Pet Insurance And Pre-existing Conditions - Confused...

LeonieLunatic

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So Pebbles, our six year old Tabby mix, has obvious breathing issues with attacks of reverse sneezing and coughing.

Our vet wants to figure out what's wrong. We need to do a chest xray. She also wants to do an ultrasound of her heart. And maybe do an endoscopy to check if she might have polyps.

My husband and I are looking at pet insurance because xrays, ultrasounds and the like are going to be very expensive.

I'm honestly very confused. Most pet insurance providers straight up won't cover any pre-existing conditions. But will they cover diagnostics? We're not TREATING the condition, we're trying to diagnose it. Some pet insurance providers also state that while they won't cover chronic conditions, they might cover curable pre-existing conditions.

Considering we don't know what's wrong with Pebbles just yet, we don't know if the condition is curable. If she ends up having polyps, they can be removed and thus, she'd be cured. If she has a heart condition, it may or may not be curable by surgery, depending on what it is. But if she has asthma, it's a life long chronic condition.

Right now, we're less worried about the treatment of a possible chronic condition, as we have a very dedicated vet who is going to help us find the most cost effective way of treating her for whatever she has. Additionally, before we worry about treatment, we need to find out what's wrong.

What we are worried about, however, is the big bills coming toward us to diagnose her. Our vet got us an estimate and the whole list of xrays, ultrasound, lab tests and endoscopy is bordering on $2000. We're currently living paycheck to paycheck and cannot afford that.

Will insurances that cover "some pre-existing conditions" cover diagnostics? Will they cover the cost of the "cure" if Pebbles turns out to have a curable condition? I'm so confused.

EDIT: Some insurances cover hereditary and congenital conditions. Again... whatever Pebbles has may or may not be congenital or hereditary...
 
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artiemom

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I will tell you about my experiences with pet insurance.

My guy had a heart murmur and needed a cleaning on his first vet exam. That information was provided to the insurance.

The insurance refused to cover any and all issues which could be related to any heart issues--- pre-existing condition.

During the initial 6 month probation period, I had to take him to an er vet due to lethargy, inappetence and vomiting.

He would periodically, over the course of the next several years, would be seen for vomiting; ending up with a diagnosis of IBD, after an endoscopic biopsy.

The insurance did pay for a large amount of the endoscopy; HOWEVER, once the diagnosis of IBD was official, (from the biopsy), I received a letter from then insurance company stating they would DENY any all future claims for Vomiting, Lethargy, Inappetence....

I was furious! That covers everything.. so now they would not cover any heart issues, nor any issues which exhibits symptoms such as vomiting, lethargy, not eating..
That is EVERYTHING!!!! They claim this was a condition which came up during the probation period; therefore it was pre-existing...

All this, because I was honest and included his ER visit...

Subsequently, I cancelled the insurance..

My advice would be: Be very cautious as to getting it.. Now that my guy is not around, I am not sure if I would get it for a newly adopted cat.. If I did, it would have to be a young cat, and I would be very, very, careful about medical care during the probation period..... sigh... it is a racket...
 

Kitcat2017

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My advice would be: Be very cautious as to getting it.. Now that my guy is not around, I am not sure if I would get it for a newly adopted cat.. If I did, it would have to be a young cat, and I would be very, very, careful about medical care during the probation period..... sigh... it is a racket...
Would you share who were you with?

I am leaning towards Petplan and my kid is a 1 year old. How can they deny all claims for vomiting and lethargy! That's like basic symptoms for EVERYTHING! That is ridiculous.
 

artiemom

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Would you share who were you with?
I cannot. I did post a thread on here, when things happened. It was out of control because the insurance company has a 'bot' monitoring the web.. it was a fiasco...

But it IS the major player in the insurance area....

I am leaning towards Petplan
It was not that one.
 

Kieka

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You'd want to contact the insurance company in writing and get a written statement that they will cover the diagnostics. Even then, I'd see them working out of it by claiming it was related to pre-existing conditions. I don't have pet insurance because my one cat who could have benefited would likely be excluded from nearly everything as being pre-existing. If I had the insurance when he was a kitten, maybe it would be beneficial but at this point there is very little that they wouldn't be able to call pre existing based on his vet records.
 

fionasmom

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My experience with pet insurance is with dogs, although my youngest cat boy Jamie does have a policy which I have not used and I am investigating other companies just because I took it out in the wake of what is going on with my dog, for which I have paid thousands. My dog has Cushings and is older. Last year I investigated getting insurance for him and was told that Cushings was an excluded condition. I was quoted a very high monthly rate because of his age and I subsequently did not take it. About a month later a sore appeared on his foot...fast forward to melanoma and an amputation and 5 rounds of immunotherapy. Would an insurance company have called the melanoma pre existing in the sense that getting hit by a car would not be pre existing...I guess we will never know. Along with the question of what they will cover, you also need to find out limits....some are ridiculously low in the end which is why I had cancelled pet insurance on three previous dogs. My vet told me the names of three companies that he has seen pay fairly, based on his experience only, but I don't know if I am at liberty to post them here or if that starts something. My other impression about pet insurance is that you need to take it out shortly after the animal is born because as Kieka stated, nothing is pre existing at that time.
 

LTS3

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I cannot. I did post a thread on here, when things happened. It was out of control because the insurance company has a 'bot' monitoring the web.. it was a fiasco...

Could a bot read a PM? :think: You could contact Kitcat2017 by PM and just list your email address so you can discuss that pet insurance off TCS.

