Edit: I have spent the majority of my 10-year career so far working in the chaotic emergency and critical care side of veterinary medicine: we fix the disasters when we can, so my range of experience is with the critical, with the chronic, with the extremely sick, with black & white situations, with life-or-death decisions. Most people don't understand, and never will understand, the way a veterinary ER/ICU works and the gamut of awfulness and sadness we see on a daily basis. There is a lot that we are not allowed to discuss precisely because clients with no veterinary medical experience will not comprehend the scope and magnitude of what we do. There is a lot of beauty and miracles and awesome too, but there is a tremendous amount of stress and sadness. Last Sunday alone we euthanized 8 patients in one 13-hour shift. Some were brought in specifically for euthanasia, others were brought in in extremely critical condition and too far gone to be able to fix them. But more than half of them were euthanised because their owners could not afford to treat. That was in one 13-hour shift. When I worked in Surgery, where most procedures were elective, we euthanized all of 4 patients in a two-year period.
So given some of the comments below, I apparently needed to explain where I'm coming from with this post. The average middle class person can't afford advanced specialty treatment for their pet out of pocket. They need to go into debt to pay for advanced veterinary care. That is the truth. Most people don't ever need to concern themselves with worrying about affording specialty treatment because they already know where they would draw the line when it comes to what they are willing to spend on their pets. And that is absolutely fine! Choosing to not let an animal suffer is always a good choice! In most cases, euthanasia is a gift, and it is one that I wish people could elect for themselves when diagnosed with chronic terminal illnesses.
But the other truth is that a lot of people don't even know that specialty services like radiation oncology and chemotherapy (you should have seen my in-laws' faces when I first announced I was going to work in veterinary oncology a year out of tech school. "You mean animals can be given chemo???" Yes, it is an option. Not one I would choose for my own pets, personally, but a good veterinary oncologist buys the patient time while maintaining a high quality of life for the pet and most of the time, that is all that the pet owner wants. So why not have the option?) and MRI and physical therapy and cardiologists and internists are options for their pets because there are general practitioners out there that won't give their clients these options, either because they think the clients won't be able to afford specialty care, they don't want to lose the income they receive from that client, or they genuinely think they can manage advanced chronic diseases on their own. (Hint: a lot of them can't. Not properly, at least.)
This post is not really directed at my regular readers, it's meant to be more of an informative post to lie around on the internet whenever anyone wants to research more info on insuring pets/horses.
Many, many thanks to those of you who commented and added your own experiences with insurance to this post! :)
Some people can afford a $3,000 three-day hospitalization for their dog with moderate pancreatitis in a 24-hour specialty hospital in the DC/MD/VA region without batting an eye. But it is not always this way: I have seen people pull out multiple credit cards, refinance their houses, and take loans on their businesses in order to pay for a pet's hospital bill. I have seen people leave the hospital and come back with an enormous wad of cash that we have no idea how they got. Some people wipe out their savings and retirement accounts for their pets. This was all especially bad during the recession.
I'm not saying any of this is good or bad or admirable or whatever: I'm just pointing out that this type of stuff really does happen in real life and we feel awful when owners are faced with black and white choices like this. A lot of owners know in advance where they would draw the line when it comes to their pet's care, the lengths they are willing to go, and how much they are willing to invest financially in bringing that pet to good health. A lot of times euthanasia really is the right choice and is encouraged. But a lot of times owners don't want to elect that choice, either because they want more time with their pet and are holding on to every last shred of hope, or because they simply don't believe in euthanasia. You might be surprised about how often religious beliefs come into play when it comes to decisions regarding a pet's care. So some clients take extreme measures to try to continue/provide care that they can't always afford. Insurance can be a huge help in scenarios like this.
Specialty care will get you a diagnosis when your regular vet is stumped on what is wrong with him/her, but it is expensive because we are using the same exact technologies for diagnosing and treating your pet that your doctor would use on you in a human hospital setting. So why is the care for your pet so much more expensive than care for yourself?
