I’ve been with Nationwide Pet Insurance since 2012, covering my dog Tara (a 13.5-year-old border collie) under their Major Medical and CareGuard plans. We have both the Major Medical and CareGuard plans, so when she was recently diagnosed with arthritis, I breathed a sigh of relief, thinking, ‘Thank God I have Nationwide.’ Then I found out there’s a $700 cap on her arthritis treatment, and I just spent $1,400 on one vet visit. After paying over $15,000 in premiums, I’m shocked by this limitation. I’m trying to get this resolved, but I wanted to warn other pet parents, especially those with older pets, to review their policies closely. Has anyone else encountered similar issues, or had success getting these caps raised?
So sorry to hear about Tara and the sticker shock at the vet’s. Not what you want to happen!
I worked in human health insurance for years and have done a lot of research into pet insurance, and I can say that Nationwide’s quote and policy page is one of the most confusing things I’ve ever read. And I’m not alone, other insurance experts find it incomprehensible at times.
It’s my understanding that the Major Medical plan has a schedule of benefits reimbursement scheme. Basically, they have a list of diagnoses and a max they will pay for each condition per year. This is outdated and frankly ridiculous.
Since the early 2000s, pet insurers have been switching over to reimbursing actual vet bills and not using a schedule of benefits to cap by diagnosis. But apparently, Nationwide still uses this Major Medical plan that does it the old way. I do not think you will have much luck raising these caps. The contract will have spelled out their obligations, and as long as they pay according to it, there’s not much to be done. I’m so sorry.
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Kelby said:
So sorry to hear about Tara and the sticker shock at the vet’s. Not what you want to happen!
I worked in human health insurance for years and have done a lot of research into pet insurance, and I can say that Nationwide’s quote and policy page is one of the most confusing things I’ve ever read. And I’m not alone, other insurance experts find it incomprehensible at times.
It’s my understanding that the Major Medical plan has a schedule of benefits reimbursement scheme. Basically, they have a list of diagnoses and a max they will pay for each condition per year. This is outdated and frankly ridiculous.
Since the early 2000s, pet insurers have been switching over to reimbursing actual vet bills and not using a schedule of benefits to cap by diagnosis. But apparently, Nationwide still uses this Major Medical plan that does it the old way. I do not think you will have much luck raising these caps. The contract will have spelled out their obligations, and as long as they pay according to it, there’s not much to be done. I’m so sorry.
Agreed. I had Nationwide for years until the premiums became too much. They cover 90% of my bill. Best advice I give anyone looking into pet insurance is to read the policy and ask questions. Otherwise, you’ll be surprised when it comes to getting reimbursed.
1 Like
Kelby said:
So sorry to hear about Tara and the sticker shock at the vet’s. Not what you want to happen!
I worked in human health insurance for years and have done a lot of research into pet insurance, and I can say that Nationwide’s quote and policy page is one of the most confusing things I’ve ever read. And I’m not alone, other insurance experts find it incomprehensible at times.
It’s my understanding that the Major Medical plan has a schedule of benefits reimbursement scheme. Basically, they have a list of diagnoses and a max they will pay for each condition per year. This is outdated and frankly ridiculous.
Since the early 2000s, pet insurers have been switching over to reimbursing actual vet bills and not using a schedule of benefits to cap by diagnosis. But apparently, Nationwide still uses this Major Medical plan that does it the old way. I do not think you will have much luck raising these caps. The contract will have spelled out their obligations, and as long as they pay according to it, there’s not much to be done. I’m so sorry.
Agreed. I had Nationwide for years until the premiums became too much. They cover 90% of my bill. Best advice I give anyone looking into pet insurance is to read the policy and ask questions. Otherwise, you’ll be surprised when it comes to getting reimbursed.
I know Nationwide has a lot of market share, mostly due to their marketing to employers as an employee benefit. But I don’t recommend them because it’s difficult to parse out their plans. Sadly, there are not many consumer protections in the pet insurance space.
1 Like
Grayson said:
Kelby said:
So sorry to hear about Tara and the sticker shock at the vet’s. Not what you want to happen!
