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philospher77

Pet Insurance Discussion: Cost/benefit Analysis

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Hello!

 

I was trying to convince a friend of mine about the advantages of pet insurance, so I sat down to do some analysis of how it has worked for me. What I found was interesting, so I thought I would put it here in case other people are wondering about the pros and cons.

 

First, the background. I've had insurance for the last 4 years (Healthy Paws, 250 deductible, 90%). I have two dogs. Pixie is an approximately 7-year-old miniature rat terrier, Katie is an 8.5-year-old greyhound. Getting Pixie was my impetus for getting pet insurance, since two dogs were going to stretch the budget in an emergency.

 

Here’s some really rough numbers. And these are only for the kinds of events that I make claims for, not the routine care. (Basically, I looked at EOBs associated with claims.) Except that I have made a few claims for what was routine and not covered, for some reason I don’t remember, and I didn’t exclude those. So this is very slightly skewed to show that less is covered than actually is.

 

Pixie has had 33 claims, Katie 17 (really 16, because one of those was a denial based on them thinking one claim was all dental when it wasn’t). Pixie’s claims hit hard early, and have been fairly routine since. Katie’s claims are hitting late, most of them this year and last year.

 

Pixie’s amount of bills for procedures outside routine care: $11824

The amount reimbursed: $8724.51. That is after excluding the office fee, deductible, and co-pays.

Percent of total bill covered: 74%

 

Highest bills: $3343.11 and $3232.88, for the knee surgeries

 

Katie’s amount of bills for procedures outside routine care: $7814.84

The amount reimbursed: $5330.70. That is after excluding the office fee, deductible, and co-pays.

Percent of total bill covered: 68%

 

Highest bills: $1459.12 for the spleen issue, and then in the $1200 range, multiple times, for rehab.

 

Totals between the two dogs:

Expenses: $19638.84

Reimbursed: $14055.21

Percent covered: 72%

 

Pixie's amount covered is higher than Katie's, percentage-wise, because she's had a few really big issues (with one vet fee per each) and then a lot of prescription refills (no vet visit fee). Katie has more even payments with associated vet visit fees.

 

Which isn't bad. But insurance isn't free. So:

 

The amount of premiums I have paid (for both): $4385.36

Amount not covered by the insurance: $5583.63

Total costs for care to me: $9968.99

Percent covered by insurance when you consider the premium costs: 51%

Avg amount premiums have increased per year: app 8% (there’s one year where it was 5%)

 

Do I still think the insurance is worth it? Yes. But what is being driven home to me, in this analysis, is the cost of vet care. There’s a lot you can do to keep your dog healthy, but there is a price that goes with the advances in medicine. If the vets are right and Katie needs knee surgery in the future (she currently has a partial ACL tear), that’s going to be another 3-4K (given that she is bigger than Pixie, the costs go up for things like anesthesia, antibiotics, etc.). And if Katie does get osteosarcoma, then that’s going to add on probably another 7K-10K for treatment, and then several thousand for rehab afterwards to adjust to being a tripod.

 

The other thing that is becoming clear to me is that it’s really easy to lose track of how much this all costs. Paying 3K for knee surgery hurts. But when you are paying 60 here, 100 there, those bits add up over time, but it’s much harder to realize. Pixie has 4K in bill that are under 350 each. If you had asked me, prior to me sitting down and doing the math, how much I pay on vet care for my dogs per year, I would have told you maybe 1K. But it's actually close to 5K (probably over, when you add in the routine care of dentals, etc.). And now I find myself wondering about whether I would have done some of the things I did without having insurance. I probably would not have done rehab if I had to come out of pocket on that, because it's one of those things that is hard to quantify on whether it helps or not.

 

So… things to consider.


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My blog about helping Katie learn to be a more normal dog: http://katies-journey-philospher77.blogspot.com/

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Also, to consider, is that insurance companies aren't in business to lose money. Which means, most of the time, people don't use enough of their insurance benefits to exceed the amount that you pay to them for your premiums.

 

Unless you are dealing with something catastrophic, you are better off to put away money, monthly, to use for your veterinary bills. Again, it is really up to the person, how many dogs, how many times do you actually go to the vet annually, etc.


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Thank you for making this thread! I would probably consider insurance if I got a larger dog than my current 21 pound girl. Otherwise I try to put money aside for emergencies. Again - so much to think about :)


Beware of dog? Forget the dog - BEWARE OF CAT! No wait. The budgie is a killer, too.

