Invisible Voices

a voice for the voiceless

“Pet” Insurance, Part 5 – overview of 2 plans missed before

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In the comments of my 3rd part of this series, ASPCA insurance was mentioned several times as well as Pets Health Plan, both of which are through the Hartville Group. Neither were in the group of insurances I researched in the earlier posts, and while I have no intention of trying to write about every insurance out there, I couldn’t bring myself to continue with some of the more specific issues I want to cover in depth until I brought myself up to speed on these other two plans.

So that is what this post is – the type of research I did for part 3 & 4 of this series, but just for ASPCA and Pets Health Plan. That will include an overview of their options and general cost, as well as reviews, if I can find them.

ASPCA overview:

  • They had a wide range of policies, 5 plans total, from Accidents only up through Accidents, Illnesses, and various “wellness” coverages for regular vet visits, and finally the most pricey policy also includes “continuing coverage for chronic and long term conditions that occur in a previous plan year.” The price ranges for the entire range for cats is $6.99/month – $67.14/month; for dogs it is $8.99/month – $76.69/month.
  • There is a $10.50/year “Issuance Fee”, which is waived if you pay your policy annually
  • Additional premiums for certain breeds, ages, and metro areas
  • Payment schedule options: monthly, quarterly, semi-annually, annually
  • Payment options: credit card or automatic check withdrawal
  • Ages for Initial Enrollment: cats, 8 weeks to 15 years; dogs, 8 weeks to 13 years. Cats and dogs can enroll at any age for the accident only policy.
  • No coverage for congenital or hereditary problems
  • Though I didn’t see it specified on the web site, I was told by Laura Bennett (of Embrace Pet Insurance) that ASPCA is a “Usual, Customary, Reasonable” type of insurance. (as opposed to a benefit schedule based insurance) I did my best to muddle through the differences between these types of insurance in one of the previous posts, though I’m not an expert by any means!
  • There is a fairly extensive list of Exclusions, which include things like torn ACL’s. I would have thought an ACL tear would be covered as a normal accidental injury, but it is not covered and they don’t explain their reasoning.

Now for the specifics. The five plans:

  • Safety – accidents only, $6.99/month for cats, $8.99/month for dogs. They can be enrolled at any age, any health, and any breed is eligible. Limits: $2500/incident; $8000/year.
  • Primary – Accidents plus illness coverage; starts at $11.58/month for cats, $16.61/month for dogs. Limits: $1500/incident; $8000/year. Note: this is basically “Safety” plus illness coverage, but notice you have less coverage per incident; this means for the same accident you’d be covered less on an incident basis than under “Safety”.
  • Advantage – Accidents, plus illness, plus some “wellness” costs; starts at $23.11/month for cats, $30.50/month for dogs. Limits: $3500/incident, $11,000/year.
  • Premiere – Advantage, plus additional tests, vaccines, heartworm medication, and an annual dental cleaning; starts at $47.31/month for cats, $54.10/month for dogs. Limits: $5000/incident, $13000/year.
  • Sterling – Advantage, plus continuous coverage for chronic and long-term conditions that occur in a previous year; starts at $67.14/month for cats, $76.69/month for dogs. Limits: 2500/incident, 13000/year.

Mo was right – that is a huge jump in cost between Advantage and Sterling just for continuous coverage.

No reviews on ASPCA’s insurance, but based on this blog post on Embrace’s site, it is a very new insurance, so people don’t have that much experience with, and those who do aren’t reviewing it!

Okay, now to Pets Health Plan. Overview:

  • Usual, Customary, Reasonable (as opposed to benefit schedule)
  • any age, breed, health is eligible for enrollment in the accident only plan
  • all other plans: max age for initial enrollment for cats is 15, for dogs it is 13.
  • $100 annual deductible, after which 80% of “usual customary reasonable” expenses are covered
  • lost and found tag covered on all plans
  • $10.50 annual Issuance Fee, unless the policy is paid on an annual payment schedule
  • Chinese Shar-Pei’s are eligible for accident only (“Accident”) coverage
  • multiple pet discount: pay your regular premium for the highest-rated pet and receive a 10% discount for up to two additional pets on the same plan
  • exclusions
  • holistic medicine is not covered

Specifics: (comparison chart)

  • Accident = accident only; hospitalization, xrays, surgery $6.99/month for cats, $8.99/month for dogs. They can be enrolled at any age, any health, and any breed is eligible. Limits: $2500/incident; $8000/year.
  • Basic = accident plus illness; starts at $11.58 for cats and $16.61 for dogs; maximum benefit of $8,000.00 per year, with a $1,500.00 per incident limit.
  • Value = Basic plus annual physical and standard vaccines; starts at $23.11 for cats and $30.50 for dogs; maximum benefit of $11,000.00 per year, with a $3,500.00 per incident limit
  • Choice = Value plus flea prevention and “advanced” vaccines; starts at $47.31 for cats and $54.10 for dogs; maximum benefit of $13,000.00 per year, with a $5,000.00 per incident limit
  • Best = Value plus ongoing coverage for certain long term and chronic conditions; starts at $67.14 for cats and $76.79 for dogs; maximum benefit of $13,000.00 per year, with a $2,500.00 per incident limit

Basically, it is the same plans as ASPCA, and again, I could find no reviews for this insurance.

I linked the exclusion page already, but it is worth taking a second look. Specifically:

Pre-existing and/or recurring illness or injury prior to the effective date, unless 180 days have past since cure and/or last treatment

This could be really good news for people. Aside from hereditary or congenital problems, it sounds like even something like diabetes might be covered as long as they are healthy for 6 months. I don’t know if there are similar clauses in all insurances, I haven’t noticed it until this one. (And I’m too lazy to go back and look!) This is a question I’d ask of an insurance person, though. For all I know, feeding prescription food is considered “treatment” and thus you can never get past it.

