Pet Insurance Benefits and Pitfalls

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					Pet Insurance:
Benefits and Pitfalls
   Dr. Bennett J Porter III
    Westgate Pet Clinic
   Minneapolis, MN 55410
   MVMA Annual Meeting
     February 12, 2011
 • I am not affiliated with any pet insurance company
 • I have no experience in processing insurance claim forms
 • The information presented was accurate at some point in time, but pet
   health insurance companies are constantly modifying their policies.
 • I do not currently purchase pet health insurance for my pets and this
   clinic does not purchase policies for the staff.
 • My knowledge about pet health insurance companies is therefore
   indirect, through reading magazines, books and websites.
Overview of Presentation
 • Facts, Insurance Models, Insurance Regulation &
   Endorsements and Branding
 • Definitions & Examples
 • Client vs. Insurance Company Strategies to manage risk
 • Review Websites
 • High-deductible pet insurance policies
 • Wellness/Dental Coverage Options
 • Final Advice
Insurance Models,
Insurance Regulation &
Endorsements and Branding
Quick Facts by Negative Perspective

 • Most clients will not save the money with pet insurance.
 • No pet insurance policy covers a pre-existing conditions.
 • When your pet gets sick or old,
   that is not the time to consider pet insurance.
 • Dental cleaning is not an accident or an illness. There is only limited
   coverage with additional riders, wellness riders.
 • Wellness coverage = Pre-Payment Plan.
 • An Anterior Cruciate Rupture is considered a pre-existing condition
   for the other healthy stifle.
Quick Facts by Positive Perspective
  • The clients owning pet insurance are
    among your very best clients.
  • Among clients who have pet
     insurance 88% would recommend to
  • Average pet age at enrollment is

                                           Aug 2010 Vet Econ
Quick Facts by Positive Perspective              5%
  • The 1-2% of your clients owning pet
    insurance are among your very best
  • Among clients who have pet
     insurance 88% would recommend to     X X X
  • Average pet age at enrollment is

                                             Aug 2010 Vet Econ
             Why Do You Need Pet Insurance?
            • Managing the risk of having an unhealthy pet (“unlucky pet”)
            • Prepare for the unexpected, the Peace of Mind Factor
                     • 81% of claims processed by ASPCA Pet Health Insurance are the result of
                       an unexpected accident or illness.
                     • 66% to 80% of dogs experience major health problems
                       over the life of the pet.*
            • With Pet Insurance, euthanasia is never the only answer
            • One in three dogs will experience a major emergency in any given
              year.* Episodes are emotionally and financially draining.
            • Each year in the US, approximately 6 million dogs
              and 6 million cats are diagnosed with cancer.

*Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs.
J Am Vet Med Assoc 2002; 220; 1315-1320, p 1319. “The Purina Life Study”.
Veterinary Costs are Rising
  • JAVMA analysis that
    expenditures for veterinary
    services in real dollars virtually
    doubled between 1980 and
  • Increase was measured in
    constant dollars, adjusted for
  • WHY?
      •   New diagnostic tools
      •   Surgery technologies
      •   Cancer treatment
      •   Referral Centers
American Veterinary Medical
    Association Study

  76 percent of pet owners said they
  would “spend any amount to keep
  their pets alive”

  American dog and cat owners
  spent about $23.2 billion on
  veterinary care in 2006
          Pet Insurance Growth
• 20 percent annual growth
  rate from 2003 to 2007
• Total growth during 2003-
  2007 was 107 percent
• Companies offering pet
  insurance has increased
  from 3 to 11
• Today pets insured in
  North America =
  over 1 million
 Pet Insurance Growth Continued

    •but           this represents only a small     2%
                                                    means that
      minority of the total U.S. pet population
                                                    veterinarians are not
   • 72 million dogs                                currently
                                                    recommending pet
   • 81 million cats                                health insurance.

• Dr. Karen Felsted of NCVEI:
    • “The recommendation of a veterinary
      professional is often a deciding factor for
      those considering a pet health insurance
Is Insurance for You?
Only if you can afford to pay for it up-front!!!

