Next frontier of health reform: pets?
california considers whether insurers must post coverage
SACRAMENTO, Calif. — While states across the nation grapple with national health care reform, a new population of patients is gaining attention in California: cats and dogs.
Many feline and canine companions face health care challenges similar to those that confront humans. Veterinary care costs are skyrocketing as pet owners are offered a sophisticated menu of potentially lifesaving services, including kidney dialysis, sonograms and chemotherapy.
U.S. consumers spent more than $12 billion on veterinary care in 2009, according to the American Society for the Prevention of Cruelty to Animals.
Yet only about 1 percent of owners have health insurance for their pets. Those who do often don’t understand what the policy covers and excludes in an industry that has faced little regulation or even attention — at least until now.
Democratic state Assemblyman Dave Jones, who is running for state insurance commissioner in November, said some of the same practices being corrected by the recently enacted federal health care overhaul are used by pet insurance companies, including denying coverage based on pre-existing conditions.
Jones has introduced a bill that would make pet insurers post detailed information on Gary Lucks of Oakland, Calif., had to fight to get the pet insurance reimbursement he expected after his dog Bodie got cancer. their websites so consumers can see exactly what is covered and what is not. They could then compare options, just as if they were buying insurance for themselves in a post-health-reform world.
“A number of pet owners have complained to me that they bought a policy, and they weren’t told about pre-existing conditions,” said Jones, who has two cats, Dragon and Blanca. He said others have attempted to buy policies but were told that because of preexisting conditions in their pets, they couldn’t get pet insurance.
The bill also would mandate that an insurer disclose whether it will reduce coverage or increase premiums based on claims filed in the preceding policy period.
According to pet insurance companies and animal advocacy groups, Jones’ effort is the first of its kind in the nation. The bill passed the state Assembly and a Senate insurance committee. It awaits hearing before the Senate Appropriations Committee.
Pet insurance varies widely depending on the company selling the policy. Just as with human health insurance, policyholders pay monthly premiums. Most pet policies require owners to pay the bill in full and submit a claim to the insurance company for partial reimbursement.
That’s where confusion can comes in. Many policies state they will reimburse policyholders a percentage of reasonable and customary costs, but pet owners say veterinary charges can far exceed what the insurer considers reasonable.
“The time when you figure out how your insurance works is when you are in the throes of an emergency,” said Jennifer Fearing, senior state director for the Humane Society of the United States.
That was the case for Gary Lucks, whose dog Bodie was diagnosed with cancer at age 10. Lucks spent about $5,000 on Bodie’s diagnosis and treatment. He expected to be reimbursed about 85 percent of the cost but said he was paid back only about one-third.
Lucks, an environmental lawyer who lives in Oakland, wrote a complaint to the company and eventually was paid the 85 percent reimbursement. He then took the money and paid his research staff to write a policy paper and asked state lawmakers to take a closer look at the industry.