I am grateful for the opportunity to interview Dr. Carol McConnell of Veterinary Pet Insurance to find out the basics of what pet health insurance is (and isn't) to help pet owners make an informed decision.
This is part I of the interview, intended for general information about insurance. Part II will focus on the specifics of VPI coverage. This interview is a companion piece to "Pet Insurance Shopping Tips" submitted by Veterinary Pet Insurance (VPI).
Question: What is the difference between a wellness plan and an insurance plan? Are they separate entities, or are wellness plans part of a comprehensive insurance plan?
Dr. McConnell: The distinction between a medical (insurance) plan and well care is the type of conditions eligible for coverage; medical plans help pay for the testing and treatment of unexpected accidents and illnesses, while well care plans are designed to reimburse for common preventive procedures such as vaccinations, annual exams, spay/neuter, etc.
Question: Do you have any criteria for selecting a wellness plan instead of, or in addition to, a medical plan?
Dr. McConnell: The choice for pet owners on whether or not to purchase a well care plan is dependent upon their desire to have a portion of their pet's preventive procedures reimbursed. Some might recognize the value of reducing the costs related to common expected veterinary visits while others may prefer to handle the expenses out of pocket.
Question: Is there a third party Web site or organization that pet owners can review the history and type of claims covered by the various insurance companies?
Dr. McConnell: Unknown if such Web site or organization exists.
Question: Are there any options for people who have found an insurance company that they like but the provider is not one offered at their veterinarian's or in the geographic area?
Dr. McConnell: Since the majority of pet insurance policies require clients to pay their veterinarian directly and then seek reimbursement from the insurance provider, there are usually no restrictions on which veterinarian the policyholder uses. However, there are a few 'membership plans' where this would not be the case and the choice of veterinary hospitals that honor the membership discount is limited.
Question: How are 'usual and customary' fees determined, and by whom?
Dr. McConnell: The source of the 'usual and customary' veterinary fee lists is unknown and are rarely disclosed by pet insurance companies.
(In contrast, VPI's plans reimburse against a published benefit schedule with established maximum allowances based off of 26 years of actuarial data. VPI has been in business since 1982.)
Question:What is the average/accepted waiting time period for coverage of pre-existing conditions?
Dr. McConnell: Pre-existing conditions are not covered typically by any pet health insurance plan.
Question: Is it reasonable to expect that coverage for health problems found commonly in certain breeds be reduced or excluded?
Dr. McConnell: In order for a pet insurance provider to cover health problems found commonly in specific breeds, the insurance company would need to charge higher premiums because their risk exposure is higher. An alternative is to not cover known problems in specific breeds at all, thus allowing the provider to charge less expensive premiums for all policyholders. Pet insurance premiums must reflect actual risk exposure (as opposed to human health care, where premiums are commonly subsidized by employers.)
Question: Is it reasonable to expect that coverage for common age-related problems would be reduced or excluded in senior applicants?
Dr. McConnell: Coverage for ongoing and age-related conditions and diseases is important to most pet owners. There are a few pet insurance companies that cover a disease in the first year, but then exclude that condition in subsequent terms. This is a method for the insurance company to reduce premium costs, even though it may not be in the best interest of the policyholder and pet.
Thank you, Dr. McConnell, for this interview and insurance information. Part II of this interview will offer additional information that is specific to VPI insurance policies.