   • Pet insurance is essentially a
     reimbursement plan
   • Contract between the pet owner and the
     insurance company
   • Need credit card or savings account with
     funds available
   • This has led many to ask, “If I can afford
     to do that, then why do I need insurance?”
   • This leaves a large percentage of pet
     owners who cannot afford to pay a large,
                                                       Dr. Doug Kenney
     unexpected veterinary bill out of the loop.
                       Click Pic HyperLink

Consumer Reports Magazine July 2003/07 & Aug 2010
Only talks about money, not whether better care provided

   •   Pet health costs should be budgeted into your regular and emergency budgets.
       If it turns out you need the money, you'll have it to use. If you don't need it,
       that's more money in your pocket, not the insurer's.
   •   If you do decide to buy coverage,
       we recommend policies that are easy to understand.
   •   If you're considering pet insurance, download a sample policy and its terms
       and conditions from the insurer's website and read them thoroughly for
       limitations, exceptions, and co-payments.
   •   We prefer coverage with simple, percentage-based payouts, and no
       reliance on judgments of what's "reasonable."
   •   Avoid riders for wellness care.
   •   If you plan to use the insurance for catastrophic coverage—say, $1,000
       and up—go for the highest deductible you can comfortably afford.
Consumer Reports 2010

Trupanion had the lowest
premiums and also the highest
Reason One:
Unlucky Pet Risk
 • The pet owner with an "average pet" is reimbursed for pet insurance
   claims that may range from 30% to 100% of the lifetime
 • The most compelling financial reason to purchase pet insurance is
   because a pet owner may have an "unlucky pet". An unlucky pet
   requires more veterinary medical treatment than the "average" insured
Reason Two:                                                         Click Pic HyperLink

Peace of Mind

  • “Insurance is a valuable tool to foster a higher quality of pet care, with
    less price resistance on the part of the client. With cost concerns
    removed, clients become more engaged and more responsive.”
  • “Insurance can help the veterinarian unflinchingly recommend the best
    course of treatment for the pet regardless of cost, and to practice the
    quality of care to which all veterinarians aspire.”
  • “Insurance can provide comfort and reassurance to
    the pet owner, knowing that the best medicine
    is available … for the pet.”
Is Insurance for You?
If the answer is NO, there are other options for
unforeseen pet medical expenses.

   • Westgate Pet Clinic accepts payment through CareCredit and
     Chase Health Financing.
       • Apply for financing online, with typical interest free options for
         3 to 6 months.
       • High interest rates occur if the payment agreements are not

                                              Click Pic HyperLink
Insurance Models at a Glance
 • HMOs Health Maintenance Organizations (Human)
     • Leveraging a large group to pay for health costs of sick individuals
 • PPOs Preferred Provider Organization (Human)
     • Costs are negotiated with health care providers up front
     • Loss/savings are passed on the network members/patients
 • Traditional Indemnity Model (Pet)
     • Client pays veterinarian then seeks reimbursement
       through their insurance company
     • A fee-for-service insurance, similar to auto or homeowner policies.
     • Pay a portion of the costs incurred as specified by the policy
     • Continuity in coverage does NOT limit pre-existing conditions
       if change policies, or company declares bankruptcy.

                                                                     Click Pic HyperLink
Pet Insurance Regulation
 • Insurer vs. Surplus Lines Insurer
     • Insurers are licensed on a state by state basis in the United States.
         Each state has a Department of Insurance (or similar regulatory body) that regulates
         these insurers:
     •   First, the regulators monitor the finances and market conduct of the insurers to see
         that they are financially sound and using fair and honest business practices.
     •   Second, they regulate or approve the insurer's policy forms (the actual content of
         the policies) or the insurer's rates, or both.
     •   These insurers contribute to a state fund, called a guaranty fund, that is used to pay
         claims if any of these licensed insurers were to fail (go bankrupt).
     • Surplus Lines Insurers generally choose to operate on an unlicensed,
       surplus line basis (personal basis). If they were to fail (go bankrupt), there
       is no guaranty fund protection for you.

