Should I Change Insurance Companies?

[krissy]

Many of you are aware that I am a HUGE fan of pet insurance and that I have it for Kili... and that we used it a fair bit in her first 6 months with us. It still stands that I believe everyone should choose an insurance plan that is right for them to help cover unexpected medical costs, but that said, I'm a little unimpressed with my current insurance company and am thinking about switching. Reason I am unimpressed? I just got a letter in the mail telling me that effective January 1 they will be decreasing my co-pay from the standard 80% to 50% because Kili had so many (or so much money... I only put in about 3-4 claims, some of which included her puppy vaccines, heartworm medication, tick medication, and annual bloodwork). Now, when I signed up the rep for our clinic told me that it was possible that if a pet had A LOT of claims that the co-pay could be dropped... but that it really almost never happened unless the pet was really running up huge bills consistently. Yes, the company did pay out over $5000 last year on Kili over about a 4-6 month window, but we have had no real claims in the past 6 months (I have some stuff sitting here waiting to be sent in, just chiro adjustments and my Healthy Mouth, and some eye ointment for an infection she had). So honestly... I'm a little unimpressed with the drop in the co-pay. We're talking one issue and although it did run up a sizeable bill... $7000 is really nothing in terms of medical bills. This was a non-lifethreatening condition that was totally corrected by the surgery. Maybe I'm over-reacting. Would you think "yeah, ok" or would you be a little put off like me?

 

Anyway, looking at possibly switching. There are some pros and cons though.

 

Pros to switching (to Trupanion)

- lower premiums (partly because they don't cover routine care like vaccines... but that's not a problem)

- premiums don't increase with age of the dog

- co-pay is 90% and never drops

- can set your deductible to be anywhere from $0-1000 (and premiums go accordingly)

 

Cons of switching

- Deductible is per condition (my current plan is per year) --- not sure this is really a con as the "per condition" is for the life of the pet. So you could have multiple deductibles in one year or none at all if conditions recur. Just different, maybe not bad.

- Kili's pre-existing UTIs will not be covered until she has been symptom free for 18 months -- again, not sure this is really a con since she has been doing well since her surgery in March and I don't anticipate any further problems.

- Kili has a heart murmur -- this is the only major problem since this will always be a pre-existing condition. That said though, again, this may not be an issue. The murmur has been checked and the cardiologist was not concerned. She was cleared for surgery and for agility. It has the potential to become a problem later on in life... or she may have no problem from it ever. We know lots of greyhounds have a mild murmur.

-Trupanion doesn't cover exam costs. Only exam costs I will be incurring will be for specialists or possibly emergency clinics (which sure, can be a couple hundred dollars) or I suppose if we are traveling. But really... the majority of my "exams" are done by me and I don't charge myself exam fees.

- Not a con, but my current company re-evaluates every 6 months so my co-pay could very likely go back to 80% in 6 months or a year. But who knows really. But if it does then I don't have to worry about the pre-existing stuff.

 

The company I'm currently with tried to tell me that Trupanion wouldn't cover Kili if she was hit by a car or attacked by another dog because she was not spayed before 12 months, however I spoke to Trupanion and was told that if there was a medical reason (which there is) that they took that policy on an individual basis. I clarified with them that since she is a large breed dog and is not being spayed until 18 months because of concerns about growth and bone development that they would still cover medical bills if she is hit by a car or attacked at the dog park. They said yes. Anyone have any experience with that?

 

Anyway, I am very seriously thinking about switching but I'm just THINKING right now and trying to figure out what is in my (and Kili's) best interest. Either way I am definitely getting Summit covered by Trupanion because he currently doesn't have insurance (I wasn't too excited about the premiums and deductibles for an older dog with my current company so didn't get him covered since he's quite healthy) and he's getting older. What would you be thinking?

[kudzu]

Do not feel knowledgeable enough to offer advice. But my curiosity forces me to ask, what does not being spayed have to do with being hit by a car?

[krissy]

I would imagine it is because unaltered dogs have a greater propensity to roam in search of a mate... and they are also probably also extending out the assumption that people with unaltered dogs allow them to roam (which is probably mostly true but think about breeders etc. who have intact animals but monitor them very closely).

[gracegirl]

Who is your current company? Have you called them to ask about the "what ifs" you mentioned here? (What if there are no claims in 6 months, will the co pay go back to 20%?)

