In a word…YES! At least it did for two recent patients of ours. Their experiences may shed some light on what to expect when submitting a claim.
“Crimson” is a very determined four-year-old female Pug who has bilateral carpal deformities and contractures on both elbow joints. She presented to us walking on both elbows. Jim made a custom carpal brace for each elbow to prevent her from knuckling and reduce any further contractures of the carpal and metacarpal joints. Crimson’s family chose hot pink for the color of her braces as appropriate for her name and reputation.
Crimson’s family submitted the insurance claim with a veterinarian’s prescription and clinical notes from us as well as her veterinarian and animal physical therapist. The insurance company agreed to pay for one brace but refused the other. The family came back to us asking for additional statements for the insurance company that further explained the purpose and uses of the braces. Ultimately the insurance company paid for the second brace.
Our second story is about “Warden”, a young, male, Neapolitan Mastiff that weighs in at a mere 120 pounds. He has one of the most engaging faces I’ve seen in the dog world and a fun-loving personality to match. He presented to us with significant external rotation of the left carpal joint, probably from a traumatic injury that occurred before he was rescued by his current family. Because Warden is a juvenile and his epiphyseal plates have not finished growing he is not a candidate for surgery. Jim made a custom carpal and paw brace for Warden that will prevent the rotation from getting any worse.
Warden with his Carpal Brace
Warden’s family submitted our invoice and his veterinarian’s prescription for the leg brace to the insurance company and they were quickly reimbursed. The family had determined in advance that Warden’s insurance covered leg braces and this may have influenced the promptness of payment.
Whether pet insurance is a “good thing” or a “bad thing” is still a hot topic for debate in the veterinary community. Many veterinarians believe that pet insurance will help their clients afford the highest quality care now offered by the increasingly sophisticated treatments the clients are expecting for their pets. On the other hand, many veterinarians are very concerned about the frequent horror stories they hear about “managed care” insurance from both human healthcare practitioners and their patients.
The pros and cons of pet insurance is a complicated subject. A lot of information can be found by searching “pet insurance” at www.veterinarypracticenews.com. A good overview of the issues – as seen by the insurance industry – can be found by following this link to one of Dr. Phil Zeltzman’s articles in Veterinary Practice News: http://www.veterinarypracticenews.com/vet-dept/vet-practice-management/pet-insurance-gurus-answer-skeptics.aspx
While I can’t speak for the veterinary community, I can tell you that the family of one of the two patients I wrote about earlier probably would not have been able to purchase a leg brace – and the improved quality of life that goes with it – had it not been for their pet insurance. On the other hand, Jim and I spent many years in human healthcare and experienced the power and influence of the managed care insurance companies. In response to this conundrum, we offer one of Mark Twain’s observations to our friends in the veterinary community, “If you pick up a starving dog and make him prosperous, he will not bite you. This is the principle difference between a dog and a man.”