Still, there are less serious health issues, like bladder infections (not serious if treated quickly, anyway), which I imagine this is meant for, and which the insurance would come in handy. Maybe I will go back and look into after all…in another post.

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31 responses to ““Pet” Insurance, Part 5 – overview of 2 plans missed before

  1. Laura Bennett June 14, 2007 at 11:03 pm

    Just to note, unless you pick the top plan option (“Best”), these plans reset the pre-existing conditions at the end of each policy year and do not cover chronic conditions in year 2 onwards. This can be a big surprise as it’s not mentioned explicitly in their terms and conditions as it’s a one year policy.

  2. Deb June 15, 2007 at 2:44 pm

    Yes, thanks for making that clear, Laura! It was in my head to point it out, but I didn’t remember to by the time I got the research done!

    I’m going to do some specific topic posts soon on questions that have come up, or just comparing things like the continuous coverage options across the different insurances. Continuing care is probably next, actually.

    I know that Embrace has it as an option you can choose, or not, for any of the coverages, and looking at the extremely high cost you’d have to pay for continuous coverage through these two plans in this post, it is really nice that Embrace allows people to fiddle with all the options, like the annual max, deductable, co-pay, etc, and regardless of whether they’re going for the cheapest per month premium or most expensive or anywhere in between, they can always make sure to have the continuing care/coverage.

    But I’ll cover that in a post soon, and compare that particular option across the companies/plans that I’ve already covered in the series.

    We’ll see what comes next – I am starting to keep track of relevant search terms that have hit my blog, and maybe I will research and discuss those in later posts. (luxating patella! i’ve had several hits for that!)

    Thanks for your continuing eye on these posts, Laura. I get things as accurate as I can, but it is nice to know that someone who knows quite a bit more about the industry is there to point out any holes, misinformation, or misunderstaning that are bound to crop up. :)

  3. Neva June 15, 2007 at 7:03 pm

    I’ve talked to Sean about pet insurance before, but we were under the impression that because most of our rescues have chronic health issues (though the dogs do not) that we would not even be able to enroll. It’s something to think about definitely. Also, I have to go back and look at past posts to see, but how many plans would cover holistic and alternative care?

  4. Deb June 15, 2007 at 7:44 pm

    Some plans do cover holistic and alternative care. Looking back at my notes, Pet Care, Pets Best, and Embrace cover it to some degree. For Pet Care, I wrote “holistic meds covered if prescribed by licensed vet”, Pets Best said “Holistic care except supplements”, and Embrace said “alternative therapies – including hydrotherapy and accupuncture”. I also have a note for Pet Care that “all guaranteed acceptance.” That might refer to the accident only insurance – most insurance companies seem to offer accident only, and for that the pre-existing illnesses don’t matter.

    For most, age can be a limiting factor, but some have fairly later-year limits, such as 13 for dogs, 15 for cats (that would be aspca and pet health plan; embrace is 10 yrs for non-breed cats), and then there are some that have senior specific care, with no upper limit on enrollment. Basically anyone should be able to get some form of coverage!

  5. Mo June 16, 2007 at 4:34 am

    Deb, the 180-day pre-existing condition thing is really great. At least one other company does have that, but like you, I can’t bring myself to go back and dig through the millions of details to find which one(s). BTW, I am amazed at how quickly you compiled all of this. I didn’t even know there was a Part 4, so I need to check that out.

    Laura, in my continuing quest I have come across your name elsewhere…it’s great that in your position you’re making your self and your knowledge so readily available. From all I’ve read, you seem like the kind of person that I want handling the insuring of excellent health care for my cats! (And I am not easy to please in that area.) :-) I am (im)patiently awaiting the day Embrace is available in the Pac NW….

    Deb and Laura, you’re providing so much valuable, detailed information in an area that is incredibly difficult for even the most devoted critter-parent to muddle through. Thanks for caring so much about our companions and helping us provide the best health care we can for them.

  6. Deb June 16, 2007 at 6:39 am

    I actually looked back at my notes, and I clearly didn’t make not of the 180 day thing when I went through this the first time. I did find for vpi this info, in answer to a question about pre-existing conditions and cures:

    “A condition such as a laceration, prior to the policy effective date, would be considered pre-existing and would be placed as an exclusion on the policy. Once documentation from your veterinarian states that the laceration has been cured and does not require additional treatment the exclusion may be removed from your pet’s policy. If your pet then has another laceration in the future, it would be considered a new claim with all eligibility requirements applicable.

    Conditions such as allergies that are pre-existing to the policy would never be covered, as they are not considered curable.”

    Mo, thanks for your own contributions! Sometimes I think that the more I research, the more confused I get, but I keep thinking that it will start to become clearer for me, especially as I start to look into specific topics and compare the companies with regards to those specific things. We’ll see, I guess!

  7. Mo June 16, 2007 at 7:39 pm

    I’m definitely getting more confused…things seem clear as a bell for a few hours(!) and then they all start to blend into each other. Your breakdowns are invaluable for that reason – one of these days I’ll use them to make up a side-by-side comparison chart to help my pitiful little memory synapses. I can only complain out of laziness, though – it’s fantastic that we now have so many options! It was really just VPI when I started with vet insurance.

    One VERY IMPORTANT item of note is that you really don’t get all the scoop until you receive your policy in the mail. At that point you need to read, and re-read, ALL of it and decide if you want to keep it. You will most likely find some surprises. I saw one where at a certain age you are required to submit vet exam notes, comprehensive bloodwork results, & xrays – at regular intervals. I wonder if they then will kick your pet out of the plan if something shows up…I imagine they will, otherwise why would they require it? I need to confirm that and will then post what I learn. (To make matters worse, the insurance will not cover the cost of those tests, which can easily run a couple of hundred dollars.)

