Embrace Pet Insurance Blog

Claim Example: leg laceration on a Boxer

There are a couple of reasons to share this claim. The first being - OMG, it was expensive! The second being that it nicely illustrates how we handle claims that combine covered and non-covered conditions.

Dallas, a five year old female boxer living in Watchung, NJ, was playing outside for a minute and next thing her mom knows, she's limping. So she carries her in just to find blood all over her hand.

Turns out Dallas had torn a chunk of skin out of her leg, which needed anesthesia to check there was nothing embedded in the wound. While she was under, the vet did a teeth clean and ended up having to pull 13 teeth. Unfortunately, Dallas's policy did not have dental coverage so the teeth cleaning and the extractions were not covered by her policy.

So how did we split the costs of the shared items on the invoice? We estimated that 33% of the surgical time was spent on fixing Dallas's laceration so we split the common items that way.

Here's the invoice without the specific teeth items in it (it would be really really long otherwise - the total bill was $2,696.61) so you can see how the 33% was applied.

DATE	ITEM	BILLED AMOUNT	Shared?	COVERED CHARGES
1/6/2011	Hospitalization	$69.03	Y	$22.78
1/6/2011	Blood Pressure	$61.95	N	$61.95
1/6/2011	Catheter	$60.44	Y	$19.95
1/6/2011	IV Fluids	$61.88	Y	$20.42
1/6/2011	Torbugesic Injection	$42.85	Y	$14.14
1/6/2011	Anesthesia Inhalant	$164.77	Y	$54.37
1/6/2011	Anesthesia Addl	$238.70	Y	$78.77
1/6/2011	Buprenorphine Inj	$42.85	Y	$14.14
1/6/2011	Penicillin Inj	$33.80	Y	$11.15
1/6/2011	Atropine Inj	$33.80	Y	$11.15
1/6/2011	Laceration Repair	$258.76	N	$258.76
1/6/2011	Drain Insertion	$68.36	N	$68.36
1/6/2011	Bandage Application	$56.92	N	$56.92
1/6/2011	Buprenorphine HCL Inj	$42.85	Y	$14.14
1/6/2011	Waste	$5.70	N	$5.70
1/6/2011	Nurse Care	$36.17	Y	$11.94
1/7/2011	Boarding - medical	$52.14	N	$52.14
1/7/2011	E-Collar	$34.91	N	$34.91
1/7/2011	Bandage	$56.92	N	$56.92
1/6/2011	Discount	($56.92)	N	($56.92)
1/6/2011	Tax	$5.57	N	$2.44
Total		$1,371.45		$814.14

The calculation of the refund is as follows (from the Explanation of Benefits):

STEP 1: Calculate Potential Refund
Billed Amount:								2,696.61
Covered Charges:	(see attached detail)							814.14
Annual deductible remaining								200.00
	subtotal							614.14
Copay 20%	(your copayment)							122.83
Potential Refund								491.31
STEP 2: Compare potential refund against your annual maximums
Annual Maximum								10,000.00
Prior refunds for this policy year								0.00
Coverage remaining								10,000.00
Your total refund is:								491.31

Eek! That was a big bill. And what's worse is that if Dallas hadn't hurt her leg, her mom would continue to be unaware of her dental issues and Dallas might have ended up much more sick than she already was, particularly as she has a heart murmur.

What do you think?

Paws for Japan Day today

If we'd seen a movie of what is now going on in Japan, we'd say it was too far-fetched, to incredible to be believed. An earthquake, a tsunami, and a nuclear event at 4 reactor in the quake zone. What next - Godzilla and a meteor?

But we're seeing and believing it now as the awful events unfold with perfect clarity and horror. One minute, life is normal; the next, nothing will ever be the same again.

There are so many worthy charities to support at this time of need for Japan but there are three in particular I wanted to bring to your attention if you wished to support those that are pet focused:

World Vets - World Vets responders are on the ground in Japan working with Japanese animal welfare groups

Search Dog Foundation - six SDF Canine Disaster Search Teams are on the ground in the Tsunami zone looking for survivors and bodies

Japan Earthquake Animal Rescue and Support - a coalition of HEART-Tokushima, Animal Garden Niigata and Japan Cat Network, three groups that have been rescuing and rehoming animals in Japan for many years.