 

Fenway just turned 7. I just signed him up for Healthy Paws. I elected the $250 deductible per year (not per condition) with 90% coverage. No wellness is included, but I'm not worried about wellness. I'm concerned about a $7,000 surgery being the reason I swing one way vs another. He has kidney damage so I already know there is potential for claims to go unpaid because of this preexisting condition.

 

I chose Healthy Paws because of the deductible being per year rather than per condition.

[krissy]

Well, I wasn't going to mention the name of the company since I was very happy with them up until this point. I just feel like $5000 isn't a lot of money to be dropping the co-pay already. I have been happy with their service and they have covered everything with no hassle. They would not give me a guarantee about when the co-pay would go back up to 80%, they just said it could. However, I called my clinic's rep with this company and am waiting for her to call me back. I will see what she has to say about the matter, but honestly if they can't tell me when the co-pay will return to 80% if I have no claims then I am seriously thinking about changing. And also, what is considered "no claims". My plan covers routine care and Kili will be due for her annual vaccines in a week or two. Is that considered a claim? I also have some stuff as I mentioned that still needs to be claimed. It is minor stuff and mostly "alternative" and "dental" stuff that is all preventative (joint supplements and Healthy Mouth and chiro treatments) but is that going to be considered a claim. So if I keep doing little stuff like that my co-pay will never go back to 80%? (I intend to ask my rep about this too when she calls me back).

 

I guess I'm mostly wondering what the majority of folks here would do if this was them. Would your first inclination be to change companies or would you just shrug it off as normal/acceptable?

[kudzu]

If this change were only for six months, assuming Kili didn't have large claims in that time, & you do not currently foresee pricey procedures in the near future then I might be inclined to give them 6 months. If Kili is basically fine & your copay goes back to normal then I'd be inclined to hang with them. However, without any guidelines outlined by the company on their policy for this situation I'd be less inclined to keep them.

 

Like gracegirl, I was just looking for a safety net for unexpected illness or injury. The wellness items I can budget for but a $3500 e-vet bill plus specialty follow up isn't as easy to squeeze into my budget. I also didn't want a per condition deductible.Trupanion wasn't my personal choice. Healthy Paws fit me better. However, my desires in insurance are not the same as yours. You are looking for something more like our human health insurance. There's nothing wrong with that. It works for you & that's fine. This really is a tough call. I think it's sucky of companies to adjust a policy so much just because they lost the bet. Unfortunately, the same thing happens with human individual insurance policies. Doubt this will change anytime soon & I could find out down the road that Healthy Paws does the same. It's all a gamble. Are you more comfortable accepting the risks of having high claims that would be rejected for the pre-existing conditions? If so, then switching may be your better decision. It's all a gamble.

[philospher77]

I'd be doing like you, and trying to find out if that co-pay would go back up and when. Is whatever caused the large payments fixed, or is it likely to recur? I'd be a bit concerned about switching companies if it is likely to happen again. The heart murmur is going to be an issue with whatever company you go with, so that wouldn't be my deciding factor. If you knew going into the insurance that there was a chance that they could drop the co-pay, and what the rules are for it coming back up, then I might stay with them and just ride it out. If they sprang this on you out of the blue, I'd be looking to get different insurance.

 

Once you know the time frame for the co-pay readjusting, something else to think about is whether it's likely that you will have major expenses in that time. I know Kili does agility…. if it's going to be a year for the policy to reset, is it possible that she could get injured in that time? And, look down the road a bit. This may be a minor annoyance now, but as she gets older, what happens if (God forbid) something major happens to her, and they drop the copay again, and then you get a lot of normal "old dog" issues? Will you be stuck with the lower copay at that time? That's what would concern me more, honestly, than the drop now. Taking the really awful view, lets say Kili has a bad accident at a meet, so there's expensive surgery, they drop the copay, and THEN she's diagnosed with osteo. What happens then?

 

Just things to think about.

[Remolacha]

I don't currently have pet insurance, so I can't really speak to specific companies, but I do like the one that doesn't increase with age. I generally seem to have senior pets, and was very annoyed with VPI for increasing my premiums based on my pet's age, regardless of the fact that I had never submitted a claim After Molly's recent $$$ (and ongoing) I am reconsidering, but premiums not automatically increasing with age would be a deal breaker for me. I have heard good things about Healthy Paws, but no experience.