    This is VERY IMPORTANT for folks to take note of because as pets age, of course more serious diseases develop. If your plan cancels your policy due to the results of that testing, you’re screwed – no other plan would cover the condition(s) because they’d be pre-existing at that point. …yikes…

  8. Laura Bennett June 16, 2007 at 10:21 pm

    Everyone here is doing a great service by asking good questions and digging up the info. Of course, there’s always more to question and compare (e.g. which companies have a money-back guarantee and how long? I’ll leave that as a teaser for now) but this just goes to show, you can’t go on price alone.

    On alternative and complementary conditions, we cover homeopathic remedies, acupuncture, chiropractic treatment, hydrotherapy, and physiotherapy by a Veterinarian who is a member of certain associations, which are listed here http://www.embracepetinsurance.com/Content/Compare/OurPolicy/alternative-therapies-coverage.aspx .

  9. Mo June 17, 2007 at 12:32 am

    I was pondering my own question about whether an ins company would cancel your policy if bloodwork/x-rays, etc. showed a problem (required when the pet reaches a certain age)…I realized they would probably simply increase your premium rate relative to the possible conditions revealed by the diagnostics. Most likely the premiums would be very high then. Oh, I do not like that. More info on the company I’m speaking of once I get firm info…it seems unethical to do that without notifying policyholders up-front that would be the case, but what do I know….

    Laura, the alternative/complementary coverage is awesome. Tap-tap-tapping my foot to the clock’s second hand…eagerly awaiting Embrace coming to a theater near me…. tick-tock-tick-tock…where is it?! ;-)

  10. Deb June 17, 2007 at 10:02 am

    Mo, really good point about reading the policy carefully! And I agree, Laura, the questions have been really helpful to me, to focus some of my research.

    Thanks to everyone who has been contributing! :)

  11. Sean June 19, 2007 at 11:53 am

    I have quite some reservations about pet insurance.
    (1) Of course, the insurance companies want to make a profit, after paying their enormous admin costs, and paying claims.
    (2) You are paying into a pool, and paying a premium to cover all their admin costs, the average amount for claims, and a profit componenent.
    (3) You hopefully take good care of them, and are paying into a pool with people who feed their animals junk, overvaccinate, let them get obese, so as a responsible pet guardian, you end up paying more than your “share,” in addition to admin costs and profit.

    The main benefit for pet insurance is for covering either catastrophic or chronic conditions that develop after you get the insurance, and some insurance companies are better at paying claims than others. And if it is not a group policy (where the insurance company cannot cancel your insurance without canceling the whole group), you risk cancellation if you start using it more than they like. The types of claims covered, and their integrity in paying claims, are more important than the relative amount of the premium.

  12. Mo June 19, 2007 at 2:07 pm

    Sean, your concerns are valid and I agree with much of what you said, but those things apply to all insurance (it’s even worse for auto and homeowners where the lienholder requires it or it’s required by law). I disagree with your (3) because people who don’t treat their pets well are far less likely to buy vet insurance policies, so their lack of responsibility shouldn’t have a very big impact on the pool. Your last paragraph is what this discussion is all about…we’re trying to weed through all the various differences and similarities between policies so we can choose a good fit. Pet insurance isn’t for everyone, though.

  13. Neva June 19, 2007 at 8:07 pm

    I do think that people who mistreat their companion animals are not likely to get pet insurance. However, in our rescue work we’ve sadly encountered some cases of too much vet care. Some people (we used to be like this) believe they are being responsible to take their animals to the vet every year to get vaccinated. This has been shown to cause some types of cancer. My friend, though I’ve been on her case about it, still gets her cats vaccinated annually for rabies, FeLV, and distemper. I’ve told her that studies suggest one rabies vaccine lasts 7 to 12 years, distemper is really only a risk for kittens and the FeLV vaccine isn’t all that effective… But all of them bring risks. Many people think that they are buying really good food for their animals when they buy the premium brand at Petsmart, but it’s the same stuff in all the brands (as the recent petfood scandal revealed). Many people who love their animals let them get incredibly obese because they find food is a primary way to interact with them and give lots of treats, or else they leave food out all the time.

    Our worst vet bills have been for some animals we just found, like when we found Willow and she was essentially starved to death, and after some hard thinking, we went ahead and got her a blood transfusion, and then subsequent health problems related to the near starvation.

  14. Sean June 19, 2007 at 8:49 pm

    Mo, you are right about other types of insurance, though with most health insurance, the employer subsidizes the cost. Though it is often most cost effective for healthy people to get what is called “catastrophic” (high deductible) insurance just to cover the big stuff. Car insurance, of course, is mandatory, and furthermore, the insurance companies try to adjust the cost based on whether you are a good driver. This doesn’t happen with human or pet health insurance.
    I would simply advise people to focus on getting the pet insurance most likely to cover the catastrophic claims, though as Neva pointed out, for us that usually occurs when we find a sick or injured stray, who would not be covered.

  15. Deb June 19, 2007 at 10:42 pm

    Neva and Sean, you of course bring up good points – there are many factors out of our control, including the care that other people in our “pool” give to the animals in their care.

    But we should also remember that feeding the best cat food isn’t a guarantee of not running into serious illnesses, and certainly does nothing to prevent accidents.