First of all: look at the cost of your care before insurance. This is a huge pet peeve of ours in the veterinary industry. And then compare to the cost of care for your pet. Yes, the cost of care for you sans insurance is exorbitant. Fun fact: medical bills are the #1 cause of bankruptcy in the US. Most of the drugs and equipment are exactly the same in both human and veterinary medicine. In vet med we use a lot of refurbished human equipment (think fluid pumps and CT machines, for example) in order to keep costs down, and our mark-ups are way less than what they are on the human medical side. But it is still going to be expensive if you want the same quality of care you would receive in the same scenario.
So when does the cost for your pet's care become comparable to yours with health insurance? When you insure your pet.
So how does this work? Read on to find out. I'm going to talk first about insurance for your cat or dog, and then I'm going to talk about equine insurance, since they are very similar but there are some major differences.
Insuring Your Household Pet
Pet insurance is not like human medical insurance in a few ways:
1. Difference #1: In human medicine, you have your insurance that offers you different levels of coverage depending on whether your healthcare providers are in-network or out of network. Cost of care for you is going to be based on that, and on whatever other limiting factors your particular health insurance plan has: only some medications might be covered; preventive care might be covered 100%; you might have to meet a deductible before hospital care is covered, etc.
2. Difference #2: In the end, though, if you have health insurance for yourself what usually happens is that you either pay a copay (especially for doctor office visits) or pay nothing up front (especially when you're hospitalized), cost of care is never discussed (this is an enormous pet peeve of mine but it has to do with the fact that hospital billing is a mess and dealing with people's individual insurance plans to determine coverage is also a mess), and you get mailed a bill after the fact where you get to see how much your insurance covered. The final price you have to pay on that medical bill is what's left over after insurance has paid for whatever it is they cover.
3. Does every veterinary hospital take pet insurance? Technically yes. With pet insurance, you go and pick whatever insurance plan you want because there is no such thing as "in-network" or "out-of-network" for animals. Exception: Banfield pet insurance. It covers routine care but it only works at Banfield hospitals. It offers NO COVERAGE at hospitals that Banfield vets might refer to. This is a huge problem that Banfield is not always clear about and we get a lot of upset owners that were trying to be responsible by insuring their pet, only to realize they still have to pay 100% out of pocket when they get referred to the specialty hospital or the veterinary ER. If you have Banfield pet insurance and are concerned about the affordability of emergency treatment for your pet, I recommend an additional insurance plan to cover specialty care in the event you ever need it.
Anyway: network or out of network is not a thing with pet insurance because it works by refunding you directly. You always pay out of pocket for veterinary care at the time of treatment (this is the same with all plans), have the veterinarian fill out a form from your insurance (I recommend having blank copies of this form in your daily driver vehicle), and then fax it to your insurance company along with a copy of the paid invoice. The insurance company then sends you a check for what you paid. This process can take anywhere from two days to two weeks depending on your plan of choice and how quickly you got the filled-out form back to your insurance company.
4. How much of that veterinary care do pet insurance plans cover? They do not cover preventive and routine care like vaccines and checkups with your regular vet. They also don't cover the cost of the veterinary exam itself. But they do cover specialty care, diagnostics and treatments, like visits to the internist, major work with a veterinary dentist, TPLO surgery for your dog's torn cruciate, bloat surgery for your Shepherd, the emergency treatment for your cat's urinary obstruction, and some even cover chemotherapy and congenital problems/hereditary disease. Some pet insurance companies only offer one plan, but others have different levels of coverage that you can choose from or even customize however you want. There is usually a deductible and what you pay per month depends on how low or high of a deductible you choose. Some pet insurance plans offer different levels of reimbursement: 50%, 60%, 90%. In other words, they'll pay you back 50%, 60%, 90% of what you paid for treatment of your pet. The more you want reimbursed, the more expensive the premium usually is.
