pre-existing condition for pet insurance

[Willow and J]

I want to hear from those who have pet insurance how their dog's pre-existing condition was defined and dealt with through an insurance company.

We have Petplan for three years and we haven't been able to use it once. I set my deductible wrong first two years and everything fell under the deductible, which I don't complain because 1) I was stupid and didn't understand Petplan's deductible is per visit 2) Willow's ailment wasn't severe enough to go over the deductible and 3) our vet doesn't charge that much.

But there has been 2-3 claims that I filed for and were all denied for "pre-exisiting condition". Willow came from the breeder with yeast infection in her ears, and because of that, Petplan considered all ear problems (not yeast infection but from unknown causes) or yeast infections (not her ears, but on her face, on her paws) pre-existing condition, which I don't agree but can understand to some degree. Treatment for itchiness whether it's her ears, paws, or whether it's yeast or unknown causes were all the same and relatively cheap - antibiotics, topicals, and steroids. So if they call all of these "pre-existing condition", then, okay, I can take it for now.

Several weeks ago, we went to a vet dermatologist because of persisting itchiness, and she's diagnosed with atopic dermatitis. And Petplan calls this a pre-existing condition too, and my claim was yet again denied. Previous visits relating to itchiness in various parts of her skin was suspected of allergy related symptoms, but there was no systematic diagnosis until now. Does this sound fair / usual to you that Petplan calls this a pre-existing condition too? Is this common across all pet insurance companies? Is there a pet insurance that would be more willing to cover in a case like ours ?

[Jane, Guinness and Murphy]

I think the key here is whether your Vet medical records show any entries for allergy related symptoms (with or without a formal diagnosis) prior to the initial effective date of your policy.  You need to get a copy of the medical records your Vet sent to Pet Plan (the two year history) and review it to see what was included.  Once you know that you may be in a position to dispute their decision.  This must be very frustrating.

[Christine & Camus]

I did not even bother to submit expenses for Camus' visits and treatment at the dermatologist because PetPlan had already decided that Camus' allergies were pre-existing based on a comment in his file.  The comment simply stated that the vet thought his ear infection could be allergy related.  This was in his chart about one week before I got the insurance, hence no coverage for any allergy related medications or visits.  I called them but got no where.

[Sue, Murphy and Bella ()*o*()]

I have pet plan and there are limits on the pre existing, such as ear infections. If there is no ear infection for 2 years either on the plan or prior to getting the plan, then It is no longer considered pre existing. I think giardia was 1-2 yrs as well along with a few others. I only know about the ears since Murphy has had bouts of horrible infections his whole life and since we were able to 1. Treat with medications we already had at home from previous visits and 2. Not take him in for this, so there were no notes on it, his last ear infection and subsequent visits for the same were covered.
Of course, if what we did at home was not enough to help him, we would have brought him in and started the two year time clock again. This is how it has worked for me and how I have understood it.

[Joanne ~ Spud*]

Oh no. I thought it was ear infections for one year, not two, for a preexisting condition

I actually had a nightmare ( so many lately) where Spud had an ear infection just 3 days before the year was up. This infection warranted a $3,000 surgical bill!!!! 

[Amy, Cubbie & Ollie]

went through the pre-existing thing for ear infections with Ollie and it is most definitely a 2 year period to get rid of that stupid pre-existing classification.

[F, Calla & Luca]

I think they only ask for 2 years of records. At least that is what they asked for for Calla when I had her gait checked out.

[Jane, Guinness and Murphy]

Yes Pet Plan asks for two years of records.

[Cyndi, The Boys & Callie]

Tank was throwing up severe enough to need the ER the week we brought him home. Nothing serious probably upset from all the changes. A few months later got a bug and was throwing up, same diagnosis, gastroenteritis. Then came the dreaded pre-existing denial letter. I had my vet write a letter stating there was were numerous causes and no way was the current condition related to the prior. The insurance promptly paid. I do not have pet plan but I would not think the definitation of pre-existing is different. Personally, I would talk with my vet and if he/she says one is in no way related to the other, I would ask they send a letter to the insurance. The opinion of the vet actually treating the condition over someone sitting at a desk making a decision should mean something. It may not work but you will have done about all I can think to do. Good luck

[Nancy, Ned, Clancy, and Charlie]

This is the main reason I don't have pet insurance.  I am one of those people who feel that basically all  insurance is a scam and if they can slide out of paying, the company will. My mom who is 90 just had her tetnus shot rejected by Medicare and her secondary insurance - a tetnus shot! Geez.   Do I wish I had insurance on my Springer Spaniel - my has-a-bunch-of-problems dog? Certainly - if they paid, but I have NO confidence that would happen.

[Karen, Jasper and Jackdoodle]

I gotta tell you, Nancy, I still wish I had gotten insurance for JD prior to his IBD diagnosis. And his ruptured disc. Just the diagnostics for those two things alone were almost $7000, and I'm pretty sure they could not have blamed them on his allergies, lol.

[Nancy, Ned, Clancy, and Charlie]

I wish I had gotten it for Gordie also, but I didn't because of my predjudice.  I would definitely get it now for a brand new puppy or rescue before  I did anything else.  We have spent $4,000 for each CCL surgery and over  $1,000 for this current dermatology episode.  We consider him our bionic dog.

[Karen, Jasper and Jackdoodle]

I hope Amy sees this, because she has the same issue going on right now. Ollie was just recently diagnosed with Atopic Dermatitis, and PetPlan is rejecting the claim and saying it's a pre-existing condition because before she got the insurance, Ollie had been seen for an infection on his paw, and his vet record listed it as a dermatitis. The vet never mentioned allergies and he had no allergy symptoms at that time.

I believe she is asking the vet to write the insurance company to clarify that the paw issue was not related to allergies in his opinion.

This may not help you, but I hope anyone who sees this discussion takes a couple of things away from it.

1: Get insurance for your dog the minute you bring him home, before there is any record of anything.

2: Always ask your vet what is being put in your dog's record any time he sees your dog for anything. The way that something is worded could cost you a lot of $ down the road.