    Human health insurance is like a medical cost plan, but pet insurance is catastrophic insurance. This entire series of posts has been focused on exactly what you’re adivsing, Sean; to find the best company with the best coverage. And yes, for “catastrophic”, though of course that is up for personal interpretation. So you’re not going to find anyone disagreeing.

    We should look carefully at the plans, at the companies, and that’s what I’ve been trying to do or at least help people do with this series of posts. There are some plans that cover routine vet bills, generally as an option which people can opt for through some companies. There is even a company that offers straight discounts for the vet bills, if the vet you go to is signed up under them. That’s not insurance, it is just a discount, yet if your vet is covered under it, it could come in very handy.

    Certainly these are all factors to consider, and everyone should make their own choices. The insurance is to cover the unexpected, and a good choice can make a big difference.

  16. Mo June 20, 2007 at 12:04 am

    It absolutely can make a big difference…as in thousands of dollars, not to mention the difference between having a general practice vet do their absolute best, which is by definition limited, and having a team of specialists available to provide the very best in medical care, including the ever-important nursing, observation, and TLC. I was stunned last year to discover that a surgeon who specializes in a particular field of surgery, had no clue about certain things an Internal Medicine specialist would know. We take these things for granted in the human medicine arena, but the same areas of specialty exist in the veterinary medicine world, and the differences in expertise can mean not only the difference between the life and death of one’s beloved companion, but the difference between prolonged, grave suffering, and peaceful final days. Vet insurance is of prime importance for some of us for those reasons.

  17. Hartville Group Employee June 28, 2007 at 1:22 am

    I work for the Hartville Group as a CSR and have a few things to tell you all. First, PET INSURANCE IS THE WORST INVESTMENT YOU COULD EVER MAKE! Do you think our company TRULY cares about the health of your pet? It sounds cold but think about it, we are an insurance company and it’s our job to deny your claim. Since we are a publically traded company, it is required by law that we maximize profits for our shareholders, this means we look for reasons to not pay your claims before looking for reasons to approve them.

    The way our company is run is the worst I’ve ever heard of. Management is never available to speak with customers if they have an issue (well, they are, but they tell all of the customer service reps to send the customers to their VM’s because they dont want to speak with them) Usually, the people that are tranx to their VM’s are never called back.

    Im sure some of you are from FL and VA and have tried to enroll but were told that “there is a technical issue with the state and we cannot write any new plans at the moment.” This is a scripted response which all CSR’s are given. We are not allowed to tell you what the true reason is. We were told by Lynn Thompson, VP Customer Relations, to repeat this script should the customer ask what the technical issue was. Well, let me tell you exactly what that issue is. The problem is with the states in which we are writing plans. The state does not agree with some of our terms in our plans. This can range from our issuance fee to our pre-existing condition clause, the company really doesn’t tell us.

    Our claims department is about 4 weeks behind on claims. We are told to tell the customers it’s because of the recent pet food recall, this is complete BS. The pet food recal did slow us down a bit but not by that much. The true problem is between the claims reps. They argue and bicker over who gets the better claim. This reluctance to complete the claims as they come in results in some claims to never get done. Hell, I noticed that there are some claims that were received in early May that STILL haven’t been touched! If you want to be paid on a claim, be prepared to wait a very long time. Odds are it will be denied anyway.

    It usually takes about seven to ten business days after your initial payment is made for you to receive your plan in the mail. Most people NEVER GET THEIR PLAN! This is because we outsource our printing to a company calld Triadex. They are terrible. I have personally requested 4 and 5 reprints for any given customer and they never receive it, sometimes I request the reprint from a manager, and still, the customer does not receive it.

    I’m not informing you of all this because I got fired or quit, thats not the case at all. In fact, they pay competitively for the positions being offered. I’m just sick of having customers call and us having to bull shit them all the time, I cant stand it anymore. I want you all to really know what you will be getting into if you sign up with us.

    ALL of the “front-line” people you speak with really understand your frustration because we are right there with you. We continuously bitch to management so we can service our customers the way a company should but nothing is done. They hear us but don’t really listen.

    Ill post a list of the internal extensions and emails tomorrow when I get home. If you have any quams with our service, please take it up with management because they cause it and have the ability to remedy it..they choose to ignore it instead. So, make them listen.

    I hope this helped.

  18. Mo June 28, 2007 at 5:33 pm

    Wow! Thank you for being so honest. Just about everything you said made me feel my suspicions were being validated with each sentence I read. That is, suspicions I have about the “big” insurance companies I’ve dealt with. Actually I have a claim from the first week in May that still has not been paid…initially it was denied pending vet records which were supposed to be requested under a separate letter. It took over a month for this information to be sent to me…and I never received the “separate letter” explaining exactly what I needed to provide for the claim, so I called the company and they had no reason why, but the CSR rep apologized and told me the letter was never even generated, let alone sent to me. He told me what records are needed so I will now get them from my vet and send them in. This means a minimum of another month on this claim ($3000+)…it’s not just the money, but this is a claim for the final illness of my little cat and it totally sucks to have this drag on and on, and to have it hanging over my head, not to mention having to tell them over and over “my cat died”, etc.

    To address your initial questions, I don’t know about anyone else, but NO, I don’t think my insurance company cares one bit about me or my cats – I’m under no such delusion and I am fully aware they are in business…as a business. That is why I’m looking into two of the newer companies. The founders put themselves out there and take a personal interest in people and their pets. One of these is Laura from Embrace, who is available in multiple places online providing information and answering questions personally…I never thought I’d see the day that would happen. The other is also a co-founder, but of a different company (also pretty new, to the US at least), who actually called me personally, off-hours, when I had called the company asking about some wording in their policy. She wanted my input and explained the meaning of the wording, understood my complaints and discussed them with me, and we had some discussion about her own pet veterinary experiences & her reasons for starting the company.