                                                                 RLI Insurance
Pet Insurance Regulation
 Regulated by individual STATE Insurance Departments
 • Each company policy must be individually approved and registered in
   a state before it can be sold in that state. Locally Regulated.
 • Minnesota Dept of Commerce Insurance Gateway has no information
   about pet insurance for consumers.
 • The Minnesota Department of Commerce Consumer Response Team
     • respond to consumer phone calls specifically about insurance.
     • attempts to resolve disputes between consumers and the insurance
       industry informally.
     • (651) 296-2488 or statewide toll free at 800-657-3602
Endorsements and Branding
Do consumers/veterinarians feel more comfortable
with an insurance policy based on image or affiliation?

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Brand Confusion
Name similarity confuses everyone

                                  Click Pic HyperLink

  Has the following Partnerships:                       Has the following Partnerships:

               Click Pic HyperLink

            Click Pic HyperLink
Definitions & Examples
Pet Insurance Lingo:

The Deductible
    • The amount the pet owner is responsible, before the company pays
    • TYPES:
       • Per-incident Deductible: the amount you pay each time a new
         condition is treated during that policy.
       • Annual Deductible: the amount you pay each year.
    • Deductibles range from $0 to $1000.
    • The higher the deductible, the lower the premium.
    • A pet with a per-incident deductible could have much higher out of
      pocket costs than an annual deductible. How to compare premium cost
      is difficult!!!!!
Pet Insurance Lingo:

The Incident
   • Annual deductibles by definition have no incidents
   • An „incident‟ is:
      • One specific episode of illness (Almost All).
      • One specific illness over the lifetime of the policy.
   • One company further defines a each incident by
      associating with 1 of 12 locations of the body: ears, eyes, skin,
     endocrine, digestive, nervous, musculoskeletal, infectious,
     Cardiovascular/respiratory, blood/lymphoid, urogenital, cancer.
     Accidents are a separate rider.
   • Reimbursements on a particular incident may be excluded after the
     current policy period (become pre-existing).
Pet Insurance Lingo:

Annual/Lifetime Maximum
vs. Per-Incident Maximum
    • If your policy had a $11,000 annual limit and a $1,500 per-incident limit,
      the company would pay out up to $1,500 for each incident. Then
      remaining $9,500 could be used during the year for other accidents or
    • If you have a policy with a company that has a per-incident limit, get the
      highest per-incident limit that you can afford
    • Policies vary tremendously:
         •   Annual Maximum but no Per-Incident Maximum but Per-Incident Deductible
         •   Annual Maximum and Per-Incident Maximum and Per-Incident Deductible
         •   Lifetime Maximum, no Annual Maximum with Per-Incident Maximum
         •   Annual Maximum and Lifetime Maximum with Per-Incident Deductible
         •   Annual Maximum and Lifetime Maximum with Annual Deductible
         •   Annual Maximum but no Lifetime Maximum and no Incident Maximum
         •   No Incident, Annual or Lifetime Maximum
Pet Insurance Lingo:

The Co-Pay
    • Amount of the total bill owed by the pet owner
    • Range form 0% to 40%
    • 0% copay
    • The deductible and the Annual Maximum are known numbers, but the
      Co-Pay total owed is just a percentage of the total bill and therefore is
      an unknown number
    • Lower co-pay equals higher premium
    • Consider 0% Co-Pay and a high but known deductible
      to keep all costs easily understood
Co-Pay and Deductible Example
$3000 Bill (assuming everything on bill is covered)
   • $100 deductible and 10% co-pay policy
       Co-pay = $3000 - $100 = $2900 x 10% = $290
       You pay $100 (deductible) + $290 (co-pay) = $390
   • $100 deductible and 35% co-pay policy
       Co-pay = $2900 x 35% = $1015
       You pay $100 (deductible) + $1015 (co-pay) = $1115
   • $500 deductible and 10% co-pay policy
       Co-pay = $2500 x 10% = $250
       You pay $500 (deductible) + $250 (co-pay) = $750      $3.95 Excel Spreadsheet at
   • $1000 deductible and 0% co-pay policy        