5. How much does pet insurance usually cost? It is going to depend on your animal's age (insure young so you don't have to pay as much later: with many companies, you're locking in your premium price for life the moment you insure your pet), gender (Ex: male cats are more expensive to insure than females because they can get urinary obstructions), species (dogs are more expensive to treat and thus insure than cats), pre-existing conditions (also why it's a good idea to insure early because these will be excluded), breed (Ex: Labs and Goldens are notorious for developing specific cancers at an early age), and the zipcode you live in, because cost of living is a factor.
That said, you're looking at anywhere from $15-$40/month average for one pet's insurance depending on the insurance company you choose, and the deductible and level of coverage you select. Can it be more than $40/month? Yes, it can. I went onto PetPlan so I could play around with their quotes and provide examples for you guys: PetPlan's Premier plan offers the highest level of coverage: you get unlimited annual coverage (aka there is no cap on what they will cover in a year. True story: they reimbursed one client $30,000 (yes, with a coma and 4 0s; I saw the bill) for a canine ICU patient's month-long hospitalization on life support while she recovered from severe pneumonia), a $100 deductible, and 80% reimbursement. Say I have a 3 year old large-breed (71 lb+) mutt living in Alexandria, VA (cost of living is quite high). This insurance plan is going to cost me $115/month. If I insure that same dog at under a year of age, that same insurance plan is $92/month. If I begin that same dog's insurance coverage at 8 years of age, that same insurance plan goes up to $323 (!!!) a month. See why it's a good idea to insure your cat or dog as young as possible?
Now, if that original 3-year old dog was small (under 25 lbs), his insurance premium with PetPlan would range from $20-$60/month depending on which plan I choose. Yes: it is FAR MORE EXPENSIVE to treat large breed dogs than it is to treat smaller ones in hospital. It can be more expensive to treat a Great Dane for a bloat + surgery than it is to treat a horse for colic + surgery. That said, PetPlan's Basic plan for a large breed dog in Alexandria, VA, starts at $31/month. So you have an enormous variation in price depending on what you select.
6. How do I find a good pet insurance company? Google. There are many, many, many to choose from nowadays. Or even better: ask your vet. A lot of vets and veterinary technicians insure their own pets; they sometimes have brochures on pet insurance at the front desk. Do I recommend any in particular? Yes, I do. (No, I do not get paid for recommending them: these two companies are the ones most often used by veterinary professionals for their own pets, are known for being kind and easy to work with, and have fast turnaround times on their refunds to you):
a) Trupanion: Trupanion lets you personalize your insurance plan quite a bit You can select your deductible of $0, $200 or $700, or you can 100% customize the plan depending on what you can afford/want to pay per month in proportion to the deductible you want to select. The deductible will not change for the lifetime of your pet. Also: once your pet is covered, your premium will not increase as your pet ages. They also offer some pretty cool add-ons like coverage for alternative therapies like chiropractic and acupuncture, and a pet owner's assistance package that covers boarding costs and euthanasia + cremation charges. They reimburse 90% of the cost of treatment for (and I'm quoting from their website): medications, diagnostics, surgeries, orthotics, prosthetic devices, hospitalization, supplements, herbal therapies, among others. They don't cover routine wellness exams, exam fees, nor pre-existing conditions (again why it's a good idea to insure your pet BEFORE it develops a problem!) When you think about it, this actually covers more than the average human health insurance plan.
b) PetPlan: This is another excellent company that offers similar options to Trupanion. They reimburse 80% instead of 90% of treatment costs, but they offer the same level of coverage: hospitalization, medications, diagnostics, referral and specialty treatments, behavior modification, alternative therapies, chemotherapy (this is huge: not all pet insurance covers this), surgery + rehabilitation, imaging including CT and MRI, boarding costs, loss due to theft or straying, death from injury or sickness, among others. One of the differences between PetPlan and Trupanion is that PetPlan already includes some of the add-ons you have to purchase separately with Trupanion. Each company has its perks though, and costs can vary from one to the other depending on the plan you choose within each company. It's easy to play with numbers on either of these websites: enter your pet's information and give an e-mail address (they won't spam you), and the website will let you click through their plan options to see what you can get depending on the level of coverage you want.