    The point is, these two companies are different than the old standards, and we want to be sure to not throw the baby out with the bathwater. I believe everything you said (and have experienced most of it in my 9 years of using vet insurance), but I am now coming to have hope that we now have options…there are some companies who DO care (of course they’re still a “business” – they won’t be petsitting for me or anything like that).

    I can’t speak for Deb, but I believe she created this series of posts to provide as much info as she could, and to create a forum for discussion and sharing of ideas & experiences, which will help all of us research our options carefully and make smart decisions. You’ve definitely given some valuable insight into how the companies “think”.

    Thanks for speaking out and expressing things from the CSR perspective. I think it’s good for all of us to be open about these things (“expose” them, if you will) – maybe the Shame-factor will help the crappy companies improve (i.e., fear of losing money); and the Fear-factor (i.e.,fear of becoming just another blah face in the insurance crowd) will help the good companies maintain their vision and KEEP their companies good!

    Your opening remark about pet insurance being a horrible investment is absolutely true. It never occurred to me to think of vet insurance as an “investment”…to me, it’s “insurance”.

  19. Deb June 28, 2007 at 7:13 pm

    Mo, you’re right on target with why I started this series of posts. The insurance can help us afford the care we will give our companions, but we certainly can’t assume that all insurance companies or policies are created equal. And, like it or not, we are in a capitalist society; businesses are in business to make a profit. If they don’t, they go under. I actually want insurance companies to make a profit, as long as they are fulfilling their contractual obligations and not trying to cheat their customers.

    And that, really, is the bottomline to this series.

    Mo, I’m curious what this other insurance company is that you mentioned! It sounds like it must be the one you mentioned, but didn’t name, in an earlier comment as well. When you’re ready, do share!

  20. Mo June 28, 2007 at 9:51 pm

    Deb, yes, I was talking about the company I’d mentioned in an earlier post – thanks for reminding me! The company is Pet Plan (www.gopetplan.com; NOT petplan.com, though that might be their Canada & UK company). I bought a policy for my cat and when I received the written policy it had some disturbing language in it…at a certain age (10 for cats) you’re required to have a yearly vet exam with bloodwork and urinalysis. That’s all fine and dandy because I’d be doing that anyway, but they REQUIRE you to submit the results prior to your renewal date. Then the section that describes the conditions under which they can cancel your policy reads like legaleze gobbledgook…leading me to think that if the labs showed anomalies/signs of disease, they would either raise your premium exhorbitantly, or cancel/refuse to renew.

    I got these weird flashbacks of how my mother was treated once she became “elderly”…almost no one in the medical profession really cared about her quality of life, or cared enough to treat her conditions as though her existence was still just as important as someone younger who happened to have the same conditions. It’s pitiful, but I know that we treat our elderly humans that way in this country…I do not want to pay someone premiums for years just to have my cats treated that way as well.

    So, I called to cancel the policy…a nice man emphatically explained that nooooo, they would never cancel based on the results of the labs…so I asked for that promise in writing. He quickly wanted me to speak to a supervisor…I thought that was a bit odd because that never happens – I always have to ask to speak to a supervisor, CSR’s just want to tell you what they’ve been told to say. The supervisor was unavailable so he told me they’d call me the following day.

    That same night I got a call from one of the co-founders. She was highly engaged in the subject matter…she told me the reasons she started the company (illness of her cat), and was very emphatic about their “insure for life” position…she said without that, they would be out of business. She said they would never cancel a policy because of an illness. It’s all nice and warm and fuzzy to hear those words, but I told her I need facts – the written policy does not say that, nor imply it.

    The bottom line is: The reason they want the vet visits and, essentially, wellness checks, when the pet gets older is because many people take their pets to the vet every few years (I hadn’t even thought of that!), and this requirement means the senior pet will be examined with appropriate labs done every year (personally, I’ve found that 3x/year is best for seniors) in order to catch things early. This makes humane sense, and it makes good business sense…because they’re serious about “insured for life”, then it costs them less in the long run if conditions are caught and treated early.

    I told her I think that’s a great idea! But how about requiring an itemized statement from your vet rather than the lab results? She understood why I had reservations about this, and she agreed the lab results are not necessary, just proof that the exam & labs were done.

    As for the convoluted cancellation wording, here is what the policy says:

    ‘We may cancel the policy (or any renewal of this policy) due to the following: a loss of or substantial decrease in reinsurance; …a substantial change in the condition, factor or loss experience material to insurability…’

    Huh???

    She explained that once contracts go to lawyers wording can get added that confuses the intent and she explained what the intent of this is. I now can’t remember what she said regarding the ‘reinsurance’ part, & I didn’t write it down so it must have satisfied me (sorry!). She explained that the ‘substantial change…’ portion refers to things like pet/companion dogs becoming working dogs, which they can’t insure. She said none of the cancellability clauses refer to the state of health of a pet.

    I believed her explanations because of her tone, the timing of reactions and responses, etc.

    In regard to my concern about them increasing premiums due to labwork results, she said they do not do that, and in fact they don’t increase premiums for individuals, they’re increased across the plan (for instance, when vet costs increase).

    She told me they’ll be refiling their Terms & Conditions in the next 6 months and they’ll be clarifying the cancellation policy wording. I think she’ll give some thought to changing the requirement from submission of lab results to submission of proof of exam and labs, though she didn’t specifically commit to it. She was aware the cancellation wording was confusing, but no one had ever brought up the distastefullness of the labwork requirements, so we’ll see what happens. She gave me her personal contact info to use if I had further questions.

    My cat is only 3 yrs old so it’s not a huge personal issue for me right now, but they wanted to know why I wanted to cancel and she was very open to my input, so I provided it.

