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Thread: Petplan - a HUGE THUMBS DOWN!

  1. #11
    Senior Member JamesTannery's Avatar
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    Are there any good alternatives to PetPlan?
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  2. #12
    Senior Member John Robinson's Avatar
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    We have had good results working with our pet insurance companies, but we had to learn the system. First lesson, pet health insurance is not human health insurance. Our pets may be family to us, but they are legally property, so you shouldn't think about it like you do your HMSA. Two you need to have careful consultations with your vet and advise him or her of the issues in dealing with your insurance company, you may have to time a certain procedure relative to the annual policy, and your vet has to be careful in how he or she phrases the diagnoses on the insurance form. I am in no way advocating any kind of cheating or fraud, I just think if your vet was more on top of the insurance issues, the form could have been filled out truthfully, but in a manner so that the insurance company would have a hard time arguing a connection between the prior illness and this episode.

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  3. #13
    Senior Member Buzz's Avatar
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    Quote Originally Posted by Rainmaker View Post
    They've covered everything for me and it was simply a matter of faxing the records and making sure the claims form, which is quite simple, was complete. Was hardly a big deal. Now, when I worked for a vet, VPI was a royal pain of an insurer when it came to paperwork and they were the ones paid very little and argued over every little detail. But, comes down to it, I'd just be happy with my dog being healthy and sound at the end of any illness or accident. If the bill's reimbursed at all, that's gravy.

    I had trouble with PetPlan back when I was using a vet that did not do a good job of record keeping. I have since switched to a vet that is more expensive, but the vets are very good, very thorough, and very good at keeping complete records. Since I made the switch, I have had no problem. I even got reimbursed for a c-section on Raven, a procedure I've read on here about others having difficulty with in dealing with PetPlan.

    And don't forget about doing annual wellness exams and dental exams. Be careful about following vet advice. And be sure that your vet NEVER puts anything in records about recommending spay/neuter etc...
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  4. #14
    Senior Member JS's Avatar
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    Are dental claims not covered by PetPlan?

    I have a policy and am expecting a tooth extraction sometime in the future. Dog has a slab fracture ... took a dive at a bird laying on a rock. Per the vet's advice, we deferred treatment but watch it closely and expect to see an abscess at some time and will then need to extract the tooth.

    I have no idea how expensive that procedure can be.?.

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  5. #15
    Senior Member Ted Shih's Avatar
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    I recently took my 10 year old female in for her annual check up. Vet said that she had three bad teeth that needed to go. We did surgery. Pet Plan processed claim. Check for reimbursement on its way. 20% co-insurance, then $100 deductible under my plan.

    Pet Plan also has a pre-authorization process you can use. I have not tried that yet

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  6. #16
    Senior Member frontier's Avatar
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    Quote Originally Posted by Ted Shih View Post
    I recently took my 10 year old female in for her annual check up. Vet said that she had three bad teeth that needed to go. We did surgery. Pet Plan processed claim. Check for reimbursement on its way. 20% co-insurance, then $100 deductible under my plan.

    Pet Plan also has a pre-authorization process you can use. I have not tried that yet

    Ted
    I just went thru the pre-authorization process for Pet Plan. Took two weeks and repeated phone calls between the vet surgery center and Pet Plan agent because Pet Plan rejected the first submission because vet's office estimate breakdown was not detailed enough. Finally received pre-approval today for the surgery in January. If the surgery center office staff had actually followed the directions on the form, the process would not have taken so long.
    Last edited by frontier; 12-27-2012 at 04:39 PM.
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  7. #17
    Senior Member J. Walker's Avatar
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    Quote Originally Posted by Buzz View Post
    I had trouble with PetPlan back when I was using a vet that did not do a good job of record keeping. I have since switched to a vet that is more expensive, but the vets are very good, very thorough, and very good at keeping complete records. Since I made the switch, I have had no problem. I even got reimbursed for a c-section on Raven, a procedure I've read on here about others having difficulty with in dealing with PetPlan.

