Dog insurer: 'jumping, running, slipping, tripping, playing' not covered (2016)
cbc.ca
cbc.ca
Costs for various treatments are already negotiated ahead of time and hospitals/doctors bill insurers directly.
If the insurer thinks you received some kind of treatment you shouldn't have, it's between them and the hospital/doctor.
Of course there's always the odd/fancy treatment people insist on getting that is not covered. In that case you'll be billed by the hospital.
In neither case you'll be fighting any insurance company personally.
Can't say I'm too fussed about impoverished people getting a few boxes of diapers, and using ambulances for transit reveals an underlying societal problem more than individual greed.
If people are willing to go through that much trouble just to get from A to B or to save a few dollars on diapers, there's something wrong.
They're investing hours and go through quite a hassle just to possibly save single digit amounts of dollars.
You don't do this if you don't think you have to.
The ambulance rides do tie up the system however. I have a cousin who is an EMT and between rescuing overdoses he has regulars they have to taxi because they have a cold, or something else trivial. There is public transportation, but even that would cost them personally and requires waiting. It's probably better to let a few selfish people take advantage of the system in the long run, but it amazes me how selfish some people can be when there's people in real need out there.
Canadian health insurers haven't been involved in any of the surgeries or pregnancies in my family. Where they were involved: dentists, massages, medications, I've never had any hassle.
Dealing with a pet insurer was eye opening. I can't imagine having to deal with that while a loved one was sick.
The GP post is exaggerating quite a lot.
There are of course disagreements, but it's the exception rather than the rule. I just two weeks ago went to a specialist and got a prescription, with no questions asked.
The American health insurance system is broken. Time to toss it out and try something else.
There are also private health insurance plans that cover things not covered by the public insurance, optometrists and dentists fall under that category as do most paramedicals. When Canadians talk about 'health insurance' we're typically referring to the private kind.
The concept itself of fighting either my health-care provider or my (state-mandated) health insurance to get coverage is completely foreign to me and I'm only familiar with it thru the Internet by reading what people from the USA write.
The last few times I can think of paying for anything other than glasses/contacts:
- $40 for a doctor visit and x-ray when I sprained my wrist and had forgotten to renew my health card. Reimbursed when I did renew.
- $25 for a month supply of bupropion (Zyban) for quitting smoking
- $9 for a bottle of Tylenol-3 after my knee surgery (completely covered otherwise)
Things that have been covered 100%:
- stitches when I got kicked in the head while tubing behind a boat
- stitches when I sliced my finger open with a knife (stupid kid stuff)
- appendectomy
- knee surgery #1 - meniscus cartilage tear when I was a kid, didn’t start acting up until my 20s. This included an MRI, a consult with a sports medicine surgeon, and the surgery
- knee surgery #2 - same knee, tore it up again 5 years later while skiing. Only cost here was optional physiotherapy afterwards, at $50/session.
The big problem seems to be the soaring prices due to the fight between insurance companies and the hospitals. Depending on who you ask, you get a different opinion on who's fault it is.
Overextending yourself, glossing it over with an extended warranty, and abdicating your pet's health to corporate cost-optimization is not a nice thing to do. The hard-to-hear responsible thing is to not get a pet until you're in the financial position to take care of them!
Let us hope this whole idea of "pet insurance" will be history in several years, rather than it succeeding in turning the veterinary industry into an overfinancialized clusterfuck like human healthcare.
Social media gives us a biased impression, as selling your truck and maxing out your credit cards to pay for your dog’s chemotherapy gets upvoted as a heartwarming feel good story, regardless of the wisdom of doing so.
On the other hand, I had a vet tech friend who said that most people would opt out of treatments that cost more than $200-$300. That's how much they value their pet.
Worthless political echo chamber hyperbole and demonstrably false.
Just off the top of my head: Virtually every American with health insurance can get flu shots for free, paid for by their insurance carrier. Ditto for women who want birth control pills (though that is usually a legislative mandate).
A friend works for a small insurance company, and she says it paid over a billion dollars in claims last year for fewer than 50k members.
The American health insurance industry is completely fucked if you think it has anything to do with providing healthcare and isn't entirely about maximizing profits for the inner circle. People are literally dying because we have the least efficient health insurance system in the world. And it's designed that way because some people are getting ridiculously wealthy from other people's pain and suffering.
Then check with your state's attorney general. In many states, insurance companies are required to provide it at no cost. Certainly in the last three states in which I've lived.
If it's not required in your state, then contact your legislators and try to get a law passed.
For example, the first back injection was denied the first time one the basis that "it was not inhibiting her daily function". The notes from the doctor submitted to insurance specifically said "the pain in her back is inhibiting normal daily function." They reject it just to see who will fight back. Furthermore, insurance is only required to look at notes from appointments and will ignore comments from doctors if they aren't tied to anything. So in order to fight an insurance claim requires another appointment with the doctor which costs more money just to get the insurance company to look at the claim again and get it approved.