[krissy]

Yup, you guys have basically hit it on the head.

 

The only way the murmur isn't an issue is if I stay with the current company. It will be an exclusion with any company I change to. It has the potential to be a problem, but I'm not overly concerned about it. It would obviously be best if it was covered. But chances are it will never be a problem, whereas there might be lots of other problems that pop up that are now going to be covered at a lower co-pay.

 

The problem that caused the big medical bills is resolved. She had surgery in March to correct a congenital malformation. I do not expect further problems from it. She has had no problems in over 6 months now.

 

I know insurance is what it is. It's a business. I get that. But I expect over the life of my pets to be paying more in premiums than they will pay me. That's how it usually goes. That's how they make money. And I'm okay with that because I buy insurance for the peace of mind that when I need it... it's there. I'm not going to call them up in 2 years if I have no claims and tell them "well, I have paid you way more in premiums than you have paid me in medical bills so I'm only going to pay 50% of my premiums from now on". That would be ridiculous. So why is it not ridiculous for them to do the same? That sort of my view on it. Especially since I don't think $5000 is really all that much. I did know that the co-pay could be dropped, but as assured that that almost never happens and only if there are huge continuing bills. 6 months and $5000 followed by 6 months and basically no claims....

 

So I guess I'll see what the rep has to say about it.

[GeorgeofNE]

I'd be surprised if another company would even insure a dog with a known heart issue. I know a murmer isn't a really big deal, but I couldn't even get coverage from one company because George has a high creatinine value (normal for Greyhound but they just wouldn't take him).

[krissy]

Wow, that's a little extreme if it is documented as being normal by the vet in the records.

 

I already spoke to the new insurance company and they didn't seem concerned, just said it would be an exclusion as I had expected. Especially since the murmur is documented with an echo as being relatively unremarkable and the cardiologist has no real concerns. I imagine if they turned down all dogs with any sort of murmur we'd have a hard time ensuring our greyhounds since so many of them do have murmurs.

 

But it's definitely something to keep in mind when switching companies or looking for insurance.

Edited November 27, 2013 by krissy

[macoduck]

Healthy Paws doesn't cover routine exams, vaccinations, dentals (unless there's an extraction). We've only had it for a month with no claims yet.

[NeylasMom]

I would really like to know who you're currently with and I think it would be helpful for others to know as well so they can factor it in when making their own choices. I don't see why you would feel uncomfortable sharing if you're just giving us factual information.

 

As for whether to switch, I honestly don't know what to tell you.

[krissy]

Well, I don't think this company is even in the States. It's called PetSecure.

[Rickiesmom]

You can ask Trupanion to provide you with a list of exclusions based on Kili's medical records. They will almost certainly cover Kili in spite of the heart murmur but may place some conditions / exclusions on coverage related to heart issues. (I say this because Jaynie has a murmur and was seen by a cardiologist who did an echocardiogram, said she saw no reason for action at that time but recommended a recheck in a couple of years or if anything changed. Trupanion has flagged heart issues for her.)

[RedHead]

I guess it depends on what you really need the insurance for. I don't mind paying for regular check-ups, vaccinations, etc. but my concern is more for bigger things like accidents, surgeries, illnesses, etc. I did a lot of research and went with Trupanion. I haven't had to use them yet, but from what I researched, they covered the most for the least price (and seemed to have a fairly good reputation from what I had read on here).

 

My only concern would be if they would exclude some of the pre-existing things. If they told you those things would be covered, I would want it documented, so they couldn't come back and tell you something different in the future.

 

I didn't even try to insure Karma who is over 10 because it would have been too complicated and expensive. I can't remember their senior age but I think it was somewhere around 8 or 9. They charge more for that so something to look into for Summit.

Edited November 27, 2013 by RedHead

[Walliered]

I have Trupanion. In the three years I have had them (for all 3 dogs, but one died of bone cancer) they have paid for 3 back surgeries. These surgeries included MRIs, CT scans, blood work, pain meds and a host of other things. They covered the bone cancer and that dog had IBD which they covered too. I can only speak highly of them.

[krissy]

Alright, here's the update after speaking to my clinic's rep.

 

The co-pay is dropped to 50% basically as soon as they pay out more than you pay them. So if you've had your dog insured for many years without claims and then have a bigger claim for a surgery you might not get flagged. But if, like me, you have a young dog or a dog only insured for a short time and you have to do surgery you're bound to lose your co-pay since you haven't paid much in premiums yet.