    I decided to keep this policy on my 3-year-old, at least until the new T&C are published…I’ll review again at that time. I was very taken aback with the personal interest I was given, as well as with the genuine belief the people with this company have in the product they’re providing, and the understanding of and appreciation for good health care for companions.

    Deb, this is the company I posted about elsewhere where I said they almost seemed too good to be true. I appreciated their website and the comprehensiveness of their online application (as well as their straightforwardness about exclusions, etc., during the application process). The application process is considerably more in-depth than some others I’ve experimented with, and I appreciated that…it gave me the impression that they take this whole business seriously.

    Once Embrace is available in my state I plan on insuring my new little one with them.

    Hope this helps!

  21. Deb June 29, 2007 at 2:36 pm

    Awesome, Mo! Thanks so much for sharing your experience. It definitely helps!

  22. Mo June 29, 2007 at 10:39 pm

    No problem, and I’m really glad it’s helpful. To tell you the truth it’s been really helpful to me in that it’s forced me to think of the pluses & minuses in more linear terms (my brain makes everything like a rubik’s cube inside and things can get overly complicated!).

    I’ve just learned that Embrace is now available in my state so I’m submitting an application for my new little one, and I’ll post whatever noteworthy experiences I have. I already have a lot of info on Embrace, including their Terms & Conditions (essentially “the policy”), and so far it’s all been positive. Will flesh out the experience once the application is done and I receive my policy et al in the mail.

  23. Laura Bennett June 30, 2007 at 7:46 am

    Mo, thanks for being the first Oregonian :) Sorry to disappoint you but you won’t get anything in the mail. We do everything via email. We have found that occasionally our email gets put in the spam box (how deflating!) but we’re working on some technology to minimize that.

    We’ve also just added Utah as a state so the only state we don’t sell in is Washington. That’s taking longer than we’d expected as it involves persuading one of our business partners to take an exam – poor baby!

    Laura

  24. Mo July 2, 2007 at 4:47 pm

    Yes, I figured that out (about not having to wait for snail mail) once I completed the application process. :-)

    I will post about the experience soon…have gotten really busy the past few days being entertained by my new little one. :-)

  25. Mo July 11, 2007 at 12:16 pm

    This post is to give you my experience with Embrace thusfar. I wanted to wait a little while before posting because as indicated in my and Laura’s posts we have been in touch via email, and I felt I needed to allow some time to pass so I could give an objective review.

    As you know from my previous posts I’ve been waiting for my new kitty (10 months…is she a cat or a kitten? technically a cat, I suppose), and also waiting for Embrace to be available in my state so I could give it a try for her. Embrace became available in my state 2 days after I adopted my new cat so I jumped at the chance to immediately submit an application.

    Their website provides pretty much all the information you need to know (as opposed to some who omit quite a bit of the details), but you do need to know to seek it out. Information is not ‘hidden’ like it is on some of the other companies’ sites, rather it is in whatever section it belongs. Meaning, if you want to know about the Continuing Care benefit, you need to look on the Continuing Care page – not necessarily on a page having to do with benefits in general.

    I really appreciated that their Terms & Conditions (“the policy”) is available online to view before even submitting an application, as are claim forms & pre-certification forms (more on that in a moment); and information on exclusions, options, and explanations of benefits is easily found and explained in plain English. You’re able to do a thorough review and go into purchasing a policy with a good sense of what you’re getting yourself into. This may seem like an obvious thing – trust me, it is not. Not only in terms of pet insurance, but other types of insurance also leave you guessing until you receive your policy in the mail, which most of us don’t bother to read because they’re too long and too full of gobbledegook.

    Embrace highly recommends that you submit a pre-certification form prior to having certain procedures done (or procedures expected to cost over $1,000). It’s not required, but they recommend it so they are prepared and can process your claim more quickly, and so you know up-front how much benefit you’ll receive. I have mixed feelings about this…it’s like human health insurance so I’m not unfamiliar with it, and I can see the practical uses and benefits. However, in my experiences with my cats I’m so mentally focused on getting my cat the help he or she needs and the consequences of whatever treatment is going to be done, follow-up care, what the diagnosis & resultant treatments are going to be, researching and understanding whatever disease process might be going on, etc., that the thought of having to pre-certify leaves me feeling frustrated & bogged down. I don’t want to be worried about money problems or potentially arguing when my cat’s welfare is my concern and my focus (there are so many medical and nursing issues to be concerned with when a cat is sick enough to need the kinds of procedures at the level the pre-certification is recommended). Plus, typically when a cat needs this level of care they are quite sick and need the diagnostics/treatment immediately…the pre-cert process can take a few days, and I wouldn’t wait. I probably wouldn’t do it and would just live with whatever the outcome was after I submitted my claim.

    (A caveat here is that I don’t have help with my cats or running the rest of my life when my cats are sick, so I don’t feel I can afford to shift my focus…most people will have another person to assist them, so my situation won’t apply to everyone.)

    I repeat, make sure you read everything – pretty much everything is there in plain English, but it’s easy to skim over things and miss them. I just noticed today that for Continuing Coverage, only 25% of your yearly maximum will be paid toward the chronic condition that requires treatment year after year (glad I got the $10,000 yearly max). I’m not sure if that means beyond the first year, or also applies to the first year the condition develops.

