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: Pet Insurance providers offer pet owners different variations of well care coverage. Some medical plans integrate well care into their base coverage. Other providers, such as Veterinary Pet Insurance (VPI) offer greater flexibility by giving policyholders the option to add well care onto a base medical plan. There are some insurance providers that do not offer any sort of well care option and strictly market medical plans.
Question: Do you have any criteria for selecting a wellness plan instead of, or in addition to, a medical plan?
Dr. McConnell: VPI Pet Insurance offers two well care options - our Pet WellCare ProtectionSM Core Coverage and the Pet WellCare Protection Premier Coverage. The Premier plan carries a higher premium than the Core plan and boasts higher returns for many of the reimbursable procedures. It also features extra benefits for procedures commonly recommended for puppies, kittens and senior pets. Our Core coverage, with its more modest premium and lower reimbursements, is a better fit for dogs or cats in their prime years.
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.) Our policyholders are cognizant of the benefit allowances for every condition eligible for coverage; each customer is sent a benefit schedule and electronic versions are housed on our Web site. VPI does not use a 'usual and customary' fee menu.
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. VPI Pet Insurance policies may cover a condition if it is cured and there has not been a recurrence of the condition for at least six months. A chronic condition, however, can never be fully cured and would always remain as a 'pre-existing' condition to the policy. For conditions that are eligible for coverage, our waiting period is 14 days.
Question: Is it reasonable to expect that coverage for common age-related problems would be reduced or excluded in senior applicants?
Dr. McConnell: A nice feature of VPI Pet Insurance plans it that they will cover a pet's medical condition when the policy renews from year to year, as long as that condition is not pre-existing to the original policy inception date.
Please see the Pet Heath Insurance Basics interview with Dr. McConnell for more information about pet health insurance for these and related questions.
Learn More:
Veterinary Pet Insurance (VPI) company web site
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.
