. I'll start by addressing how it works. It's important to understand that pet insurance is very different from human insurance in a lot of ways. With pet insurance, the client pays for the services upfront, then submits the invoice to the insurance company for reimbursement.

The insurance company looks at the invoice and oftentimes requests medical records and approves or declines reimbursing the expenses based on the policy that was purchased. Basically, this means that the insurance company is hands off in terms of dictating which services should be provided by the veterinarian. On the other hand, in human medicine, the human insurance company often directs which services the doctor should perform.

in order to be in accordance with the insurance company parameters. And the human patient is billed after the insurance is accounted for. Another difference between pet insurance and human insurance is that pet insurance does not cover pre-existing conditions. With human medical insurance companies, they are required to cover human pre-existing conditions.

The reason for this difference is that legally animals are actually classified as property, so they don't carry the same status as a family member. So pet insurance is actually more similar to property and casualty insurance as one might have for their car or house. Next, I want to address if it's worth getting pet insurance. For me personally, as a veterinarian, I like to recommend pet insurance.

Ted The Vet (02:20.738)
The main reason is that I know when a client has insurance for their pet, they're more likely to approve the recommendations because they know a large portion of the expenses will likely be reimbursed. This can help make a very difficult emergency situation, which can also be very emotional, more manageable when the financial burden is easier to bear. Lastly,

What's included with different pet insurance carriers really varies with the individual company and the different policies they might offer. Some have different levels like gold or silver, where other carriers might have a single broad encompassing policy. Like any insurance, it's very important to read the small print because I have seen cases turned down that I thought for sure would get reimbursed. In my personal experience,

The most common reason reimbursement gets turned down is due to pre-existing conditions clause. So watch out for that in particular. Some hospitals offer quote wellness plans, but I want to make a point that these are not insurance policies. A wellness plan is usually something you pay for that might cover annual exams, vaccines, fecal testing, for instance. But as the name suggests,

These plans are usually for when the pet is well and healthy and not the same as pet insurance for when there is a problem such as accident or illness. So let's use an example. Let's say you have a young dog and you do have insurance for her. She's at the beach running around on the sand and all of a sudden comes up limping on her back leg. She's taken to me, her veterinarian, and I diagnose her with a cruciate rupture.

or otherwise known as an ACL tear. By the way, this is very common situation and common type of injury that I see. Because she is young and has a lot of running around to do in her long future, we decide that she should have her knee surgically repaired. In this case, I would create a surgery treatment plan for the owner, which includes the cost.

Ted The Vet (04:41.426)
and recommend that the owner submit it to the insurance company ahead of the surgery for pre-approval. Most of the time, this helps prevent issues with reimbursement after the surgery. From what I have seen, and depending on the insurance company, usually around 80 to 90 % of the surgical expenses should be covered by insurance. One of the biggest factors owners face for deciding about insurance or their pet is the cost.

And the cost of insurance can vary greatly depending on the breed, the age of the pet, and the geographic location. The North American Pet Health Insurance Association noted an increase in the cost of dog accident and illness insurance coverage, increasing by about 5.6 % between 2022 and 2023. When inflation goes up,

The cost of everything goes up, including veterinary medicine. And because insurance companies, because of that insurance companies have to charge more in order to keep up with the payouts. Also during COVID, there was a huge influx of corporations buying private veterinary practices. And when private equity firms and corporations get involved in consolidating veterinary practices, the cost of veterinary medicine increases.

A relatively new legislation was introduced in Congress which could help offset some of the rising veterinary costs. It's called the People and Wellness Act or PAW and would allow American pet owners to use their health savings account and flexible spending accounts to pay for their pets' unexpected veterinary expenses. Along with HSA and FSA account holders,

It would also allow military veterans with service animals for PTSD and other disabilities to care for their pets. In summary, there are many pet insurance companies out there and making the right choice can be daunting. Like any insurance, you have to be careful and read the fine print. At my hospital companion pet care, we are happy to provide insurance company suggestions for your pet based on feedback we get from our clients.

Ted The Vet (07:08.93)
That's a wrap for Ted the Vet podcast. Thanks for joining me. And together we can take great care of your pets. To learn more about my veterinary hospital, you can head over to our website, companionpcvet.com and connect with us on Instagram at companionpetcare. The links are also available in the show notes. If you enjoyed the episode, be sure to subscribe, leave a review and share it with your fellow animal lovers. I'm Dr. Ted Burghardt.

Until next time.