Thank you for chipping in what ever you can. Every little bit helps.

We're Adopting the Internet Today! Courtesy of Petfinder

Today is Petfinder's 15th anniversary and to celebrate, I have pledged to spread the word online about adoptable pets today, March 15, 2011.

My three cats, Lily, Rocket and Rosie were all adopted, either from a shelter or from "under the gooseberry bush" and I encourage all of you to consider adopting your next cat or dog. All you need to do is go online to search the type of dog you are looking for.

Petfinder has so many beautiful cats and dogs on their website but I thought I'd pick one for you in the Cleveland area - just in case you happen to live nearby.

Here is Gracie, a Husky / German Shepherd Dog mix (Cleveland, OH) and here's her story:

Gracie is a very sweet 5 year bundle of joy. Gracie is very well behaved, likes other dogs, cats, and children. She is a very smart girl who will make a family a wonderful pet. She has lots of love to give and she needs to find a new forever home. Her former owner suffered some medical problems and had to be put in a nursing home. Please help Gracie find a new owner she can love.

 

Don't you just want to wrap her up in your arms and take her home with you?

Cardiomyopathy in Cats

Cardiomyopathy is any disease of the heart muscle but diseases of this type tend to fall into one of three major categories:

Dilated cardiomyopathy -  inability of the cardiac muscles to contract properly. In cats, it's almost always caused by the deficiency of Taurine in the diet so is preventable and treatable

Hypertrophic cardiomyopathy - most common in cats, an abnomally sized left ventricle that is assumed to be hereditary

Restrictive cardiomyopathy - where the heart muscle fills in the chambers. Occurs in cats but rare

Cats go their whole lives without any symptoms; however, others may: 

• collapse or have difficulty breathing (often the result of major changes to heart rhythm or congestive heart failure, respectively)
• have sudden life-threatening blood clots (usually leading to hind limb weakness or paralysis known as Saddle Thrombus) or
• suddenly die (for those who suffer sudden, devastating electrical disturbances to their heart rhythms)

Diagnosis generally involves looking at the heart with:

• X-rays (demonstrating marked enlargement of the heart),
• EKGs (electrocardiograms, which may or may not show electrical disturbances in the heart) and
• cardiac ultrasonography (echocardiograms) to elucidate the physical changes in the heart muscle (most effective)

Maine Coon cats and American Shorthairs are most prone to cardiomyopathy, though all cats are potentially at risk.

For more details, the Embrace Pet Health Center has a very informative view of Cardiomyopathy written by Dr. Patty Khuly.

Related Posts:
March is Genetic Condition Month at Embrace Pet Insurance
Guest Post: the importance of consider hereditary conditions when choosing a dog
Claim Example: portosystemic shunt surgery
Cardiomyopathy in Cats 

Claim Example: calcium oxalate kidney stones in dogs

Poor little Lokey, just a year old and already suffering from bladder stones; more specifically calcium oxalate stones.  This poor French Bulldog had to undergo surgery to remove the stones and has had several claims as a result. 

Total costs for the condition over just a few weeks accumulated to $1,010.99.  Because Lokey had already had a previous claim to meet his annual deductible, his mom got an automatic 90% of the surgery and aftercare covered, making her reimbursement $847.15.

Date	Diagnosis	Claimed	Covered	Paid
1/4/2011	Bladder Stones Surgery	$888.12	$818.40	$736.56
2/8/2011	Resolving Hematuria	$83.93	$83.93	$75.54
3/1/2011	Recheck Urinalysis	$38.94	$38.94	$35.05
	Total	$1,10.99	$941.27	$847.15

Note that the difference between the claimed and covered amount on the surgery was a correction for a pre-existing Umbilical Hernia Repair that was not covered.

Angela writes:

I'm very grateful for the coverage provided for the bladder stones.  It helped us out so much!...You guys have been great to deal with and I will be happy to do a review….I've attached some of my favorite pictures of Lokey and he also says thank you so much!!  I really appreciate everything you've done and hopefully we won't have any more claims for a while!