       You pay $1000 (deductible) + $0 (co-pay) = $1000
Strategies to manage risk:
How Clients Manage Risk
Some clients manage the risk by purchasing pet insurance,
But each client needs will differ:

   • Decide on Incident or Annual Deductible
   • Decide on amount of deductible
   • Decide on level of incident/annual/lifetime maximums
   • Since no prediction on which health risks our pet will eventually face
     choose a policy that has few and easy to understand limitations
   • Compare pricing last
Insurance Companies must manage Risk
Companies manage the risk to keep payouts in line with revenue,
But each company runs their company with differently:

   • Increase Premiums as the pet ages
   • Benefits Schedules define how much to pay out Primary vs 2ndary
   • Set Incident, Annual or Lifetime Limits to reimbursement
   • No coverage on Breed Specific or Hereditary Conditions
   • Enrollment limited to younger aged pets
   • Pre-existing Conditions Excluded
     (The most common reason a claim is denied.)
   • Exclude various less common veterinary services like behavior
     problems, pregnancy issues and breeding issues
   • Exclude Cosmetic procedures like tail docking, declaw, ear crops
   • Exclude diseases like Parvovirus that are preventable by vaccinations
Tactics to manage risk Continued
 • Diagnosis becomes pre-existing in subsequent policy years
 • Increase Premiums or cancel Insurance based on claims experience.
     • Healthy Paws, Embrace and Trupanion state
       would absolutely never do this.
 • Certain breeds or groups of breeds are charged higher premiums.
 • Separate riders for cancer coverage, dental, emergency,
   hip dysplasia, chronic illness, medications.
 • Pre-certification for certain conditions,
   like hip dysplasia
Tactics to manage risk – Example 1
Increase premiums as pet ages

  Never Increase
  Premium with
Tactics to manage risk – Example 1
Level Premiums or Age Based Premiums

  • Level premiums throughout the life of a pet means, the
    reimbursements in the early years of the policy are less than the
    premiums collected
  • This frontloading of the policy allows money to be set aside insurance
    companies to invest and be more profitable
  • Clients may like to pay less during the early years of a policy when the
    pet is healthier, and understand that as the pet ages the cost of
    insurance in more since there are more health concerns.
    (Similar to human health insurance).
  • OR Clients may hate the idea of paying pet health premiums but
    continue because they know their premiums will only increase with the
    cost of veterinary care and inflation..
Tactics to manage risk – Example 1
Level Premiums or Age Based Premiums - Continued

  • PurinaCare adjusts every year
  • PetPlan has 10 age adjustments
  • VPI has 14 age adjustments

                                              Pet Health Premiums

            80                                                             Stable Premiums
            60                                                             Age-based Premiums
                  1   2   3   4   5   6   7    8   9   10 11 12 13 14 15
Tactics to manage risk – Example 2
Reimbursement Methods
Whatever the veterinarian charges
Benefits Schedule
Geographic based reasonable and customary
                                             A         B           C
                  Company                 Invoice    Benefit    Regional
                                           Based    Schedule   Customary
                   Pets Best               Yes
                    ASPCA                                         Yes
                   PetsHealth                                     Yes
                     AKC                                          Yes
                    PetFirst               Yes
                   Embrace                 Yes
                    PetPlan                Yes
                      VPI                             Yes
         PetCare/ShelterCare/24PetWatch    Yes
                   Trupanion               Yes
                 Healthy Paws              Yes
                  PurinaCare               Yes
Tactics to manage risk – Example 2
Comments on Benefit Schedule Method

  • VPI benefit schedules are publicly available and are filed with the
    Department of Insurance, ensuring that each step of the claims process
    is fully transparent.

  • This type of reimbursement may be most beneficial
    for rural settings where cost of all services including
    veterinary medicine would be more affordable.