 

35618219502_5f27c04249_s.jpgAaerro by Vampiric Conure, on Flickr

 

Rainbow Bridge - Aaerro march 2018

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Also, to consider, is that insurance companies aren't in business to lose money. Which means, most of the time, people don't use enough of their insurance benefits to exceed the amount that you pay to them for your premiums.

 

Unless you are dealing with something catastrophic, you are better off to put away money, monthly, to use for your veterinary bills. Again, it is really up to the person, how many dogs, how many times do you actually go to the vet annually, etc.

 

I kind of think this is a really unfair way to look at pet insurance. I don't understand why people want to get more than they pay into insurance. That is BAD! It means your pet is sick a lot! My plan is to never "get my money" out of insurance. If you look at it that way you are always going to see insurance as a waste of money. When I think about what I'm paying for with insurance, it's peace of mind. Catastrophic emergency with initial bills over $6000? Just do it all, no discussion necessary. Insurance allows me to be able to say, "yes, give them the best care possible" without needing to consider it. Would I give them that care without insurance? If I could afford it, even if I had to stretch things, then yes... but insurance means these things are pretty much always affordable. It's a lot easier to budget $100 a month for insurance than it is to budget for an unknown sum of money at an unknown time.

 

If a person can have a large enough savings account to cover large vet bills for multiple pets, then obviously that's ideal. My experience in the veterinary field is that isn't typical though.


Kristie and the Apex Agility Greyhounds: Kili (ATChC AgMCh Lakilanni Where Eagles Fly RN IP MSCDC MTRDC ExS Bronze ExJ Bronze ) and Kenna (Lakilanni Kiss The Sky RN MADC MJDC AGDC AGEx AGExJ). Waiting at the Bridge: Retired racer Summit (Bbf Dropout) May 5, 2005-Jan 30, 2019

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Also, to consider, is that insurance companies aren't in business to lose money. Which means, most of the time, people don't use enough of their insurance benefits to exceed the amount that you pay to them for your premiums.

 

Unless you are dealing with something catastrophic, you are better off to put away money, monthly, to use for your veterinary bills. Again, it is really up to the person, how many dogs, how many times do you actually go to the vet annually, etc.

But who doesn't "deal with something catastrophic" anymore? It only takes one illness or major injury to make up for premiums paid. As mentioned above a single cancer diagnosis can costs thousands and thousands of dollars. Doing some quick math, I spent about $8500 on Zuri's osteo diagnosis and that's not counting any small vet visits, medications or supplements which I imagine add up to at least another thousand or two, and this was just palliative care. If we just call it $10K there's no way I've saved the amt I need putting the amt of the premiums aside each month. And we're not even counting other medical costs over his lifetime that I was reimbursed for.

 

Now he had crappy VPI so we probably didn't make out as well with his policy, but the way Healthy Paws works, you recoup a very large percentage of the costs. For me, it really is the difference between finances being a factor in care or not. I would not go without it and sometimes I even question choosing the 80% reimbursement level to get a lower premium.


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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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When I think about what I'm paying for with insurance, it's peace of mind. Catastrophic emergency with initial bills over $6000? Just do it all, no discussion necessary. Insurance allows me to be able to say, "yes, give them the best care possible" without needing to consider it. Would I give them that care without insurance? If I could afford it, even if I had to stretch things, then yes... but insurance means these things are pretty much always affordable.

I agree with this 100%. Murray's cyberknife treatments were close to $20,000. Never once did we consider cost when it came to his care and his numerous hospital stays. Trupanion paid 90% of everything. That piece of mind was absolutely worth it for the eight years of premiums I paid. For what it's worth, I got back every penny I had paid in premiums for Murray with that expensive cyberknife procedure.


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Tricia with Holly Oaks Holly and Hopper the terrier mix 
Always missing Murray MaldivesBee Wiseman, and River, our perfect hounds gone too soon
Walls turned sideways are bridges. -Angela Davis

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I can say Trupanion is very good at paying back the amount they owe me. It has been many thousands of dollars. They only thing they have not paid is DaVid's IBD and they have always maintained he has allergies. My vet has even written them a letter explaining why it is IBD, but they will not honor it. I have no choice but to stay with Trupanion with him, but choose to insure the Galgos with Healthy Paws and they have been great with the claims. I would NEVER have a Greyhound with insurance.