The Wonders of a $1,000 Deductible Pet Insurance Plan

I was looking at the high dollar claims that came in to Embrace today and here are a few that stood out:

• $1,308.78 Patellar Luxation claim  ($1,553.64 already claimed for this condition this year) in a 3 year old Golden Retriever
• $2,051.25 Congestive Heart Failure secondary to Hypertrophic Cardiomyopathy in an 8 year old mixed breed cat
• $1,636.24 Eyelid Mass Removal Left Eye in a 3 year old Doberman Pinscher

None of the people looking after these pets had any idea that they were going to be facing such high dollar claims for such young pets. Could that be you?

Since quite a few people question the cost of pet insurance, believing their pets will not have a claim, and certainly not a high dollar claim, I decided to do a quote for each of the pets above as if they had a $1,000 annual deductible - a much more affordable policy with still great coverage.

Here's the new Embrace Pet Insurance premium assuming $1,000 annual deductible, 20% copay, $10,000 maximum, and prescription drug coverage, all living in Cleveland OH: 

• $12.42/month for the 3 year old Golden Retriever
• $7.08/month for the 8 year old mixed breed cat
• $15.64/month for the 3 year old Doberman Pinscher

BONUS: if you were adding these to another pet already insured, you'd save another 5% off the new pet's premium, PLUS another 5% off the other pet. For example, if the other pet is a Golden Retriever, the savings could add up to another $3 per month.

You'd practically be getting your high deductible pet for free!

The point is, for the cost of one lunch out per month, you could be protecting yourself from some pretty serious veterinary surprises.

Food for thought anyway.

Do you just love Embrace? Be an Embrace Pet Insurance Ambassador!

This is not the time to be modest so here goes.

We often find our Embraced pet parents telling us how they rave about Embrace with their friends and family.

It warms the cockles of my heart, it surely does.

Some even expound our virtues to their veterinarians and bug them about not having any Embrace brochures in their clinics.

*gasp* It does happen!

So, we thought we would help. Wouldn't it be fun if you had something to take along to your veterinarian just in the case you become a little tongue tied in his or her presence? Voila! The Embrace Ambassador program.

All you have to do is go to the Be An Embrace Ambassador page on our website, download and print the handy sheet (sample below), and take it to your friendly vet staff. That's it! If you wish to expound further, feel free!

Isn't that a lot of fun? 

Oh please do tell us what they thought of your ambassadorship. I can't wait to hear!

Claim Example: portosystemic shunt surgery

I am not a veterinarian so I had never heard of a Portosystemic Shunt before working in pet insurance. Have you ever heard of it before now?

Despite my ignorance, a Portosystemic Shunt is a serious hereditary condition that affects both small dogs (particularly Yorkshire Terriers and Miniature Schnauzers) and large dogs (Irish Wolfhound) as well as people too.

What is a Portosystemic Shunt?

For those of us not versed in veterinary speak, it's a blood vessel that bipasses the liver so that some of the dog's blood is not scrubbed of toxins and the liver doesn't get the blood flow it needs to do some of the other good stuff it does like help the immune system and produce important blood chemicals. Over time, the poisons accumulate and the dog eventually dies if left untreated.

Treatment

Surgery is the most effective treatment where the offending blood vessel is clamped off, forcing the blood to go where it's supposed to. I've seen surgery costs range anywhere from $2,000 to $5,000 so it's definitely something you want pet insurance to cover given the costs involved (make sure your pet insurance policy covers hereditary conditions though).

Here's a claim example from 2010 from a simple surgery on Ozzie, a 1 year old Yorkshire Terrier in Havre De Grace, Maryland.