    (Sorry Deb if you already went through all of this in your blog, but here are how things went for me):

    I moved on the Application process – it was a cinch, and not like any other policy I’ve applied for or checked out. I’ve tried at least half a dozen others and have found Embrace’s to be the ‘best’. Having information available on the website helps a ton before you even start the application process, and then it gets even easier. You have choices for how much copay you want, how much annual deductible (paid once per year, not per diagnosis/condition), and how much yearly maximum benefit you want. You can also choose prescription & dental coverage, and continuing care for chronic conditions requiring treatment over a period of years. There are little explanations for each item so you don’t have to go back and search throughout the site if you’ve forgotten what something means – they’re little mouseovers rather than new windows so things are kept clean and simple. Little things like that mean a lot when you’re going through a complicated insurance customization process.

    Each time you change a selection you not only see the adjusted total amount in the main section of the page, but on the right hand side there is a running tally which includes the premium, state taxes or fees, discounts, and the total amount, and you can fool around with monthly and yearly payments to see what suits you the best.

    All in all, the experience was painless and frustration-free. I knew what I was buying and it was very, very easy to customize and understand each item and just how much each item was going to cost or save me. The “understanding each item” part is really important here – a few dollars a month to cover…what was that again? Pull up those neat little mouseover explanation things and you can make your decision easily.

    I felt I was able to purchase a policy that met my needs (relatively speaking), and I was comfortable I was making an informed decision. I can’t say that about any of the other companies I’ve dealt with in the past – about a half-dozen other companies. I also had an overall sense that Embrace ‘cared’ because of the plain-English they provide AND the policy options they provide. (They provide information so freely, as well as welcome feedback…it gives the impression of honesty & integrity).

    Of note is that my Embrace policy cost is higher than others I’ve had, but there is a wide range of premium cost available depending on what you choose. I’m paying about twice as much as I have with some of the other companies, but I bought the 2nd highest available level of coverage (it’s a higher coverage than most of the other companies offer so it’s not a one-to-one comparison). I felt it was worth taking the chance that in this case I might actually “get what I pay for”.

    Immediately after submitting my application and paying for my policy, I got a confirmation page showing my policy number and a summary, including effective dates, waiting periods, and contact info and hours of operation. Included were pdf’s for the Terms & Conditions (“the policy”) and a claim form with my info pre-filled in. I also received an email with this information and the pdf’s as attachments. These things may seem minor, but they must not be because none of the other companies provided me with this stuff – it’s a courtesy which saves you time and answers questions right away – I really appreciate that kind of thing. One company (ASPCA) never sent me anything beyond the initial payment receipt email telling me I had to wait for underwriting approval – after about 3 weeks of Nothing I canceled, which didn’t seem to concern them at all.

    Hopefully my cat will be healthy and safe for many years and I won’t need to submit any claims, but if I do submit claims I’ll let you know how that process goes.

    I want to add that the experiences I’ve had with Laura, one of the co-founders, have all been positive, which is important to add but I wanted to be sure I didn’t report everything about Embrace in a rosy glow simply because of my communication with her. She is not only very helpful and up-front with information about pet insurance in general (not just Embrace), but I’m impressed with her integrity and professionalism in that she does not attack or judge other programs or companies out there. This quality trickles down to a perception of the company in general, which is a big plus. I had asked her a question about some cancellation policy terminology, for another company actually, and later she posted clarification of Embrace’s cancellation policy on her blog just to be sure it was well understood. Open communication is a big plus in my book. Embrace’s other co-founder, Alex, is also to be found on other blogs online, providing information and assistance on Embrace and pet insurance in general.

    I hope this is helpful.

  26. Deb July 11, 2007 at 9:25 pm

    Thank you so much, Mo!

    It is very helpful to hear your thoughts on the entire experience, from the research to the application and claims and reimbursements, all of it. Research can only tell me so much – I’ve not only never had insurance on my companions in the past, I’ve been dragging my feet on getting some now, despite all my research! Actually, my excuse is that I need to finish researching some of the issues, do a couple more posts, to prove to myself that I’m not just being lazy about it.

    Though, I also have to say that you have pretty much eliminated the need for some of the posts I thought I’d do! ;)

    Maybe I’ll have a post where I just quote you! :D

    Thanks again, Mo!

  27. Mo July 12, 2007 at 1:30 pm

    I’m glad to hear it’s helpful! I can understand your taking your time on choosing a policy…perhaps all the research you’ve done could actually be getting in your way because everything tends to melt together after a while. :-) I’ve thought of making a spreadsheet with info on all the companies (including those I was not interested in, for comparison sake), but at some point I got myself overwhelmed with all the details I just gave up on the idea.

    Feel free to quote away. Thanks to you too, Deb – you and your blogs have been a huge help! :-)

  28. Mary December 19, 2007 at 4:30 pm

    I think I may be one of the few who have some pets under Pets Health Plan, and so, I will leave some comments here based upon
    my experience thus far with them. Currently, I have 1 dog, a 13-14 year-old Lhasa Apso mix that is insured with Pets Health Plan — specifically their Value Plan. My dog didn’t qualify for the
    Best Plan because she had a pre-existing condition of
    hypothyroidism. However, I must say that Pets Health Plan
    is the ONLY company that I know of that will insure a dog as
    old as 13 years old. The cutoff for the other companies
    seem to be between 8 and 10 years old. So, if you have a senior
    pet, Pets Health Plan may be the only viable option. I’m
    currently in the process of signing my 13 year-old cat up
    under the Best Plan, since he hasn’t been sick a day in his life
    and would thus qualify.

