[Wylie's Mom]

Pre-existing condition: Refers to a condition, injury or illness that was present – or which manifested itself – prior to the effective date of the policy. Coverage for any pre-existing condition was excluded under all the policies we reviewed.

It’s best to contact the insurance company prior to purchasing a policy if you’re not sure your pet has a pre-existing condition. For example, with Embrace, if your dog tore her right cruciate ligament (a common knee problem which requires surgical repair) before you bought your policy and later ruptures her left cruciate ligament – the new left cruciate tear is considered a pre-existing condition and will not be covered. Insurance business can be tricky stuff!

Per Incident limit: Refers to the maximum amount that will be paid for a single incident. Some companies will have a per-incident limit for the lifetime of the policy (as long as your pet lives) referred to as a lifetime limit. Companies may offer a range of lifetime limits to choose from. Pets Best offers lifetime limits ranging from $42,500 to $100,000 with corresponding per-incident limits from $2,500 to $14,000. For example, if you choose Pets Best Basic Plan with a lifetime limit of $42,500, there is a corresponding per-incident limit of $2,500. If your pet becomes ill with diabetes, then the maximum available reimbursement for any diabetes treatment would be $2,500 for the remaining life of your pet. RED FLAG: When treating chronic conditions, this could result in a total lack of coverage whether or not you renew your policy with Pets Best. Remember, pre-existing problems will not be covered if you later change insurance carriers.

Other companies, such as Petplan and Embrace, have no per-incident limits and will reimburse for a single incident up to the maximum annual policy benefit. For example, if you had Petplan’s Gold plan with a $20,000 maximum annual policy benefit, then you could be reimbursed up to $20,000 for a single incident. However, if you max out coverage for your policy year – no further coverage can be provided until your policy renews.

Benefit schedule: Insurers can use an itemized list of reimbursement amounts for specific medical diagnoses and treatments. This makes it very difficult to know what amount of any claim will be reimbursed and what amount you will pay out of pocket (remember company X!). Petplan, Embrace and Pets Best do not use a benefit schedule; instead, they reimburse you up to the limit of your policy. This has been a major improvement, leaving inferior insurance companies in the dust!

Chronic Conditions: Any condition that is likely to reappear and/or is not likely to be cured, such as allergies, some gastrointestinal diseases, diabetes, heart disease, cancer and so on.

Embrace offers restricted continuing care for chronic conditions that last more than one policy term. Its maximum reimbursement you can receive in any given year for chronic conditions is 25% of your policy maximum. For example, your cat is just diagnosed with kidney disease. If you choose a policy with a $2,000 annual limit (too low in my opinion – I would recommend at least $10,000 of coverage) a full $2,000 could be applied to treat the kidney disease. RED FLAG: However, when your policy renews in the second year, your cat now has a chronic condition and coverage for her kidney disease will only amount to 25% of your annual limit. So, with a $2,000 policy, only $500 will be reimbursed for care and treatment in all subsequent years. The remaining $1,500 is available for all new conditions, which again will be considered chronic in the following year.

Pets Best will cover up to the per-incident limit for the lifetime of the policy – so there is a cut off point on coverage. If your per-incident limit is $2,500, you can expect a total payout for the care and treatment of kidney disease not to exceed this limit over your pet’s lifetime. Also, with their lifetime $42,500 policy – you now have $40,000 worth of coverage when you renew your policy. Contrast lifetime limits with lifelong coverage – which do you want?

Only Petplan offers full lifelong coverage – any chronic condition the pet develops will be covered for the life of the pet so long as the policy is renewed annually and it will be renewed back to the full amount the of policy limit.