DATE	ITEM	BILLED AMOUNT
1/14/2010	Referral Examination	$121.00
1/14/2010	Protein C	$45.00
1/14/2010	Bile Acids Test	$50.50
1/14/2010	Nuclear Med Portal Scintigraphy	$120.00
1/14/2010	Butorphanol -Omnicell	$6.00
1/15/2010	Lactulose Syrup	$6.00
1/15/2010	Biopsy	$53.00
1/15/2010	Cefazolin -Omnicell	$7.00
1/15/2010	Buprenorphine	$18.00
1/15/2010	Dextrose 50%	$4.00
1/15/2010	Professional Fee	$42.00
1/15/2010	ICU Care Level 2	$100.00
1/15/2010	Portosystemic Shunt, Extraheptic	$184.00
1/15/2010	Professional Services	$300.00
1/15/2010	Material Charges	$75.00
1/15/2010	Inhalant	$277.00
1/15/2010	Doppler	$21.00
1/15/2010	Bair Hugger	$16.00
1/15/2010	Misc Drugs	$40.00
1/15/2010	Continous Rate Infusion	$16.00
1/15/2010	Ventilator Surcharge	$16.00
1/15/2010	Dopamine	$0.75
1/15/2010	Initial Fluid Set up	$100.00
1/15/2010	PCV/TP	$8.50
1/15/2010	Glucometer Reading	$34.00
1/16/2010	Meloxicam Suspension	$6.00
1/16/2010	Neomycin	$6.00
1/16/2010	Buprenorphine	$18.00
1/16/2010	Meloxicam Inj	$6.00
1/16/2010	Professional Fee	$42.00
1/16/2010	Professional Fee	$42.00
1/16/2010	ICU 1/2 day	$47.50
Total		$1,828.25

This surgery was performed at a specialty clinic at the University of Tennessee's College of Veterinary Medicine. More complex surgeries can run over $4,000, depending on the number and location of blood vessels involved and where they were performed.

Ozzie's pet insurance payout was calculated as follows:

STEP 1: Calculate Potential Refund
Billed Amount:							$1,828.25
Covered Chgs:							$1,828.25
Annual deductible remaining							$0.00
	subtotal						$1,828.25
Copay 10%	(your copayment)						$182.83
Potential Refund							$1,645.42
STEP 2: Compare potential refund against your annual maximums
Annual Max							$10,000.00
Prior refunds for this policy year							$46.48
Coverage remaining							$9,953.52
Your total refund is:							$1,645.42

Ozzie had a $500 annual deductible, which had already been used up by his preliminary visits to the veterinarian to investigate his illness, and a 10% copay and $10,000 annual maximum. His policy premiums are $278.14 a year.

Do you have a dog that has gone through this surgery?

Related Posts:
March is Genetic Condition Month at Embrace Pet Insurance
Guest Post: the importance of consider hereditary conditions when choosing a dog
Claim Example: portosystemic shunt surgery
Cardiomyopathy in Cats 

Guest Post: the importance of considering hereditary conditions when choosing a dog

Today, Dr. Rex Riggs talks about hereditary conditions in dogs. Dr. Rex Riggs is the owner of Best Friends Veterinary Hospital in Powell, Ohio. He is a veterinarian, and an Advisory Board member of Embrace Pet Insurance.
_________________________________________________________________________________

When we talk about pure bred dogs and cats we need to realize that along with the individually beautiful traits, specific to a breed, hidden harmful genetic traits can often be lurking.

Mixed breed animals often get the best traits of each breed they are mixed with, called hybrid vigor. They are often healthier then their pedigreed counterparts. Mixed breeds are not immune to genetic defects though, but the conditions occur much less frequently.

Purebred dogs are dogs whose parents have been bred to another of the same breed. When you breed within a specific breed group, you decrease the gene pool, thus allowing genes that are normally recessive to be expressed.

Some of these hidden genes can be good; some can be bad. Hair color, disposition and size are some of the desirable traits that breeders try to emphasize. The more popular a breed becomes, the more of the unfortunate genes become expressed. Multiple hereditary diseases are seen in specific breeds. Some of these diseases which have a genetic component include hip dysplasia (many large breeds), cataracts (huskies), kidney disease (Shih-Tzu), liver disease (poodles and yorkies) and breed specific cancers, just to name a few.

One such disease with a breed predilection is malignant histocytic diseases in Bernese Mountain dogs. This is a rare but nasty disease in most breeds but unfortunately is becoming more commonly seen in Bernese Mountain dogs.

