A Vet's Review of ASPCA Pet Insurance

by Frances Wilkerson, DVM

This review discusses coverage and payout structure

To get the most from this review, please read the Guide to Pet Insurance first.
For a detailed look at ASPCA, see ASPCA's Comparison Sheet.



Overview

ASPCA / Hartville / PetsHealth Pet Insurance brands are all under one company, Hartville Group, Inc.

Hartville Group, Inc has offered pet insurance since 1997.

This review refers to the following plans: Level 2, Level 3, and Level 4.



Coverage Overview

In general, ASPCA / Hartville / PetsHealth Pet Insurance covers diagnostics and lab tests, surgery, treatments, hospitalization, and prescription medications for accidents/injuries and illnesses as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.

I would like to see more clarity for the pet owner on whether or not they cover the exam fee for accidents/injuries and illnesses.

Non-routine dental coverage is limited.



Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

ASPCA / Hartville / PetsHealth Pet Insurance offers coverage for chronic diseases, but if your pet develops a chronic disease that is hereditary/congenital in nature you will not be covered.



While ASPCA / Hartville / PetsHealth offers continual coverage for chronic diseases, you must remember to purchase it as an add-on. If you do not purchase the 'Continuing Care' add-on and your pet acquires a chronic disease, that medical condition will only be covered the first year it is diagnosed, unless 180 days have passed since cure and last treatment.

Because many chronic diseases continue for the life of the pet, continual care for chronic conditions should be a part of the base plan not an add-on. Pet owners who do not have a medical background may not understand the importance of this type of coverage and skip it. Making it part of the base plan would be a benefit to the pet owner.



Hereditary & Congenital Coverage

ASPCA / Hartville / PetsHealth Pet Insurance does not cover hereditary or congenital conditions including hip dysplasia. This is one of the important pieces of coverage that must be part of any pet insurance plan. (See: 5 Points of Coverage Your Pet Insurance Plan Must Have).





Cancer Coverage

ASPCA / Hartville / PetsHealth Pet Insurance offers cancer coverage but...
  1. If you do not purchase the 'Continuing Care' add-on and your pet acquires cancer, that cancer condition will only be covered the first year it is diagnosed, unless 180 days have passed since cure and last treatment.
  2. If a cancer is shown to be due to hereditary/genetic reasons, it may not be covered.



Coverage For Breed Specific Conditions

Breed specific medical conditions often occur as hereditary/congenital issues. ASPCA / Hartville / PetsHealth Pet Insurance does not cover hereditary/congenital conditions so coverage for breed specific conditions is minimal.



Maximum Payout Structure

ASPCA / Hartville / PetsHealth Pet Insurance has a per-incident maximum payout structure combined with an annual maximum payout structure. While the annual maximum is very generous, there is a maximum you will receive per-incident depending on the plan you purchase. This per-incident maximum payout may work for people who's calculated "Worst Case Scenario Costs" are on the low end...but if your calculated "Worst Case Scenario Costs" are higher than $5,000 then the payout may not meet your needs. (See: Picking the Right Maximum Payout)


The 'Continuing Care' add-on has it's own per-incident limits and lifetime limits. This means there is an additional limit on how much you will be reimbursed for ongoing / recurring conditions. This limit may not be enough for some.



Summary of Coverage and Payout Structure

Gotchas

  • No hereditary or congenital coverage
  • The per-incident payout structure may not be enough for those with high "Worst Case Scenario Costs"
  • Offers continual coverage for chronic diseases, but you must remember to purchase it as an add-on AND it has its own per-incident limits and lifetime limits which may be too low for some
  • If a cancer is shown to be hereditary or genetic, it may not be covered
  • Non-routine dental coverage is limited



Good Points

  • Strong underwriter
  • Coverage when travel out of state or to Canada



Additional Comments:

  • Make sure you understand what the waiting periods are.
  • Make sure you understand their bilateral conditions policy.
  • Make sure you understand any requirements that you must adhere to to maintain coverage.
  • Make sure you read the terms and conditions to get a thorough understanding of all exclusions.
  • Make you call the company to understand how and when your premium can increase.
  • If you change plan levels, there is a possibility that all medical conditions present under the old plan will be considered pre-existing in the new plan. Make sure you ask the company if this is the case.
  • Pre-existing conditions can be based on symptoms alone, a diagnosis is not needed. For example, if your pet had a cough before you applied for pet insurance and this cough was discussed and written in the pet's medical record, there is the possibility that all future cough conditions, no matter what the cause, would be considered pre-existing - even if there was no treatment given. Make sure you ask the company if this is the case.
  • Pet insurance companies are businesses. The top priority of any business is to make a profit for their stakeholders. Pet insurance companies can and may change your rates and terms to meet that top priority. A change of business ownership or underwriters can also be a catalyst for changes in your rates and terms.

    When you purchase pet insurance make sure you have a realistic understanding of this and how it can affect you.


Additional Reviews:

AKC | ASPCA | Embrace | Healthy Paws | PetFirst | PetPlan | Pets Best | Purina | Trupanion | VPI | 24 Pet Watch


**Disclaimer:This review is meant to supplement not replace your own due diligence. Please read all terms and conditions of the pet insurance plan before you buy.

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