The Hartville Group / Pets Health PlanPolicy exclusions

1

I have 4 dogs and 2 cats, and all but the 2 cats have pet insurance. 3 of the dogs are with VPI Pet Insurance, and the 4th dog is with Pets Health Plan by the Hartville Group. Since I have had pet insurance, so far neither of the companies have had to payout for anything, as my dogs have remained healthy. However, my dog, Sugar, who is insured with Pets Health Plan fell last week and hurt her back badly. My vet said that the injury might heal on its own, but if not, back surgery would be necessary. Either way, I wasn't too worried because I had pet insurance, and it covered accidents, of course. In fact, each and every plan offered by Pets Health Plan covers accidents and injuries.

However, this past weekend, I did some research and found out how the plans at Pets Health Plan work, and I am absolutely horrified. You see, Sugar's plan was renewed, and the effective date for the new plan period is December 15th. There is an exclusion with Pets Health Plan that states that if an illness or injury occurs in one plan period, any treatment for that illness or injury that is done in the next plan period is NOT covered. Basically, this means I can take my dog to the vet now, but unless her back injury is treated (that is, unless the surgery is done) by December 15th, it will NOT be covered by Pets Health Plan. The other option is to just not take her to the vet and basically let her suffer until December 15th, to make sure any back surgery would be covered. By the way, this back surgery will cost anywhere from $5000 - $8000, and so, you can understand why I need to make sure this is covered.

Fortunately, I have a friend who is a veterinary technician, and she has given me some medication for Sugar to ease the pain until I can figure out what to do. Pet insurance should NOT work this way. Coverage for an illness or injury should not be dependent on when in a plan period the illness or injury occurred. If the illness or injury is covered, then the insurance should pay -- period.

Incidentally, I talked with my 2nd pet insurance company, and their plans do NOT work this way. Instead, they have a payout "cap" for each illness or injury. So, for each illness or injury, they will pay for any treatment anytime up to a certain monetary cap. This is reasonable to me.

Anyways, I thought this information might prove useful to you. If you want to talk to Pets Health Plan, they can be reached at US +1 [protected] Call. And, if you have any other questions for me, feel free to email me back.

Responses

  • Ma
    Mary Sue Johnson Jan 16, 2008

    UPDATE:

    Sugar actually DID end up having her surgery prior to December 15th (December
    13th, in fact). I took her to a specialist, and they recommended immediate
    surgery. So, this *should* be covered.

    However, Pets Health Plan is fighting it tooth and nail. It was a $2600 surgery,
    and so, of course, they don't want to pay. But, I won't give up. I'll keep coming at
    them with appeals until they do pay.

    Mary

    0 Votes
  • Co
    Coleen M Lyon Oct 20, 2009

    Excellent information! Thank you! I am researching which pet insurance co. to go with, and this was very informative!

    Coleen

    0 Votes

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