 

The situation is reassessed every 6 months. But... the co-pay only increases in 10% increments each time. So it will take 18 months with no major claims to get back to my 80% co-pay. I think that's kind of bullpoop personally.

 

They say that preventative care claims won't affect my co-pay reassessment (vaccines, joint supplements, etc.). So they say.

 

Still not sure if I should switch Kili. But I am definitely not insuring Summit with them.

[Riverhound]

I can't tell you how much I love Trupanion. They're fantastic; the checks come quickly and with no difficulty. I haven't had any trouble getting reimbursed for Brees's cat-eating, which sort of surprises me. That seems like the kind of thing an insurance company would balk at after a few times.

 

I have a zero deductible plan for each dog, which amounts to about $50 each per month. Brees's premium went down a little last year; Joe's went up. I think we ending up about $3 higher monthly.

[Hubcitypam]

Poodle has had a grade 3 murmer for about six years now.

[TINMANPDX]

I don't currently have pet insurance, so I can't really speak to specific companies, but I do like the one that doesn't increase with age. I generally seem to have senior pets, and was very annoyed with VPI for increasing my premiums based on my pet's age, regardless of the fact that I had never submitted a claim After Molly's recent $$$ (and ongoing) I am reconsidering, but premiums not automatically increasing with age would be a deal breaker for me. I have heard good things about Healthy Paws, but no experience.

I have had Healthy Paws coverage at 90% on my two and have never made a claim because we've never had anything exceed the 250.00 per dog annual deductible. The monthly premium has gone up every year due to their age, which is a little disappointing, since we've never made a claim, but they do disclose that the premium will increase annually.

[krissy]

Is the premium increasing every year because your dog is getting older or just because the premiums increase every year due to inflation? I expect about a $5 increase per year just for inflation. Even if we switch to Trupanion the premiums will generally be increasing (though as Riverhound noted, they CAN actually decrease some years) but it's not because the pet is getting older, it's just because things tend to get more expensive every year.

 

Riverhound - With Trupanion... what they have basically told me is that nothing changes with your policy except that premiums fluctuate a little every year due to changes in the economy and industry (capped at a 20% increase, can decrease, generally $3-5 a year increase). So if you make claims... your co-pay doesn't drop, your premiums don't increase, they don't force you to have a higher deductible. Is this true in your experience? NOTHING changes your policy (except as noted the fluctuations due to outside influences). It's just hard to believe, but I can't find a question to find a loophole in what they're saying.

[TINMANPDX]

Is the premium increasing every year because your dog is getting older or just because the premiums increase every year due to inflation? I expect about a $5 increase per year just for inflation. Even if we switch to Trupanion the premiums will generally be increasing (though as Riverhound noted, they CAN actually decrease some years) but it's not because the pet is getting older, it's just because things tend to get more expensive

 

In all fairness, it our Healthy Paws premiums have only gone up around 5 or 6 bucks a year .... I just assumed for age, but inflation may be the reason

[krissy]

In all fairness, it our Healthy Paws premiums have only gone up around 5 or 6 bucks a year .... I just assumed for age, but inflation may be the reason

 

If it's only a couple of dollars that's due to inflation and changes in the veterinary industry. Generally speaking they don't change your policy annually for age. There are generally age brackets and when your pet reaches the next bracket there will be changes. For example, the company I am currently with has the brackets as 0-3 years, 3-7 years, and 7+. The only change is that they force you to increase your deductible as the pet gets older. Other companies increase your premiums. But almost all insurance premiums will change on an annual basis, generally up (though with some companies they can even go down a few dollars).

[NeylasMom]

Is the premium increasing every year because your dog is getting older or just because the premiums increase every year due to inflation? I expect about a $5 increase per year just for inflation. Even if we switch to Trupanion the premiums will generally be increasing (though as Riverhound noted, they CAN actually decrease some years) but it's not because the pet is getting older, it's just because things tend to get more expensive

 

In all fairness, it our Healthy Paws premiums have only gone up around 5 or 6 bucks a year .... I just assumed for age, but inflation may be the reason

It depends on the company. Healthy Paws attributes it to rising costs, basically inflation like you said. VPI increases the premiums annually because of age. It doesn't really matter what the reason imo as long as you can expect that the increases are reasonable. That's the reason for looking into it a bit further imo.