  • The cost of this type of policy is very affordable,
    but benefits also are less than others.
Tactics to manage risk – Example 2
Comments on Geographic Customary Method

 • The amount reimbursed is determined by the company reviewing the
   claim submission.

 • At point of care impossible to determine out of pocket costs.

 • Process hidden with no published documents.

 • Declined to participate in a „Sample Invoices and Reimbursement‟ on
   accident and illness coverage in Dr. Kenney‟s Pet Insurance Book.
Tactics to manage risk – Example 3
Incident, Annual or Lifetime Limits
                                                                        Annual          Lifetime
   Company                      Policy Name          Incident Max       Max             Max

   24PetWatch/ShelterCare   *   QuickCare Gold                 $3,000   none            $3000/$36,000

   24PetWatch/ShelterCare   *   QuickCare Complete             $5,000   none            $5000/$60,000

   AKC                          Essential                      $1,500      $11,000

   ASPCA/PetsHealth             Primary                        $1,500          $8,000

   PetsFirst                    Basic                          $1,500          $7,500

   PetsFirst                    Senior                         $2,000          $2,000

   ASPCA/PetsHealth             Safety                         $2,500          $8,000

   ASPCA/PetsHealth             Sterling                       $2,500      $13,000

   * 24PetWatch/ShelterCare describes incidents by body location, not specific diagnosis.
   Incident Maximums refer individually to ears, eyes, skin, endocrine, digestive, nervous
   system, musculoskeletal, Cardiovascular/respiratory, blood/lymphoid, urogenital, cancer,
   infectious. Accidents are considered separately and are not prescribed to body location.
Tactics to manage risk – Example 3
Incident, Annual or Lifetime Limits

                                                                Annual           Lifetime
   Company            Policy Name      Incident Max             Max              Max

   PetsFirst          Preferred                        $2,500          $12,000

   PetsBest           Basic                            $2,500   None               $42,500

   AKC                Essential Plus                   $3,000          $11,000

   ASPCA/PetsHealth   Advantage                        $3,500          $11,000

   PetsFirst          Preferred Plus                   $3,500          $15,000

   AKC                Wellness                         $5,000          $13,000

   AKC                Wellness Plus                    $5,000          $13,000

   ASPCA/PetsHealth   Premier                          $5,000          $13,000

   PetsBest           Pets First                       $7,000   None              $100,000

   PetsBest           Pets Premier                    $14,000   None              $100,000
Tactics to manage risk – Example 3
Incident, Annual or Lifetime Limits

                                                         Annual        Lifetime
   Company        Policy Name             Incident Max   Max           Max
   Embrace        Budget                  none                $5,000

   VPI            Medical                 none                $7,000

   PetPlan        Bronze                  none                $8,000

   Embrace        Everyday and Complete   none               $10,000

   PetPlan        Silver                  none               $12,000

   VPI            Major Medical           none               $14,000

   VPI            Injury                  none               $14,000

   PetPlan        Gold                    none               $20,000

   PurinaCare                             none               $20,000

   Healthy Paws                           none                 none       $25,000

   Trupanion                              None                 none         none
Tactics to manage risk – Example 3
Incident, Annual or Lifetime Limits

   • “If you end up purchasing a policy from a company that has a per-
     incident limit, get the highest per-incident limit that you can afford.”
   • “An annual maximum or annual deductible is preferable to a per-
     incident maximum or per-incident deductible because „per-incident‟ is
     simply an additional limit on how much the insurance company will
     pay out for an accident or illness.”
   • Dr. Porter believes a policy with less than a $7000 per-incident
     maximum should never be selected.
Tactics to manage risk – Example 4
Hereditary Conditions Limits
                                                                        Click Pic HyperLink
  • At Embrace Pet and Trupanion there is an excellent guide
    to help you understand the most common risks
                                                                        Click Pic HyperLink
    with your pet‟s breed.

  • Hereditary conditions may be covered, partially covered or denied
    coverage depending on the company guidelines.