It may be best to just set aside money every month or however often you can in a bank savings account. Set up a savings account just for veterinary expenses so the money is separate from your personal every day account.
 

fionasmom

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Consumer Reports recommends doing a savings account rather than insurance, or at least they did the last time I checked. The frightening thing is that in this day and age, and possibly depending on where you live, you could be looking at more than a few thousand to treat or save your pet.

I moderate a support group for German Shepherd owners whose dogs specifically have degenerative myelopathy and bots come and read that as well.
 
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fionasmom

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Interesting. I just went to the Consumer Reports website where I subscribe and there is a short video about pet insurance. They do not rate them by name. They say that it is better to insure a young healthy pet rather than an older one, to see if premiums increase as the pet ages, that purebred dogs and cats might be more to insure. Average cost per month for a young cat is $16 vs. $22 for a young dog. I moderate a support group for German shepherd owners whose dogs specifically have degerative myelopathy and bots come and read that as well.
 

fionasmom

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To go along with what Kitcat2017 is saying, my dog would not have cleared any probation period with the melanoma, and I certainly could not stall and hope that it did not spread in the meantime. Plus, with a one month window between my inquiry and the dx of the melanoma I am sure that it would have been considered preexisting.
 

abby2932

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No, unfortunately if the symptoms are there prior to getting insurance or during the probation period it is considered preexisting & will not be covered.

I have had a better experience with pet insurance than the above posters and I'll explain it here:

I first got pet insurance in 2014. When you first sign up for a policy, the insurance company will want the "chart notes" from your veterinarian. Basically these notes will have details of all your visits, including any illness, symptoms, diagnoses', notes about anything you told the vet might be concerning you that they wrote down in your pet's chart, etc. You must send in the chart notes to the insurance company. All insurance companies want them, this is not an option.

My cat was having some diarrhea shortly before I purchased my policy. It was an undiagnosed, short bout of diarrhea that cleared on its own within a few days. The insurance company considered this a "temporary" preexisting condition, stating that they would cover no illness that had diarrhea as a symptom. That is MOST, if not all, illnesses. They stated that if my cat went 12 months of not having diarrhea, the temporary exclusion would expire & he would be covered.

My cat went about 4 years with no issues & the temporary exclusion expired. In March 2018, Malibu got very sick. Two visits to regular vet and one visit to a specialist and he was diagnosed with Stage 4 Large Cell Lymphoma, an aggressive cancer. We tried steroids for a few days but he was declining quickly and I had to put him to sleep.

Embrace covered every penny of office visit fees, testing, radiograph, medication and the cost of the Euthansia & public cremation (minus my deductible & copay).
 

artiemom

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Interesting. I just went to the Consumer Reports website where I subscribe and there is a short video about pet insurance. They do not rate them by name. They say that it is better to insure a young healthy pet rather than an older one, to see if premiums increase as the pet ages, that purebred dogs and cats might be more to insure. Average cost per month for a young cat is $16 vs. $22 for a young dog. I moderate a support group for German shepherd owners whose dogs specifically have degerative myelopathy and bots come and read that as well.
I have to agree with this.

The Pet Insurance I had, did increase premiums, yearly; as he aged.

I think if you have a young cat, without any issues, then it would be a good thing to have; however, with an older cat, I not quite so sure about that.

It is easy to say that you can put some money away in a special account for your pet. In reality, it is very hard to do. It seems to be easier to just pay a monthly bill...

I will say, that the insurance was pretty good, until Artie had the biopsy, and got the official notice. It seemed as if they had changed their policy, gotten new adjusters, whose priority was to screen for Denying as many claims as possible.

My Vet, at the time, told me that she suddenly had several patients who had claims denied.

I fought it, but the aggravation was really not worth it at the time. I did not care for their customer service.. and the Bot really got me furious...
 

fionasmom

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I have to agree with you that pet insurance is probably slippery at best. Without getting off the subject, I had trouble with a home warranty company insurance policy and found that any insurance can be grieved to the state department of insurance, so I assume that means pet insurance as well. But what a hassle that would be.
 

fionasmom

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I apologize for overlooking the post about Malibu and am sorry for the loss. A friend of mine with a cavalier spaniel made an exhaustive search of pet insurances and chose Embrace...I assume I can say that since it is positive. The previous cavalier had developed cardiomyopathy which is almost a given in that breed and they had massive bills to pay before it passed on.
 

ailish

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Consumer Reports recommends doing a savings account rather than insurance, or at least they did the last time I checked. The frightening thing is that in this day and age, and possibly depending on where you live, you could be looking at more than a few thousand to treat or save your pet.
I have considered this savings account idea, but my issue is - what happens when it is exhausted? I was lucky in that I adopted a young cat with no problems and have made it past all "preexisting" insurance obstacles. I think! My thought is to research all plans exhaustively and with the understanding that insurance companies exist to collect money and not pay it. I would get insurance again on a young, healthy cat and I would do the savings account for a cat that had preexistings, simply because it would be better than nothing. I really hate the idea of having to make a treatment decision based on money. My big fear when I got the insurance was an accident, because in 60 years of having pets in the family (I never had my own pet until now) the only major bill has been the result of an accident.
 

fionasmom

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My two German shepherds both went beyond what anyone might have thought was reasonable to save for an emergency or medical issue. The first had degenerative myelopathy and it was my decision to try to proceed with treatment when the outcome was unfortunately guaranteed. The second has Cushings and melanoma, both of which could be treated, so I did and have continued to do so. I think that your plan for insuring a young healthy animal and saving for the older ones is very reasonable and is basically what I am doing as well.
 
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