    So far, I’ve had to file 3 claims with them. The first one
    went well — it was for gastroenteritis, and they promptly
    applied $91 towards my $100 deductible. The 2nd claim was
    for allergic bronchitis, and I had to fight with them about this
    one. They initially claimed that the allergic bronchitis could
    result from the hypothyroidism, and so, was a pre-existing
    condition. Well, I did my own research and found out that
    SKIN allergies can be linked to hypothyroidism NOT inhalant
    allergies. They finally approved that claim, and I got a
    check for $218. Now, for the 3rd claim. My dog fell off my
    bed, and slipped a disc in her back. She had a myelogram
    and back surgery done, and the specialist ultimately diagnosed
    her as having IVDD(Invertebral Disc Disease). Well, Pets
    Health Plan does NOT cover hereditary conditions, and Lhasa
    Apsos are on the list of breeds that are pre-disposed to IVDD.
    The problem is that my dog was a stray. I found her in 1996,
    she has no papers, and thus, you really can’t prove what breed
    she is. I wrote a letter to Pets Health Plan explaining this
    to them along with my claim, and even provided the name,
    address, and phone number of my veterinarian from back in 1996,
    so that he can verify that my dog was a stray. We will see what
    happens. Question: Can an insurance company actually deny
    a claim if they can not prove your dog/cat is of a specific
    breed? Isn’t the burden of proof on THEM? If your dog/cat isn’t
    registered, how can they prove that?

    One last thing — be VERY leery of the ‘180 days since last
    treatment clause’. This does NOT mean that if 180 days has
    passed since your pet was last treated for an illness/injury,
    then the treatment will be covered. The illness/injury must
    be a CURABLE illness/injury, and it must have been CURED 180
    days or prior. So, what does this mean? This means that if
    your pet gets gastroenteritis and then, gets it again after
    180 days, it will be covered because gastroenteritis is considered
    to be a curable disease. Several examples that are not ‘curable’
    diseases are cancer, IVDD, and even diabetes (which someone else
    mentioned earlier). This means that if your pet is diagnosed
    with diabetes, Pets Health Plan will cover the treatments up
    until the date on which your plan renews. Once your renewal date
    is past, diabetes will be considered a pre-existing condition,
    coverage will STOP. And, since diabetes is not curable, no
    further treatments will EVER be covered — even after 180 days.
    The only exception may be the Best Plan because it says it
    covers ‘some’ chronic and recurring illnesses, but they don’t
    publish a list of what chronic illnesses are covered.

    I know all of this because I have read the policies, word for
    word, and have spent a great deal of time asking pointed
    questions to the Customer Care Specialists at Pets Health Plan.
    They don’t like questions like this, but I must say they are
    honest.

    Mary

  29. Deb December 26, 2007 at 4:32 pm

    Mary, thanks so much for the detailed review. It is great information, and my apologies for taking so long to go through my spam folder and releasing this comment! I’m so glad you clarified the 180 days thing, and I’m also glad to hear that they will answer the questions honestly. From what I’ve heard, having to be assertive but having it pay off in the end is a fairly common experience. If I’ve learned nothing else (from others’ experience, since I’ve yet to need to make a claim), I’ve learned that persistence is or can be extremely important.

    That is a really good question about genetic diseases and breeds. Please let us know what you find out, when you hear back from Pet’s Health. I have a feeling it could depend on the insurance company themselves, how they determine these things. I know that some companies have small premiums for pure-breds because they are more prone to certain diseases, and thus can be expected to require more medical care. For those companies, I think it would all be based on what you claimed your dog (or cat) as when you signed up, though if they suspected fraud they could presumably ask for additional information.

    I’m going to shoot an email to another friend who has had extensive experience with pet insurances to see if she knows. She’s like you, and reads every word and asks many questions! Laura of Embrace often stops by when she sees I’ve gotten new comments to add what she knows. And she knows a lot about insurance, as you could guess!

    Thanks again for your review!

  30. Deb December 27, 2007 at 5:30 pm

    Mary,
    I heard back from my friend. She’s never had specific experience regarding breeds, but based on her otherwise extensive pet insurance experience, she thought that it would be our burden, as customers, to prove that a cat or dog is not a purebred, and that being a “mix” of a specific breed might be enough for them to consider your dog to fall under the breed limitations for that particular breed. In this case either the vet papers have her listed as a “lhasa mix” or you listed that yourself when you signed up. So they’re basing it on that, and I’m guessing that “anything mix” is the same in their minds as “specific breed.” It would be helpful if they were clear about this in their policy, of course.

    She also recommends always framing these questions to the insurance companies as “appeals” because they apparently take you more seriously in that case!

    We’d love to hear how it turns out! Best of luck!

  31. Laura Bennett December 27, 2007 at 11:39 pm

    Mary, it’s great to see pet parents taking the time to not only learn about their pet insurance policies but also share it with others.

    I can’t answer your breed question specific to Pet Health Plan but I’ll comment in general on hereditary conditions.

    ALL dogs and cats can get hereditary conditions, not just purebred ones. For example, hip dysplasia is always a hereditary condition (as is luxating patella, PRA, and numerous other conditions) and mixed breed dogs do get it (just think of Golden Retriever mixes). It’s just that certain purebred dogs are MORE prone than mixed breed dogs in general.

    So, it’s a bit confusing if a pet insurer lists out the conditions that are excluded by breed if they don’t also include a list for mixed breed dogs and cats. That would be a more consistent thing to do (IMHO) if you are going to exclude hereditary conditions.

    When we (Embrace Pet Insurance) were deciding on what to cover, one thing we said for sure we’d include was hereditary conditions. Apart from the fact that arguing over painful issues around what is and isn’t a hereditary condition is no fun for anyone involved, pet parents expect all health conditions their to to be covered. Often, it can be quite shocking to find out how extensive hereditary conditions are after the fact.

    Anyway, I sort of got on a rant there but it annoys me when people don’t understand what their policy covers because its impossible to know from the policy documents and the accompanying website.

    Pet insurers need to do a whole lot better in this respect (amongst others!).

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