A Vet's Review of Physicians Mutual Pet Insurance
2024

• With certain plans, to get Prescription Drug and Exam Fee coverage you must remember to purchase the add ons
• This company has additional Injury and Illness situations that will be deemed pre-existing. See sample policy or contact the company for a complete description.
• 6 month waiting period Orthopedic-Related Conditions, this includes hip dysplasia. May vary by state.
  
  While the orthopedic waiting period can be waived by submitting a Orthopedic Waiver Form completed by a Veterinarian, please note that a Vet may want additional diagnostics (e.g. x-rays, ultrasound, etc) before they will feel comfortable certifying this. The cost of this will be out of your own pocket.
• Dental coverage for accidents and illness is limited

• Offers a variety of annual max payouts that will meet most people's "Worst Case Scenario Costs"
• Provides comprehensive coverage in the 5 important areas as part of the base plan:
  1. Chronic disease
  2. Continual coverage for chronic disease
  3. Hereditary/congenital conditions
  4. Cancer
  5. Breed specific conditions

• Physicians Mutual Pet Insurance plans are newer. Based on what I've seen since 2008, it can take time for a company to settle in on consistent premium pricing and policy terms.
• If a bilateral condition happens on one side before they policy starts or during the waiting period, that condition will not be covered if it happens on the other side. Even if it happens after the waiting period. Their Bilateral Conditions policy doesn't clearly list the medical conditions that fall under this exclusion.
  
  There are so many body systems that inhabit both sides of the body (e.g. eyes, ears, knees, hips, front paws, elbows, toenails, kidneys, lungs, femur, etc). Not clearly defining which systems they are referring to leaves a big door open that could allow them to deem something as a bilateral exclusion whenever they see fit. Letting customers know what specific conditions and/or systems fall under this exclusion would be much more transparent. Even if they want the definition to include all body systems that inhabit both sides of the body, it is important that they clearly let the customer know this.
• Based on their pre-existing conditions policy, signs and symptoms can be used to denote something as pre-existing. As with all pet insurance companies that use this wording, I have concerns that this can be used to deny claims even when these previous signs/symptoms are not directly related to the disease or condition currently in question.

• Make sure you research what customers are saying about the company. A company may have the 5 components that should be part of a pet insurance plan, but the company may not be a hit with customers. Sites to check include but are not limited to: BBB.org, Yelp.com and PetInsuranceReview.com. Things to look for include but are not limited to: How fast are payments paid?, What are customers saying about the pre-existing conditions policy?, How often are claims denied and for what reason?, What is the customer service experience like?, Are there issues with premium increases?
• Check with your state's Department of Insurance to see if any complaints have been filed for the company you are interested in.
• 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 sure you understand when and by how much 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.
• For some companies, pre-existing conditions can be based on signs and 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.

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