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How does the pet major medical portion of my membership work? The program reimburses you for veterinarian expenses in connection with covered illnesses and injuries. Covered illnesses and injuries can be loosely defined as those injuries and illnesses that begin after the effective date of the program. In other words, illnesses and injuries that are unknown and unexpected at the time you enroll. Everyone whose pet qualifies will have peace of mind and security - knowing that if they are unfortunate enough to need the major medical program, they will not have to endure the additional pain of paying for 100% of the care. Can I go to any veterinarian or is there is list of veterinarians that accept The Major Medical Program? You may use any licensed veterinarian in US. Why is there approximately a 30 day waiting period to issue the pet insurance policy? It takes approximately 30 days to process and during this 30 day trial period you will have complete access to all the savings benefits provided to a member. You will also receive a complete overview of what the program provides. What is a benefit allowance and how does it work? The program reimburses members based on actual medical costs. The program reimburses 90% of actual cost to you, after a $50 deductible has been met. For example, if your veterinary bill is $1500.00, a deductible of $50.00 will be subtracted. Your 90% reimbursement will be figured on that sum of $1450. So your reimbursement would be $1305.00 Is my pet eligible? If your pet is at least eight weeks old and no more than 10 years old your pet will qualify. You will not be reimbursed for pre-existing conditions. We leave no pet behind. If your pet does not qualify due to age your pet will be covered for accidents only. The accident coverage covers unexpected accidents and injuries. Reimbursement of 100% of treatment costs after a $50 deductible up to $3000. Do you provide the major medical program for other pets besides dogs and cats? No. What about older dogs and cats? No dog or cat is rejected on the accident coverage. All coverages can be continued at older ages with an additional charge added to the membership fees. Is there a discount for multiple pets? Yes, a 15% discount for each additional pet. What is a deductible? A deductible is when the program member pays the first $50 cost of covered expenses. The $50 deductible is per incident. Is there a waiting period? Yes. After the effective date of the pet health of program there is a waiting period 14 days for illness - none for accidents. What is a pre-existing condition? A pre-existing condition is any illness or injury that existed prior to the effective date of your program. Are pre-existing conditions covered? Any illness or injury that existed prior to the effective date of your major medical program is not covered. Remember, this program is designed to protect against unforeseen events. Are prescriptions covered? Yes, except prescription dog food. What happens if I am traveling? Will my pet be covered in the event of an injury or illness? One of the highlights of the accident and illness program is that you can use any licensed veterinarian to treat your pet... no lists, no hassles. So, if you are traveling in the United States and something does happen, rest assured you can have your pet taken care of by any licensed veterinarian. Whatever vet you choose, remember to get the proper information you need to process your reimbursement form, including a receipt. Is dental work covered? Yes, accidents only. How do I apply for Paws & Claws Pet Club? It's easy! Just fill out the two applications, pet information and personal information form. All applications are promptly reviewed. What happens next? After your application is reviewed and accepted, you will be notified concerning how to use your benefits. How do I file for a Major Medical Reimbursement? When you become a member and a policy holder you will receive a membership kit that will contain information on how to file a claim and who to contact, and explain how much you save as a member when you go into the website's member's area. Who fills out the Reimbursement form? You should fill out the form and sign it. If you need assistance, ask your veterinarian. Should my veterinarian sign the claim form? Yes. Be sure the reimbursement form is completely filled out, signed and dated. Be sure the receipts from your veterinarian are attached. Who pays the veterinarian? The member is responsible for paying the veterinarian and should file requesting reimbursement. How long do I have to file for reimbursement? The insurance company must receive the form within 90 days of the treatment date shown on your veterinarian's invoice. Do I have to include my pet's medical records with each claim? No. However, sometimes medical records are necessary to expedite the processing of your claim. If when you make your first claim, the policy has been active less than 6 months, we ask that you provide you pet's medical history for the last 12 months. What documentation will I receive after my reimbursement form is submitted? If you are due payment, you will receive a check. If are refused payment, you will receive an explanation that will include the reasons for denial. |