It's a terrible game.
These tend to make financial sense for insurers - flu shots are cheap and a lot cheaper than hospitalizations, same thing for avoiding pregnancy... and even then, both were explicitly made free via the ACA, not the kindness of health insurers.
These aren't the sorts of claims insurers kick up a fuss over.
We had Buster, the GSD, for 13 years and over the course of that time his vet treatments cost a fair amount in addition to normal stuff
* Root canal (he broke a fang chewing a rock)
* 2x surgery for ACLs in both hind legs
* surgery to remove carcinoma on his jaw
* prednisone shots for arthritis
That probably comes to something around $10K over those 13 years. But really, it's not that different from what we'd have been paying in premiums anyway.
My dog got it suddenly at around 1.5 years old and our insurance paid out for the full emergency surgery (about 5k) with no issues; as with any providers the details are what matter.
Care to share more? What was the premium for the cat? Are you American?
Those plans cost in the hundreds of dollars, vs the US plans which cost in the thousands.
What makes me the most upset about these little games of chance companies want us to play, is how it takes advantage of certain demographics, like the elderly.
That offer really caught me off guard.
I was shocked by the 15% premium! I could self insure and break even if 1/6 products were defective.
Televisions will be around for years. The 3 toothbrush heads should last under a year. How are they going to break? I'm sure the manufacturer would give me a coupon for a free head if something was wrong, and it'd take about the same amount of time as finding the receipt, driving to, and doing a return at Walmart.
You should never insure anything you can afford to replace yourself.
But there are many people who don't understand the math or theory of insurance. And those people often have less overall education and earning potential. And those people are getting swindled hard.
I find that most people have such an emotional loss aversion, that there is no point to explaining the math or the simple concept of only insuring losses that you can’t afford.
You can even try to show them that if the grocery store offered insurance for a cucumber, would they buy it? And they will say no, and if you ask why, it’s because they can buy another cucumber for not much money.
But then they will turn around and buy insurance for a TV that costs a few hundred dollars, even though they can very well afford a new TV.
So I stopped seeing it as people getting swindled. What I see as having negative utility, they percent as positive utility due to the emotional comfort it provides.
This is true if you are an average person. If you know yourself to be a higher-risk, it could be a good deal.
4.01 'Revel provides third party auto liability coverage ... if the Member complies ... with all terms and conditions of this Agreement'
2.06 'maintain a safe driving record during the entire Term'
https://gorevel.com/rental-agreement/
consumers have been generally willing to sign long contracts without reading them but small businesses with legal resources are going to start getting burned by their vendors and insisting on shorter, simpler, fairer contracts (I hope). These contracts are pure slime.
The insurance policy doesn't cover running, jumping, playing... Things that any healthy dog do. But they also don't cover "preexisting conditions".
So... if your dog doesn't play, he is unhealthy and therefore he isn't covered.
At the end of the day, it’s just a marketing plan for the covered dentists.
And nowadays, it's morphed into a crazy scheme where large Dental Service Organizations (DSO) offer super cheap cleanings to the insurance, and then treat their dentists and hygienists like sales staff who try to push bullshit like fluoride treatments and sealants with 1,000% markups that you have to pay for out of pocket.
It's crazy what the situation is, I stopped going to certain dental practices and had to find an independent one I could trust. I'd almost rather forego the employer provided insurance cleanings and pay cash just to makes sure the incentives are aligned and the dentists and hygienists aren't trying to scam me.
Dental’s historic lack of insurance and relative ease of opening a clinic has obviously made it much more cost-competitive than medical care, so we kind of feel like we are contributing to a future problem by using dental insurance, but it’s hard to turn down the savings now.
I agree. It feels awful to make a rational choice in your best interest and to see the mess it can cause at scale. The reason health insurance is such a mess in the US was from a tit-for-tat battle of people operating in a rational way (providers, insurance companies, and drug companies).
Insurance companies have pre-negotiated rates for everything. I didn't like paying for my dental insurance, and asked my dentist what the cost would be for 2 cleanings/year with no insurance. Something like $120/cleaning and another $75 for x-rays periodically. No cash discount because they'd run into legal issues by offering a better rate for non-insured patients.
My insurance is around $10/month. Since I get my teeth cleaned 2x/year, the rational choice is to buy my insurance and realize I breakeven after the first cleaning. But it feels bad. If my dentist is getting $40/cleaning through insurance, I'd rather be able to pay him $45/cleaning and keep insurance out of it all.
This blog post describes some of the mechanics in a bit more detail.
http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...
This is not true. There are teams of MDs and PharmDs that evaluate what treatment options are effective and are backed up with data, and they create the criteria with which to determine what is appropriate or not based on the persons medical history and chart notes. Also, employers and governments often provide insurance (or better named managed care organizations - MCO) companies with the criteria of what they want to pay for, so many times it’s not even up to the MCOs themselves.