Malignant histiocytosis is a cancer syndrome which can present in many different ways. It can present as a solitary nodule in the lungs or the dog can present with neurologic signs such as paralysis or seizures. It can also attack the bone marrow causing all sorts of problems with white and red blood cells. In addition, abdominal organs such as the spleen and liver are often affected and the pet presents with vague and nonspecific signs.

Diagnosis involves biopsies of the affected organs and blood, and can be difficult to make. There have been cases in which the dogs responded to chemotherapy but the vast number of dogs affected will not respond to treatment. It is such a heartbreaking disease. I know many of the Bernese Mountain dog breeders are well aware of this problem and are working hard to eliminate this disease from the breed.

So why am I depressing you with this story?

I want you to please do your research on the breed you want to get. You need to know what they are predisposed to. You need to know what questions to ask the breeder. Even though this is a common problem seen in Bernese Mountain dogs, I am sure many owners have never heard of it. I know this is true of other breed owners and the conditions their pets are genetically prone to. So don’t be afraid to ask questions of your breeder. Good ones will be happy to answer you.

It takes diligence and ethical breeding policies to eliminate hereditary and genetic problems. The United States have a much higher incidence of genetic conditions when compared to the rest of the world. We have much more lax laws concerning breeding of dogs and cats which allows puppy mills and unethical breeders to flourish in some states (unfortunately, my home state of Ohio, is one of the worse) making a lot of money at the expense of the animals and their heartbroken owners.

Finally…… don’t buy pets online or from pet stores. They invariably come from puppy mills, which do not concern themselves with the health issues of a particular breed or dog.

Related Posts:
March is Genetic Condition Month at Embrace Pet Insurance
Guest Post: the importance of consider hereditary conditions when choosing a dog
Claim Example: portosystemic shunt surgery
Cardiomyopathy in Cats 

Other posts by Dr Riggs

___________________________________________

Dr. Rex Riggs grew up in Wadsworth, Ohio, near Akron. Dr Riggs is co-owner of Best Friends Veterinary Hospital in Powell, Ohio. He is also on the board of the North Central Region of Canine Companions of Independence, a board member of The Ohio State College of Veterinary Medicine Alumni Society and Small Animal Practitioner Advancement Board at The Ohio State College of Veterinary Medicine. Dr. Riggs lives in Lewis Center, OH with his wife Nancy, their dogs Maggie, and two cats Franklin and Speeder. Outside of work, Dr. Riggs is an avid golfer and enjoys travel and photography.

March is Genetic Condition Month at Embrace Pet Insurance

Pop Quiz: which of the following conditions can be hereditary in dogs?

• allergies
• glaucoma (clouding of the eye)
• hanging tongue (tongue does not retract properly)
• hygroma (fluid filled sac on dog's elbow)
• flank sucking (licking the skin on the side of the body)
• patella luxation (slipping knee cap)
• pyometra (bacterial infection of the uterus)
• skin neoplasms (tumors of the skin)
• zinc-responsive dermatitis (scaly skin that responds to zinc in the diet)

What do you think?

Well, the answer is ALL of them.

Fr example, while allergies aren't necessarily hereditary, there are some breeds that are known to be more prone to allergies than others, hence the genetic component (such as Dalmatians, Retrievers (especially Golden Retrievers), and Terriers.)

That is why it is so important to know what conditions your pet's breed is prone to and how to deal with them. (our Pet Health Center has a comprehensive list of breeds and their health conditions)

And of course, there's how pet insurance treats hereditary conditions - either as pre-existing even if there are no clinical signs or only pre-existing if there are clinical signs. There's a big difference. (Embrace is part of the latter group - we cover hereditary conditions as long as there were no clinical signs of the condition)

Have you had a dog or a cat (they aren't immune) that had a hereditary condition you knew nothing about beforehand?

Related Posts:
March is Genetic Condition Month at Embrace Pet Insurance
Guest Post: the importance of consider hereditary conditions when choosing a dog
Claim Example: portosystemic shunt surgery
Cardiomyopathy in Cats