Other pet insurance companies we see a lot through the veterinary hospital are VPI aka Nationwide (very popular among pet owners that come to the specialty hospital), Healthy Paws, Figo, Pets Best, Pet First, and Embrace.
So that's it in a nutshell on insurance for your cat or dog.
Insuring Your Horse
- Insuring your horse is a little different because you are buying mortality insurance and adding major medical and surgical to it. Some insurance companies won't let you buy major medical & surgical coverage for more than your horse's mortality value. In other words, if your horse cost you $1,000, they won't let you buy $5,000 major medical & surgical coverage for it. There are exceptions: Broadstone is one of these exceptions. They WILL let you buy up to $15,000 in major medical & surgical coverage for your $1,000 horse.
- Equine insurance works the same as pet insurance in that you pay out of pocket for your horse's medical care at the time of treatment, and have your vet fill out a form that gets faxed to the insurance company along with your paid invoice; you are then reimbursed by the insurance company.
- The other catch with equine insurance is that you can only purchase mortality insurance if your horse is over 15 years of age; major medical & surgical is not usually offered for horses older than 15. Broadstone, the agent I use, will cover horses with major medical & surgical up to 20 years of age. This is not common.
- Gingham does a great job of explaining the mortality and loss of use aspect of equine insurance in this post. Gingham focuses on the pros and cons of loss of use in her second post on the subject because that was her major concern when she imported Windsor. I'm going to focus on the major medical and surgical coverage addendum, because that was my major concern at the time I decided to insure Lily.
1. Mortality Insurance: in order to get your major medical & surgical coverage, you usually have to buy mortality insurance for your horse. This is the biggest catch with equine insurance. Mortality insurance basically means you get paid x amount for your horse in the event your horse dies or is euthanized. Obviously you have to declare a value for your horse in order to be able to insure it for mortality. Different equine insurance companies won't cover horses that aren't worth x minimum. Markel, for example, is considered one of the best equine insurance companies out there in terms of the enormous range of treatments they will cover + the % of reimbursement you receive for treatments, but it is meant for very valuable equestrian athletes: I believe they won't cover animals worth less than 5 figures. Most other companies aimed at "little people" (amateurs) and the horses they ride for fun will cover horses worth far less. If your horse has a show record or is being trained/worked by a professional or if you are in a regular lesson program with that horse, you can use all of these to substantiate the value of your horse for that mortality premium in addition to your horse's purchase price. At the time I insured Lily, I was consistently taking dressage lessons on her with a professional, so my agent encouraged me to use the value of my lessons to pad Lily's $1 purchase price. I came up with $1600 as her value, which was more than enough for me: my insurance premium cost was still affordable, and in the event she dies, this would be enough for an adoption fee for a nice horse from one of the local equine rescues, a young horse to train as a project, or a grade horse to have fun with. This value left me with plenty of room to get what I really wanted out of her insurance: that major medical & surgical addendum.
2. Major Medical & Surgical: coverage for this is going to vary depending on the insurance company. I researched Markel and was literally laughed at when I told them I wanted to buy insurance for my $1 horse...so I turned to another company that consistently came up in searches with good reviews: Broadstone Equine. At the time I was looking to insure Lily, I was in a hurry: we already knew we were moving from South Florida to the DC/VA/MD region and I wanted her covered STAT before loading her on the trailer for the long drive north. Broadstone had come up enough in searches that they were the only other company I called. They offered coverage for everything I wanted, were happy to insure my basically free horse, were wonderful to talk to, and had Lily covered at the time of my phone call. I had 30 days to sign the paperwork they e-mailed me and get it back to them. They were awesome. Broadstone is sort of an umbrella agent for other companies: Lily is insured through Broadstone with The Hartford. I renew her insurance with Broadstone, but when handling medical costs I work directly with The Hartford's agents (who are also amazing btw.)