I would never have a Greyhound with out having insurance on them. LOL

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I have insurance for peace of mind. I have paid a lot into it already (close to $90 per month) and thankfully have never had to use it, but Teague is 9 1/2 now and you really never know at this point when something major might pop up. I was initially just going to put aside money every month, but even if I did $100 it would only be $1200 in savings per year. If Teague needed a $10,000 treatment I would have nowhere enough, even after years of saving. The insurance company will likely make money off of me in the end, but I have peace of mind knowing that I won't have to reject something due to cost.

Edited by RedHead

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I know at one time my premiums were well over $200.00 per month, but not that much since Lady died. But, I have to figure that Lady had 3 back surgeries and DaVid has had 2. Both dogs had corns that had to (and still are with DaVid) be hulled weekly. DaVid is 10 1/2 so who knows what will happen towards the end of his life. Trupanion has not made money off me, but that is the breaks for them. I will always be pissed with them over the IBD issue.

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We all have insurance on our cars and our homes and our health. Most of us would not want our claims to exceed our premiums for those things, in fact would prefer no claims at all. Pet insurance is no different, and I totally agree with Krissy.

 

I would much rather have healthy pets. If most people came out ahead, premiums would have to rise quite a bit, because the company would otherwise be losing money, which is unsustainable.

 

More than anything I value being able to make treatment decisions based solely on the best interest of my dogs and not on cost. That to me is worth the premiums.

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Out of curiosity - does pet ins work like human insurance when it comes to what the ins co will pay the provider? ie. you are billed $1000 for XYZ, but the ins co only allows $439 for XYZ. And if your portion is only 20%, then you pay $200, so vet only gets $639 instead of $1000?

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I have had Embrace for both dogs for 4 years.

Premiums run a little under $500.00 a year for each dog.

That worked out to $1.37 a day for his insurance.

 

Last year, Embrace paid out $10,000.00 (80%) for Taylor's care for Osteosarcoma.

I pay the vet. Submit the claim form with the invoice. Have a check in my hands within 10-12 days.

Dozens and dozens of claims.

Always approved.

Always paid.

 

The $400.00, 500.00, 600.00 you don't spend annually on premiums, and "set aside", will be used up in an overnight stay or two at the vet.

Chest x-rays and an exam run around $400.00.

It will take you around 4-5 years of "saving that premium money" to pay for chemo.

 

 


Out of curiosity - does pet ins work like human insurance when it comes to what the ins co will pay the provider? ie. you are billed $1000 for XYZ, but the ins co only allows $439 for XYZ. And if your portion is only 20%, then you pay $200, so vet only gets $639 instead of $1000?

Embrace pays approved claims in whatever % you agreed to in your policy; could be 70%, 80%, 90%.

Your deductible only needs to be met one time, not per claim with them.

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I pay the vet and Trupanion and Healthy Paw pay me. They have already paid 90% of whatever the bill is. There is no "allowable", just 90% of the bill. I have never reached a ceiling with Trupanion on any of the 3 dogs that I have had covered with them.

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Out of curiosity - does pet ins work like human insurance when it comes to what the ins co will pay the provider? ie. you are billed $1000 for XYZ, but the ins co only allows $439 for XYZ. And if your portion is only 20%, then you pay $200, so vet only gets $639 instead of $1000?

That's sort of how VPI used to work though only on the reimbursement side. The vet charges what they charge, you pay out of pocket, submit your receipts and then the insurance company reimburses you. With VPI they had allowable amounts bases in diagnosis that were nowhere near the actual costs of veterinary care, at least in my area. I don't know if anyone still offers policies like that. I know VPI was bought by Nationwide and they've switched over. I would never get a policy like that again.

 

Most of the new companies are more?straightforward. You pick a deductible amount, typically ranging from $0 to $500 and a reimbursement amount (usually 80% or 90%). Once you meet your deductible they simply reimburse you the 80 or 90% of your costs. There are some variations between companies - Trupanion has a per incident deductible vs Healthy Paws with an annual ded (which I much prefer) for instance. Most don't cover exam/consult fees, most don't cover dentals, some cover holistic care or have an option at extra cost while some don't and so on. But basically, once you know the fine print of your policy it's very straightforward.

 

Healthy Paws makes everything incredibly simple. They have an app. To submit claims I literally take a photo of the invoice using the app and click submit. I did that standing in my vet's office Thursday morning and a few hours later I was receiving the notifications that my claims were processed. The money is directly deposited into my checking account.