  • I believe this is the most important reason for
    getting an insurance policy
Tactics to manage risk – Example 4
Hereditary Conditions Limits

     • Full Hereditary Coverage

     • Full Hereditary Coverage except Hip Dysplasia
     • Limit Hereditary Coverage to purchase before age 2,
       coverage is less and differs from annual limits
        $500 To $2500 Lifetime Limits Depending on PetsBest Plan

     • Limit Hereditary Coverage to purchase before age 1,
       $250 Diagnosis and $500 Surgery per year.
       No lifetime limits, renews yearly.
     • Must add Riders for Hereditary Coverage
       (Not included with initial quotes, not advertised?)
     • No hereditary Coverage
Tactics to manage risk – Example 4
Hereditary Conditions risk
and definition of Pre-existing Condition Varies

   •   Healthy Pet: “What matters most is that, as long as the clinical symptoms are
       not present prior to enrollment or during the waiting period, we cover
       hereditary and congenital conditions so you can rest assured you're protected
       financially and can give your pet the quality medical care they deserve.”
   •   Petplan: “covers all hereditary and congenital conditions, so long as clinical
       signs were not present prior to the commencement of the policy or during the
       waiting periods.”
   •   Trupanion: “Illness resulting from any condition for which evidence and/or
       symptoms of their potential manifestation already exist at, or 18 months prior
       to, the policy enrollment date”
   •   Pets Best: “Any illness or injury that begins before your policy is effective, or
       during your waiting period, will be considered “pre-existing”. Even if your pet
       had no signs or symptoms and wasn‟t diagnosed, some conditions can still be
       considered pre-existing.” (No congential coverage).
Tactics to manage risk – Example 5
Company specific tactics that aren’t easily categorized

   • Must pay for all office calls.
   • Penalized with surcharges or premium increases based on number of
     claims filed.
   • No claim for multiple incidents (more than one) of foreign object
     ingestion in a 12 month period.

   • Deny Coverage for Hit By Car Injury
     because pet was not spayed.
   • Missed Premium cancels policy, reinstatement with payment of missed
     premiums. But still no coverage for new pre-existing conditions
   • Prescription Drug Coverage a separate rider. including antibiotics, pain
     relief, allergy meds, insulin & supplies, eye & ear drops.
Tactics to manage risk – Example 5
Company specific alterations that aren’t easily categorized

   • Excludes Hip Dysplasia coverage, unless started prior to 1 year with
     additional rider
   • Chronic Conditions considered single incident
   • Wellness benefits included in a single annual deductible
   • Wellness benefits automatic but $50 per incident co-pay
   • Excludes osteoarthritis

   • Denies claims based on slow filing but still within policy period
       • Denied if filed greater than 180 days from first Treatment
   • Different reimbursement for Emergency/Referral Care (30% co-pay)
Tactics to manage risk – Example 6
Policies Available Online prior to purchase

   • Trupanion
   • Purina Care
   • Embrace
   • VPI
   • Pets Best
   • Healthy Paws
   • ASPCA
   • AKC

 Never found for 24PetWatch/ShelterCare
Tactics to manage risk – Example 7
less restrictions = less administrative costs

     “Newer companies have attempted to simplify the
       reimbursement process so that it is more understandable
       for veterinarians and pet owners alike. At this time, it
       remains to be seen if these newer companies can stay
       competitive (keep their premiums affordable) while
       taking this new approach.”
 • PetInsuranceReview's goal is to assist pet owners who are shopping for
   pet insurance. We believe that by providing information on benefits,
   pricing and customer reviews, we can help pet owners make the
   appropriate decision for themselves and their pets.

 • This website is not owned or controlled by any pet insurance company.

 • The user reviews are opinions submitted by customers of various pet
   insurance companies and do not reflect the opinion of the operator of
   this website. The profiles of the pet insurance companies are accurate
   to the best of our knowledge and are updated on a monthly basis.

 • Individual submissions with a rating of 1 to 10.
Will the ‘real’ review site stand up!              