    And don't forget about doing annual wellness exams and dental exams. Be careful about following vet advice. And be sure that your vet NEVER puts anything in records about recommending spay/neuter etc...
    Actually, my vet's documentation is outstanding. It's a large practice with FIVE veterinarians, I don't know how many assistants, two waiting areas, a full modern boarding facility, etc. My vet actually specializes in canine infectious disease. The bottom line is that Petplan had highly detailed documentation but even their agent said since the vet referenced "arthopathy" again, that it was a "pre-existing condition." I talked until I was blue in the face telling her she (or someone) needed to actually review the documentation as it was clearly evident the actual symptoms and even test results were dissimilar. The bottom line is that they were looking for any means possible to deny the claim. I've gotten with my vet and we're going to resubmit it with further explanation for what clearly shouldn't need further explanation.

  8. #18
    Senior Member JusticeDog's Avatar
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    Quote Originally Posted by J. Walker View Post
    Actually, my vet's documentation is outstanding. It's a large practice with FIVE veterinarians, I don't know how many assistants, two waiting areas, a full modern boarding facility, etc. My vet actually specializes in canine infectious disease. The bottom line is that Petplan had highly detailed documentation but even their agent said since the vet referenced "arthopathy" again, that it was a "pre-existing condition." I talked until I was blue in the face telling her she (or someone) needed to actually review the documentation as it was clearly evident the actual symptoms and even test results were dissimilar. The bottom line is that they were looking for any means possible to deny the claim. I've gotten with my vet and we're going to resubmit it with further explanation for what clearly shouldn't need further explanation.
    If you need the email address of the head vet, I can get it for you.

    The trouble is that the claims reps are purportedly vet techs. As we know, all are not created equal. My most recent issue: I had one look up a medication, deny paying for it because I should have to submit another claim for a "stomach issue", which the dog did not have. This would require another deductible, etc, and another "label' on the diagnosis list. This chick then went on to tell me she was going to submit it back through claims. But she had not. She had lied. She went on to tell me that she ad 10 years of experience as a vet tech and had looked it up online. (It must be true if it's on the internet). And when I asked her where she went to vet school and obtain her DVM, she had nothing to say. I told her it was not up to her to second guess my vet. Just to pay the claim. The record did not reflect a stomach issue, and I was not going to let her create one for the dog. I demanded that the claim be sent back through, and they had one of their staff vets contact mine. The claim was paid.D This second guessing is part of their M.O.

    While getting your dog healthy is the ultimate goal, paying the claim is te company's contractural obligation. Companies like this count on people just being grateful for what they give them in reimbursements and walk away from the disputes.

    Like you, my vet's practice is large. Documentation is not the issue.


    TPLOs are straight up ortho injuries, which they have no problem with, unless it goes on too long ie: rehab. A tooth fracture is also straight up. There is either coverage or not.

    I have only had one problem with my VPI policies in 10 years, they just don't provide the coverage I want. I have 2 policies with Purina Care. Embrace has gotten good reviews on this board under product review. Jeff Telander who writes on this board has had good luck with Pet's Best. I have also heard good reports about Trupanion.
    Last edited by JusticeDog; 12-27-2012 at 10:42 PM.
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  9. #19
    Senior Member J. Walker's Avatar
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    Well, after jumping through hoops, filing another claim, getting a detailed letter from my vet stating that he had no reason to believe the two incidents were related, as well as presenting the laboratory results from both incidents, the claim was denied AGAIN! I have cancelled my policy and recommend that others do the same because if you think they're not looking for any way possible to deny a claim, guess again. The lab results were COMPLETELY different. The ONLY similarities were that my dog had lameness (although in one limb the most recent time and all four the previous time, what they're calling the "pre-existing" condition) and that antibiotics were administered. In the second incident, they were administered as a precaution because no pathogen was ever found. Basically, if your dog has EVER had any common malease (nausea, loss of appetite, lameness, etc.), prior to you getting a Pet Plan policy, your claim WILL be denied whether the latter incidents were related or not.
    Last edited by J. Walker; 02-17-2013 at 06:55 PM.
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  10. #20
    Senior Member sick lids's Avatar
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    I showed a few offers for pet ins to my ins guy and he told me to put $30-$50 a month in savings every month and skip the plan. Most likely I will be ahead he said after looking at the maximum pay outs. Remember they exist to make money not help us.

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