 

Easy peasy, and I think Rickiesmom summarized it nicely. Cost does not factor into my decisions. In fact, I was considering not doing Violet's rehab at our specialty clinic and having my vet just do cold laser instead because Zuri's osteo wiped me out until I remembered Violet has HP. So instead of paying $140 per session, we're paying $28 and I didn't have to do a subpar treatment option. :clap

Edited by NeylasMom

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I took Houndtime's point as being more, put money away every month to make your own insurance -- the self-insured option. So far, despite some very high expenses for a few of my dogs, I've come out ahead that way. If you're not a good saver, or if your finances are not able to adjust to one of those sudden and large events, then buying insurance may be better for you.

 

Houndtime is right that the insurance companies are in business to make money. Overall the company needs to come out ahead, just as with people insurance companies.


Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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What I will add to this discussion is - if you DON'T have insurance yet, get it BEFORE something happens. My cat Merlin had a urinary blockage - cost me about 1200 dollars. I got pet insurance AFTER he blocked, but they will NEVER cover anything to do with his urinary tract/kidneys in the future! Pre-existing condition. Next pet I get will be covered from day 1!!


PS - I also ALWAYS get trip insurance when I go on an organized trip. Had to use it ONCE (cancelled a trip to Africa 'cause the anti-malarials made me really sick) and that one time has paid for ALL the other times I got the insurance...


Jeannine with Merlin, the crazed tabby cat and his sister, Jasmine, the brat-cat

With GTsiggieFromJenn.jpgAngel Cody(Roving Gemini), and Weenie the tortie waiting at the Bridge

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What I will add to this discussion is - if you DON'T have insurance yet, get it BEFORE something happens. My cat Merlin had a urinary blockage - cost me about 1200 dollars. I got pet insurance AFTER he blocked, but they will NEVER cover anything to do with his urinary tract/kidneys in the future! Pre-existing condition. Next pet I get will be covered from day 1!!

 

PS - I also ALWAYS get trip insurance when I go on an organized trip. Had to use it ONCE (cancelled a trip to Africa 'cause the anti-malarials made me really sick) and that one time has paid for ALL the other times I got the insurance...

You're exactly right. The day I decided that Bowie was staying with us I signed her up for insurance. I've had friends wait too long and something happened that created a pre-existing condition.


Sunsands Doodles: Doodles aka Claire, Bella Run Softly: Softy aka Bowie (the Diamond Dog)

Missing my beautiful boy Sunsands Carl 2.25.2003 - 4.1.2014

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You're exactly right. The day I decided that Bowie was staying with us I signed her up for insurance. I've had friends wait too long and something happened that created a pre-existing condition.

I did the same thing with each dog. Before any pre-existing conditions get reported on a new application.

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This post has been very helpful, thank you! I just enrolled Sweep in Healthy Paws. After spending at least a couple of thousand trying to diagnose her wonky toe over the last year, this was just the push I needed to sign up.

 

ETA: Question: Though we never got a 100% certain diagnosis, the operating theory was tenosynovitis and developing arthritis in a toe likely resulting from an old racing injury. I would expect this means anything related to that toe won't be covered, but given the urinary blockage example above, would any future claims related to arthritis or tendonitis elsewhere also be denied?

Edited by ramonaghan

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Rachel with Sweep and kitties Olive and Momo. Always missing Mud the meezer and Henry, my sweet bubba.

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Between Dec 1999 and July 2000 I spent $12,000 in vet bills. I still lost 5 yr old Topaz but 6 yr old Brindle survived.

 

It was after that that I got insurance. At that time there was only VPI.

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We had insurance on Bella for a couple of years and discontinued it. The only thing that we may have needed it for was the $1,500 repair to her paw. If she had done it during our regular vet hours, cost would have been much less. Now that she is 11.5, anything catastrophic requiring major procedures probably would mean we would let her go, but more because of age and concerns over quality of life remaining.

 

I do have Healthy Paws for Kirby because with the things he chews, his interest in chasing small fuzzies (including killing a squirrel) and just being a big klutz, I can see something expensive happening. That peace of mind is well worth $48/ month. I hope to never get my money's worth, same as with my home, car, life and liability insurance.....

Edited by sarabz

bella-1.jpg
KT Britta (race name), now Bella
Gotcha Day - 4/10/2010

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Guest Sportingfields

Not an intentional highjack but curious, for those that 'never had but now do have pet insurance'

 

 

Do you find yourself going to the vets more than before?