I worked in human health insurance for years and have done a lot of research into pet insurance, and I can say that Nationwide’s quote and policy page is one of the most confusing things I’ve ever read. And I’m not alone, other insurance experts find it incomprehensible at times.
It’s my understanding that the Major Medical plan has a schedule of benefits reimbursement scheme. Basically, they have a list of diagnoses and a max they will pay for each condition per year. This is outdated and frankly ridiculous.
Since the early 2000s, pet insurers have been switching over to reimbursing actual vet bills and not using a schedule of benefits to cap by diagnosis. But apparently, Nationwide still uses this Major Medical plan that does it the old way. I do not think you will have much luck raising these caps. The contract will have spelled out their obligations, and as long as they pay according to it, there’s not much to be done. I’m so sorry.
Agreed. I had Nationwide for years until the premiums became too much. They cover 90% of my bill. Best advice I give anyone looking into pet insurance is to read the policy and ask questions. Otherwise, you’ll be surprised when it comes to getting reimbursed.
I know Nationwide has a lot of market share, mostly due to their marketing to employers as an employee benefit. But I don’t recommend them because it’s difficult to parse out their plans. Sadly, there are not many consumer protections in the pet insurance space.
Completely agreed. I moved my pet to MetLife, and I am much happier.
Kelby said:
Grayson said:
Kelby said:
So sorry to hear about Tara and the sticker shock at the vet’s. Not what you want to happen!
I worked in human health insurance for years and have done a lot of research into pet insurance, and I can say that Nationwide’s quote and policy page is one of the most confusing things I’ve ever read. And I’m not alone, other insurance experts find it incomprehensible at times.
It’s my understanding that the Major Medical plan has a schedule of benefits reimbursement scheme. Basically, they have a list of diagnoses and a max they will pay for each condition per year. This is outdated and frankly ridiculous.
Since the early 2000s, pet insurers have been switching over to reimbursing actual vet bills and not using a schedule of benefits to cap by diagnosis. But apparently, Nationwide still uses this Major Medical plan that does it the old way. I do not think you will have much luck raising these caps. The contract will have spelled out their obligations, and as long as they pay according to it, there’s not much to be done. I’m so sorry.
Agreed. I had Nationwide for years until the premiums became too much. They cover 90% of my bill. Best advice I give anyone looking into pet insurance is to read the policy and ask questions. Otherwise, you’ll be surprised when it comes to getting reimbursed.
I know Nationwide has a lot of market share, mostly due to their marketing to employers as an employee benefit. But I don’t recommend them because it’s difficult to parse out their plans. Sadly, there are not many consumer protections in the pet insurance space.
Completely agreed. I moved my pet to MetLife, and I am much happier.
I’m glad MetLife has been better for you! Nationwide honestly seems like a pain for a lot of people.
Appreciate that insight! It just sucks, but I’m going to try and see what they can do. I also read they canceled one of their insurance policies, and people are upset because if they get a new policy, pre-existing conditions are considered.
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Raven said:
Appreciate that insight! It just sucks, but I’m going to try and see what they can do. I also read they canceled one of their insurance policies, and people are upset because if they get a new policy, pre-existing conditions are considered.
Yes, earlier this year Nationwide dropped about 100k policies and left those customers with nothing. People with senior pets basically can’t get any meaningful coverage anymore. It’s a real mess.
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I’m dealing with this right now. I resubmit almost every claim I file. They told me I had met the limits on most medical conditions, which isn’t true because I track everything. I had to get notes from my vet saying the treatment was medically necessary. If resubmitting with notes doesn’t help, I’d file a claim with the department of insurance and accuse them of fraud.
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Kase said:
I’m dealing with this right now. I resubmit almost every claim I file. They told me I had met the limits on most medical conditions, which isn’t true because I track everything. I had to get notes from my vet saying the treatment was medically necessary. If resubmitting with notes doesn’t help, I’d file a claim with the department of insurance and accuse them of fraud.
+1
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I had Nationwide for 6 months. It was a pain.
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