Saturday, October 10, 2009

Insurance, When the Patient Is a Pet

pet insurance comparison

LIKE a lot of Americans, I’m obsessing about health insurance.

Only in my case, the issue is whether or not to buy pet insurance for Scout.

Soon, she will be 6 months old, the age recommended for spaying, a procedure that will probably cost several hundred dollars, once tests and medications are included. A less invasive technique, done through laparoscopy, is far more expensive. And we’ve already spent quite a bit on vaccinations and routine checkups. Then there are possible future expenses, like an accident or a really severe malady, like cancer.

As with humans, pet insurance programs are complex; some are expensive, and it’s hard to tell for sure what kinds of illness and conditions will be covered. Most plans offer tiers of coverage, which grow in price depending on how expansive the coverage is, the breed of dog, where you live and other factors. For many pet owners, of course, neither veterinary care for complex health problems nor paying monthly pet insurance bills is affordable or even possible, so I know that having the choice is a luxury.

The costs I’ve checked out for Scout with two leading companies that offer pet health insurance range from monthly premiums of about $12 to $45. Ouch.

Personal experience, discussions with a few trusted veterinarians and guidance from friends and fellow dog owners have tipped me in favor of buying the insurance, although I am still poring over the fine print and deciding among plans.

Frankly, I think the possibility of a big out-of-pocket puppy health expense is pretty high. Scout is, in dog training parlance, extremely food motivated. She managed to grab a shrimp off the counter the other day, even though I was keeping careful watch (or so I thought) and had shoved the plate way back from the edge. While her chewing has abated somewhat, I worry that her occasionally successful sneak attacks on our laundry basket could result in her swallowing a sock, or something else that could cause a blockage. (I have a lot of friends who have suffered through surgeries on their dogs to deal with this kind of problem.)

When he was a pup, Buddy, our dog before Scout, got into a box of chocolates (poisonous for dogs) that one of our children had carelessly left within reach. An expensive nighttime visit to the emergency clinic ensued. At midlife, Buddy also developed unbearable skin allergies, requiring tests and even biopsies, before a change in his diet brought the problem under control. What we spent on Buddy’s health issues (as well as the more serious problems we confronted with Dinah, recounted in an earlier column) probably exceeded the cost of insurance, even over his long life span.

Of course, I didn’t even know pet insurance was available with Buddy. And still, although it is growing in popularity, only about 2 percent of dog owners buy insurance. Two of the largest providers are VPI Pet Insurance, which has been offering policies since 1982, and Hartville Group, which has a licensing agreement with the ASPCA. There are about a dozen other companies that also sell pet health insurance. With most policies, the dog owner picks the veterinarian, pays the bill and is reimbursed from the insurance company, after deductibles are subtracted. And all policies are different, with some treatments and ailments either uncovered or not fully reimbursed.

Dr. Ann E. Hohenhaus, an oncologist at the Animal Medical Center in Manhattan, cited cases where dogs with the coverage were treated successfully when their owners probably could not have afforded treatment if their pets were uninsured. “We were able to make the decisions based on medicine, not on money,” she said. As Christmas gifts, Dr. Hohenhaus gave her two nieces, both dog owners, pet insurance policies. When one of their dogs needed surgery for bladder stones, she received an extra thanks for the gift.

But Dr. Hohenhaus recognizes that “insurance is a gamble.” And there are striking similarities in the pet-insurance world to some of the loud complaints that were voiced about the health care system at all those town hall meetings over the summer. Web sites focused on pet issues include discussions from both satisfied and dissatisfied customers. As with humans, existing conditions sometimes are not covered and older dogs with congenital ailments are sometimes rejected for coverage altogether.

That has been an upsetting experience for my colleague, Sarah. Her dog, a young Shih Tzu named Sammy, started shaking, panting and even biting the dog walker about a year ago. After medical expenses of about $1,200, Sammy’s liver disease was diagnosed. It’s a condition that makes it impossible for him to metabolize regular dog food. Even worse, Sarah was told Sammy might need a $1,500 operation, although the problem did not turn out to be severe enough to warrant the procedure. She did not have insurance, and set about trying to get it. Unfortunately, the company she approached rejected Sammy, saying his liver condition made him ineligible for coverage. She is going to see if another company will cover him. “It’s not a happy ending,” Sarah said, “because he will be 4 in January and if this liver disease doesn’t shorten his life, that’s another 10 years at least of potential health problems with no insurance.”

The rejection of one little dog pales next to the hardships suffered by many humans with existing health problems, who are routinely denied health coverage or find their health insurance policies suddenly canceled. But it underscores Dr. Hohenhaus’s point about insurance being a gamble.

But, in another case involving a colleague, Jo, insurance has turned out to be a good idea. At a monthly premium of $38.50, she bought insurance through the ASPCA for her dog, Humphrey, adopted in 2007. When his form of canine lupus was recently diagnosed, her policy covered a good portion of the costs. Here is her account.

According to Elysia Howard, vice president of marketing and licensing, the ASPCA started its pet insurance program three years ago. Since then about 140,000 pet parents (the organization’s preferred nomenclature for owners) have bought insurance through the organization. (By comparison, VPI Pet Insurance says on its Web site that it has helped protect more than a million pets since 1982.) The ASPCA receives a cut of between 5 and 10 percent on each policy and a guaranteed revenue stream of $1.6 million over five years. Ms. Howard said the insurance program is in keeping with the ASPCA’s broader mission of championing animal welfare. She bought a basic $11 a month accident policy for her dog, who subsequently injured her leg jumping over a fence, to the tune of a $350 emergency clinic visit. “Insurance helps you plan for the stuff you don’t anticipate,” she said.

Her words remind me that Scout isn’t the only family member whose health insurance needs my attention. Will, my 24-year-old son, has recently switched jobs and I’m not sure whether he still has insurance, especially since he is working as a consultant, not in a staff position. I’ve just sent him a nagging e-mail message, because we’ve discussed this several times, to make sure he either has, or buys, coverage. Luckily, he doesn’t have any health problems or existing conditions, but a health crisis, in dogs or in humans, can arise out of nowhere. Indeed, although it is painfully expensive for most consumers — and even then coverage can be insufficient — this is still the most powerful reason to buy insurance.