Are you authorizing treatments that you wouldn't even have considered before?

Are your present dogs whom you 'do have' insurance on, living longer & healthier lives than previous pets for whom you didn't have insurance? or would this have made no difference?

 

Just curious, don't feel anyone need to reply. We've never even considered pet insurance. We've been blessed in that finances have never needed to be a part of any decision we made. There are a few times I refused super expensive testing when no matter the results, the treatment would not differ. We are also very blessed with a super vet whom diagnosis's are so right on the money, every time, that the testing just confirmed what he already knew. So we felt comfortable saying no to somethings and yes to others.

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OK, here goes with the questions: I have to take DaVid in every week for corn hulling--The bill is $51.00 and Trupanion pays $47.00 of the bill. My premium is $102.00 a month. But, when he was about 5 years old he had to have back surgery and then had to have it again with a neurologist because it was not done correctly the first time. The bill was out the ceiling and Trupanion paid both surgeries with not problem. Actually 90% of it. So much for bragging on them. They have really missed the mark with the IBD. He is now 10 1/2.

 

Huck had IBD and Trupanion paid for the surgery to take out pieces and send them to Texas A&M. At that time Trupanion was paying for 1/2 of his Hills food. He then came down with bone cancer and had all of the tests associated with that. I put him down 3 days after the diagnoses. He was 6 years old.

 

Lady had back surgery 3 times. Once to take out the bad disks. Once to put in stainless ones and once again to redo those SS disks. Trupanion paid 90% of all three surgeries. They were about $7000 each. She also had corns that had to be hulled every week. That is two dogs with corns every week to the vet. They paid the bills with no problems. She died at 11. There is no way I could have afforded all of these surgeries and hullings on Social Security.

 

Not meaning to change the subject of insurance, but I have said no more Greyhounds around here. I absolutely cannot afford the money or the mental ups and downs with the breed. I do have two Galgos and for now they seem to be a healthy breed.

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I did not have pet health insurance on my first 3 greys. I wish I did on Ducky, my 3rd, because he ended up with huge vet bills due mostly to having IBD/PLE, and many UTI's. So when I got greyhounds #4 & #5, I got insurance on both of them.



Do you find yourself going to the vets more than before? No, I would go based on what is going on with them, regardless if I had insurance or not.



Are you authorizing treatments that you wouldn't even have considered before? No, I would have tried to just make it work, like maxing out my credit cards, etc.



Are your present dogs whom you 'do have' insurance on, living longer & healthier lives than previous pets for whom you didn't have insurance? or would this have made no difference? No, I would've probably treated them the same, Insurance or not. Wylie (my 5th) had osteo and we did palliative care along with several pamidronate infusions ($700+ per treatment, 5 or 6 treatments), and I would've paid it whether I had Insurance or not, because it was helping him. Yes, it was great to be reimbursed, but again, I would've just maxed out my credit cards for him.


Edited by JenniferS

Jen, Tessa & Raspberry
Forever in my heart, my boys: Quiet Man, Murphy, Ducky & Wylie
www.greyhoundadventures.org

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Out of curiosity - does pet ins work like human insurance when it comes to what the ins co will pay the provider? ie. you are billed $1000 for XYZ, but the ins co only allows $439 for XYZ. And if your portion is only 20%, then you pay $200, so vet only gets $639 instead of $100

 

This is how human health insurance works if the human goes to a doctor that participates in the health plan. The medical practice agrees beforehand to accept only $639 instead of $1,000. I've never heard of a vet practice participating but then I don't know about many practices.

 

General comment: I have Healthy Paws for Annie. The premium is $44 a month. I have just over $130 worth of meds that Annie gets every month (she has an eye disease and arthritis). My deductible is $250 a year with a 90% reimbursement. Therefore, I receive $1,180/yr in reimbursement from the insurance company. Deduct from that the total yearly premium of $528 and I am "ahead" by about $650 (figures rounded up/down to nearest dollar). Every 18 months or so, Annie has one little thing or another for which she needs to see the vet. While the insurance doesn't pay for the office visit, it does pay for tests and special meds, so I am "ahead" even more. I don't have the insurance to be ahead of anything. I'd be much happier if Annie had no eye disease about which I worry she'll lose her vision. I have the insurance to be able to treat her the big things or the emergencies, and I hope I never need it for that!

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