                                                           Each site claims to                                   review pet insurance,
                                                           but only one is free of
                                                           advertising, free of
                            outside influence and
                                                           has actual customer
                  Average Rating
PurinaCare    Embrace         Pet First   Pet Plan    Trupanion
Pet Health      Pet          Healthcare     US           Pet
Insurance    Insurance                                Insurance
   8.4         9.2              8.1         9.3         8.6

Veterinary    Healthy         AKC Pet     Pets Best   Pet Health    Hartville
   Pet         Paws          Heath Plan   Insurance   Insurance       Pet
Insurance     (6/2010)                                             Insurance
   7.2        10.0              4.4         8.2         4.3          7.3

              January 2011
              Average 7.5
                  Average Rating
• Most companies appear to get lower ratings because clients do
  not understand what they have purchased.
    • Fault of client for not understanding
    • Fault of Insurance company for not explaining
• Occasionally companies appear to get lower ratings because
  they offer poor customer service, deny claims based on what the
  client believes is a technicality related to a pre-existing
          Understand what you are purchasing and
         avoid companies that don’t meet your standards
AAHA Seal of Acceptance
for high-deductible policies

   • These high deductible policies must be equal or
     better than all other offered policies

   • Underwritten by A.M. Best Rating of B+ or higher

   • Sell these high deductible policies in all states licensed

   • Allow client to seek care from any licensed veterinarian

   • These high-deductible policies will receive the AAHA Seal of
     Acceptance, not the companies themselves
AAHA accepted
pet insurance policies
  • AAHA is the American Animal Hospital Association,
    the only organization that accredits animal hospitals        Click Pic HyperLink

    throughout the U.S. and Canada.
  • AAHA believes that most pet owners need coverage for catastrophic
  • Studies have shown that the majority of pet owners can manage
    expenses between $500 and $1,000, but would have difficulty with
    expenses beyond that level.
Deductible & Co-Pay Pet Health Plans
Balancing the needs and wants of the consumer
  Company                  Per-Incident Deductible      Annual Deductible         Co-Pay

  24PetWatch/ShelterCare   $50, $100                                              10%, 30%
                                                                                  0%, 10%, 20%
  PetPlan                  $50, $100, $200, ($500?)                               30% for Emerg.

  VPI                                                   $0, $500, $1000           0%

  Trupanion                $0 to $1000 + Office Calls                             10%

  Embrace                                               $100, $200, $500          10%, 20%, 30%

  PurinaCare                                            $100, $250, $500, $1000   20%, 30%, 40%

  AKC                                                   $125                      20%
  ASPCA/PetsHealth                                      $100                      20%

  PetsFirst                $50                                                    10% most, 20%
                                                        Office Calls+
  Healthy Paws                                          $50, $100, $250, $500     10%, 20%, 30%

  PetsBest                 $100, $250, $500                                       20%
Wellness Coverage
Appropriate only with thoughtful review

  • covering routine daily healthcare issues
    is not cost effective for the pet owner

  • Insuring for the routine is a pre-payment plan, not true insurance

  • PurinaCare offers a unique approach to including wellness visits:
      • Defined amounts for wellness services
        are included in calculating the annual deductible.
Wellness Coverage
Appropriate only with thoughtful review
   Wellness Coverage                       PurinaCare                  PetsBest                    Embrace
   Per Month                                                 $5-$13                          $22             $14.95
   Annual Limit                            No Limit                                      $480                  $200
                                               Annual Policy
                                              $250-$1000 after
   Deductible                               Co-pay 20%,30%,40%               No Deductible         No Deductible
   Includes Heartworm/Flea Meds                             $56-$75                          $25                $50
   Includes Vaccinations                   $150 including Physical                           $65               $200
   Includes Teeth Cleaning                                $150-$200                      $100      Now separate rider

   Includes Lab tests                      Yes                         Yes                         Yes         $200
   Includes Fecal and Meds                                  $30-$40                          $15
   Includes Hw Test                                         $30-$40                          $25
   Includes Urine analysis                                  $26-$35                          $25
   Includes Annual Wellness                                 $56-$75                          $60
   Typical Dog TOTAL BENEFIT                $380 minus deductible                        $300                  $200
   TOTAL COST for 1 year                                   $60-$156                      $264               $179.40