Congenital condition: Any condition or disorder that is present at birth or is recognized anytime after birth. Congenital disorders can be a result of genetic abnormalities or occur during fetal development. When discussing congenital, hereditary, and genetic conditions it becomes confusing when comparing different companies. For example, Pets Best lists patellar luxation (knee cap displacement) as a congenital condition which is therefore excluded from coverage. However; Embrace lists patellar luxation as a breed-specific condition (hereditary or genetic defect) which is covered as long as it’s not pre-existing. If you are paying attention you have just blurted out loud; “How can a problem be considered genetic (born with it) and not also be considered pre-existing at the same time?” Well, if the problem was never noted in your pet’s medical record prior to the effective date on your policy – it did not exist! Fortunately for your pocketbook, your vet failed to discover the problem on physical exam or the problem had not yet started to show any symptoms. Petplan also covers congenital conditions as long as they are not discovered as pre-existing conditions.

Hereditary condition: Refers to a condition, defect or disease, which was transmitted to the pet genetically from its parent(s). The condition, defect or disease may not be manifested until later in life. Some common examples are orthopedic problems such as Hip Dysplasia, Elbow Dysplasia, Osteochondritis Dissecans, and Legg-Calve-Perthes Disease; an eye disease leading to blindness called Progressive Retinal Atrophy; a blood disease called Von Willebrand disease; and Cryptorchidism – failure of one or both testicles to descend into the scrotum. Pets Best does offer coverage for what it considers to be hereditary conditions, but coverage is limited and the pet must have been enrolled before their 2nd birthday. Both Petplan and Embrace cover hereditary conditions as long as they aren’t pre-existing. Note: it is unlikely that the hereditary condition, Crytorchidism, would qualify for coverage, as it can be detected by veterinary exam as early as eight weeks of age, making it a pre-existing condition.

Be aware that the incidence for hereditary problems occurs far more often in purebreds than the good old fashion mongrel. Purebreds demand higher premiums and earlier age enrollment, making mutts a more affordable option. :-) Save your money and save a life – Adopt!

Select your own veterinarian: Be aware that some companies require you to select a veterinarian from a network. Founders is not part of any such network and we feel strongly that everyone should be able to choose their own docs!

Annual check-up by veterinarian: Preventive health care measures such as annual exams and laboratory testing may be required to maintain your coverage. Petplan requires an annual health check, dental exam and any treatment normally recommended by the vet to prevent illness such as an annual heartworm test and preventative medication if indicated. For renewal of older pets*, an exam, blood test and urinalysis two months prior to the date of renewal is required. Embrace only requires an annual check-up performed by a veterinarian. Pets Best does not require annual check-ups. Personally, we don’t understand Pets Best position.

*Dogs 8 years or older OR 5 years and older if a select breed; cats 10 years or older.

Emergency and Specialist care: Emergency visits and care provided by specialists such as orthopedic surgeons, oncologists, ophthalmologists and internal medicine doctors should be included in any policy you purchase, or pass on it! Companies may vary their rates on co-pays for this type of coverage or have some restrictions. Please inquire before you purchase your policy.

Alternative care: considered as acupuncture, hydrotherapy and chiropractic. Will only cover alternative treatments when administered by a licensed veterinarian. Policies that cover alternative care may or may not cover equipment purchase or rental. We recommend you get a pre-certification before treatment so you know if it will be covered and how much will be reimbursed.

Dental care: (excludes routine dental cleaning) Basic policies with Pets Best and Embrace* will cover orthodontic care such as tooth extractions only if caused by accident or injury like a hit by car. Therefore, a company may or may not consider a broken tooth due to chewing on something hard as an accident or injury. Petplan will cover orthodontic care such as a tooth extraction for any reason deemed necessary by your veterinarian.

*Embrace does have the option to add a Drug & Dental plan at extra cost which would treat dental problems and extractions due to other reasons besides accident injuries.

Cancer treatment: includes surgery, radiation and chemotherapy.

Years in business: Petplan was founded over 30 years ago in the United Kingdom and was launched in the U.S.A. in 2006. Pets Best and Embrace are newer companies in operation since 2005.

Licensed in the State of California [apply this info to other states]: An insurer may or may not be licensed within the state it operates. If it is not, the insurer cannot participate in the insurance guarantee funds created by California law. Therefore, if the insurer becomes insolvent and is unable to make payment to you as promised, these guaranteed funds will not pay your claims.