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Discussion Starter · #1 ·
I submitted a pre-authorization form for Java's 2 upcoming TPLO surgeries.
DENIED by PetPlan.
I blew my stack and ripped into them.
They're going to "look into it" and get back to me.
Friggin insurance companies.
$7000 for both surgeries, NOT including after-care.
I am SO not giving up on this...they are going to pay for the surgeries.
 

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Wow! I am so sorry, but I'm glad you're going to keep fighting. I have no experience with pet insurnace, just insurance for my horses.
 

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Discussion Starter · #5 ·
I too am curious as to their explanation...

I have read all the terms and conditions as well as clauses and exclusions.
All they require is that a complete exam has been within the 12 month period prior to signing up for insurance to rule out pre-existing conditions. Now they are telling me that in order for the surgery to have been covered I needed to have gotten a health certificate specifically stating that Java's knees were healthy within 30 days of signing up for the insurance, prior to her injury. My vet clearly stated that Java had never been treated for a cruciate injury prior to this and I alsio have faxed over her COMPLETE medical records and doctor's exam notes since the day we brought her home at 8 weeks. The guy told me that that is not good enough, they need a certificate from her vet prior to the injury stating that her knees were healthy. A certificate after she is injured saying her knees were healthy prior to this injury is not enough. I signed up specifically over the phone so I would know EXACTLY what I needed to do to make sure my dogs and myself were covered completely. The agent I signed up with neglectd to mention the health certificate thing....the supervisor I spoke with is going to review the calls and get back to me.

I'm so frustrated and don't know what we're going to do at this point. We paid/still owe for Moka's $5000 vet bills for her broken leg. We can't swing another $7000+ for this. It was the whole reason I signed up for pet insurance. I am beyond mad at this point.
 

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Do you also need something stating that her elbows are healthy, her eyes are healthy, her back is healthy, her hips are healthy, etc., etc., etc.? It seems weird that they are saying they need something specifically stating that her knees were healthy. If you hadn't turned in the paperwork to their satisfaction, why did they accept your money? This is exactly why I hate insurance companies; it is the only industry that can make up their own rules as they go along.
 

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Wow... I can totally see where you are coming from. I seriously never heard of anone needing a certificate of health from their vet BEFORE signing up for insurance. If they wanted one, they should have sent you an email or a letter stating that, and their file should have had this noted as outstanding AND they should have sent you correspondence following up on it, or something...
Don't let those suckers win!!!
 

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That sucks :( We finally dropped the insurance we carried on my horse because they were excluding so many things a few years ago. Hopefully someone will get back to you soon with good news on coverage.

On the off chance that they don't - I would have the traditional repair done. There are no studies that prove that TPLO has a lower reoccurrence rate or better long-term results than traditional repairs, and a number of highly regarded orthopedic surgeons/veterinary hospitals don't do TPLO repairs. Don't feel like you're shortchanging your dog just because you're not able to afford the newest surgery. You might even try a compromise with VPI, or whatever insurance you use, on the surgery (I'll have the cheaper traditional versus the TPLO).

If scientific evidence makes you feel better :)
http://avmajournals.avma.org/doi/abs/10.2460/javma.2005.226.232 (no difference in outcome between the two)
http://avmajournals.avma.org/doi/abs/10.2460/javma.2003.222.184 (TPLO has more complications - I think this is mainly because dogs walk sooner after TPLOs, so owners let them do too much, not necessarily a fault of the surgery itself)
http://avmajournals.avma.org/doi/abs/10.2460/javma.234.2.229 (lateral suture had fewer complications)

*Not a dig on people who have TPLOs done, each person has to decide what is right for them and their dogs. I just think it's irresponsible for surgeons to present the TPLO as the best simply because it's newer (and more expensive with cooler prosthetics).
 

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Do you also need something stating that her elbows are healthy, her eyes are healthy, her back is healthy, her hips are healthy, etc., etc., etc.? It seems weird that they are saying they need something specifically stating that her knees were healthy. If you hadn't turned in the paperwork to their satisfaction, why did they accept your money?
I would say exactly this to the representative. I mean, how ridiculous!
 

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I have wondered from the get go why they are doing two TPLO surgeries on a dog with partial tears.

Normally they try to let partial tears heal.

Magnum finally tore hers completely and that's when we needed to do the surgery and we opted for the "fishing line" surgery. It was $1200.00 and served her well. She went on to compete in agility again. Now that she is 9 years old I am seeing arthritis and some limping but that's pretty normal with ANY dog.

I know you are working with your vet on this, but I'd be looking for some less expensive options as well. There's no way I could afford $7000 for surgery on my dog.

I used to carry pet insurance, but I hear too many times of them declining to pay, so I dropped them. I have a $2000.00 savings for pet health care, what would go beyond that amount would have to be charged or really considered on what I would opt to do.
 

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Fight on ---- and please keep us informed.

I'm sorry you're going through this -- unfortunately, this isn't rare, especially for the big ticket expenses. Pet insurance companies are profit-making companies so they're always looking for ways to increase assets and reduce liabilities.

You might check with some of the vet schools/colleges in your vicinity. Some of them (if they're like the K-State CVM I use) might be quite a bit less than local vets plus also have above average, highly trained vets. Treatment and surgeries are NOT done by students but only by licensed DVMs.

You are within driving distance of 3 of the best schools/colleges of vetmed in the world -- Tufts' Cummings School of Vet Med in (IIRC) Walpole, MA; Cornell's CVM in Ithaca, NY, and UPenn's CVM in or near Philadelphia.

While some of these may be as expensive (or more) as a local vet, some may be significantly cheaper. Some allow self-referral, some require referral from a local vet.

 
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