   Most companies hide the cost of wellness coverage within the general policy, making it difficult to determine
   the true value of the premium. Pets Best option to cancel Basic or First plans if Wellness cancelled.
Dental Benefits
 • Embrace Dental Rewards Plan premiums $299/yr. Max Benefit $400
 • ASPCA states coverage of dentals for level 4 only
     •   Policy states no coverage for Preventive care or routine check-ups including but not limited to
         pre-surgical tests or procedures, dental cleaning or scaling except as listed above; (one annual
         Dental Prophylaxis (cleaning) with pre-operative blood profile, no mention of anesthesia, pain
         meds, catheter support). Premium $88/mo
 • Purina Care with Preventative Care
     •   Maximum claim of $250 for entire procedure (payout max of 60% or $150) once deductible is
 • Pets Best with Preventative Care
     •   Maximum claim $100.
 • Healthy Paws Insurance
     •   No Dental health care, however if injury to teeth is caused by an accident, we do cover the
         cost of extractions of damaged teeth and of reconstruction of upper and lower canine teeth .
Monthly Premiums for Cats
Vary widely by company and
don’t appear to match previously described risk factors VS. benefits
                                          Monthly Premium
                 Company                  Comparison

                 24PetWatch/ShelterCare   $27.95

                 PetPlan                  $14.88

                 VPI                      $42.47

                 Trupanion                $21.38

                 Embrace                  $47.83

                 PurinaCare               $10.41 to $15.21

                 AKC                      ???
                 ASPCA/PetsHealth         $23.07

                 PetsFirst                $83.70

                 PetsBest                 $59.10
Final Recommendations
•   Buy and read this book, on eBay and get the Excel
    spreadsheet on comparing cost of individual plans.

•   Remind clients that pet insurance is not about saving
    money, it is about the risk of caring for the “unlucky

•   AAHA Client Guide „Ensuring Your Pet‟s Health‟

•   Have copies of actual sample policies on hand for
    clients to review.

•   Recommend two to three options for your clients,
    each with clearly understand criteria and high
    satisfaction ratings.

•   Educate your staff about pet insurance.

                                                               Click Pic HyperLink
What would you do, Dr. Porter?
  • Reimbursements by veterinary invoice and has annual deductible
    instead of per-incident deductible.

 • Has Per-Incident Limits >=$7000 Limits.

                                                     Do not choose BASIC
                                                     policy, with limit of $2500.
What would you do, Dr. Porter?
 • Full Coverage for Hereditary Conditions.

 • Chronic disease coverage renews completely each year up to
   Annual/Lifetime Maximum.

 • Reduce long-term cost lifetime of premiums but have coverage.
What would you do, Dr. Porter?
  • Meets the High Deductible Policy Standards of the AAHA,
    in business >3yrs, annual deductible, full coverage for Hereditary
    Conditions and have a superior customer rating at

 • Meets the High Deductible Policy Standards of the AAHA,
   in business >3yrs, pre-incident deductible, full coverage for Hereditary
   Conditions and have a superior customer rating at
                                                   Co-pays are always 30% with referral or emergency                          clinics, regardless of the co-pay on the policy.
                                                        Offers 0% Co-pay
       No hip dysplasia coverage

       No Reimbursements Maximums.

          for More Information about
             Your Pet’s Best Care.

• Online Appointment Scheduling
• Up-to-date information about current health reminders
• Online refills of prescription medications and prescription foods
     Westgate          •   AAHA-accredited hospitals
     Pet Clinic            voluntarily choose to be evaluated

          is               on 900 standards in the following
                           areas: quality of care; diagnostic &
 American Animal           pharmacy; management; medical
                           records; and facility.
Hospital Association
    Accredited         •   The Standards developed and
                           published by AAHA are widely
                           accepted as representing those
                           components of veterinary practice
                           that represent high quality care.
                           The Standards are periodically
                           reviewed and updated to ensure
                           that they remain consistent with
                           evolving knowledge and

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