- The Hartford offers different tiers of coverage for major medical & surgical: up to $5,000, $7,500, $10,000 or $15,000 annually. In other words, that's how much they will cover for your horse's medical costs for a year. Remember that some horses can max out any of these in one go: Lily used up all of her $7500 coverage in 2015 with her leg injury. Colic surgery is a worst-case scenario and can cost anywhere from $5k to $10k. Obviously the higher your annual coverage, the more expensive your premium.
- Each equine insurance company varies in what they cover and how much they cover. Exams and barn calls are never covered (Lily's repeated emergency vet calls after she returned home from the equine hospital in 2015 racked up an additional $3,000 that we paid for out of pocket without reimbursement. Veterinary visits add up quickly! Imagine how much that would have been if the treatments she received each time hadn't been covered by her insurance!), and just like with pet insurance, neither is routine care like vaccines, dental floats, and farrier work. Surgeries, hospitalizations and prescription meds (think bute, SMZs, GastroGard and Marquis, for example) are usually covered 100%. Ultrasounds and x-rays are also covered. Advanced therapies like stem cells and PRP are covered to a degree, joint injections are covered to a degree, and shockwave is also covered to a degree. Coverage for advanced imaging like MRI and CT also varies from one company to another, with some covering 100% and others only a percentage.
- There is always a deductible. In other words, this deductible will be subtracted from the treatments that your equine insurance covers. In Lily's case, the deductible is $350, so not worth calling my insurance for treatments/care that cost less than that deductible because I am not going to get reimbursed for it. But for big things like her ligament strain in 2013 and her splint bone surgery in 2015, you bet I'm filing claims.
- You want to file your claim as soon as possible, which is usually initially done via phone. Most insurance companies have an after hours phone number as well. The agent will then email you a claim number along with the form for your vet to fill out; your vet can fill this out at any time. I've e-mailed the form to my vet in the past, since at the time Things Have Happened, we kind of have our hands full with actually treating the horse.
- Turnaround time for reimbursement checks has always been quick for me with The Hartford (can't testify as to other companies, as everyone else I know that has equine insurance also uses them): I usually have a check in my mailbox within 3 days after faxing my paid invoice and the form filled out by my vet.
- How much is an insurance premium for a horse? For my $1 trail horse with a value of $1600 and major medical & surgical up to $7500 in Maryland, I pay $350 for the year. The insurance literally paid for itself x10 when Lily had her annular ligament injury after our move to Maryland. Your cost will vary depending on how much coverage you get for mortality, the region you live in, the sport your horse participates in, your horse's breed and gender, and the level of coverage you select for major medical & surgical.
- The other big catch: if your horse is majorly injured and you claim that injury, that body part is most likely going to be excluded from coverage from your horse's insurance. Example: Lily's left fetlock is excluded from her insurance due to the annular ligament injury. This doesn't affect the cost of your premium, it just means that if, for example, Lily were to re-injure her left hind annular ligament, I would be paying 100% out of pocket without reimbursement. So this is why it's a good idea to insure your horse before they develop stuff like broken splint bones and hock arthritis: if you try to get coverage for your horse after the fact, treatment for these things is not going to be covered.
*I am not affiliated with any of the insurance companies mentioned in this post. I am using them as examples to illustrate costs and coverage for readers to have an idea because apparently it is super taboo to talk about insurance and money on blogs but I really don't give a shit. I'm just trying to inform because I care about people being able to have the choice of giving their pets a chance if that's what they want to do, without going into inordinate amounts of debt to do so. That's all.