Run around with pets best

I have had Pets best since 2011.  My cat has Gingiostomatitis and this is what is upsetting me about Pets Best.  I understand that they do not cover teeth cleanings and Dental.  

They told me that his condition is a covered Illness under the policy but they will not authorize Dental.  I am paying $1700 to have his teeth removed August 5, 2015.  What makes no sense is if they treat this particular illness,,,,,,the teeth extraction IS NEEDED TO CURE THE ILLNESS. 

I will put my claim in and appeal when they deny it. Are there any lawyers that could help me with this?   How can they say they cover the illness but then wont cover teeth removal when that is something that is done to TREAT and CURE the condition, 

Very upset

I wish you the best of luck with the insurance.  

Believe me, I have had my fill of a different one. I will not go into either the brand or my difficulties...

I just believe it is all a racket.

That is all I will say......

Good luck

Legally, you are entitled to a first appeal and a second appeal (must be filed within 30 days of decision of first appeal). If they deny the claim after the 2 appeals, then you can file a complaint with your State Department of Insurance. Let them know you intend to follow through on this.

I wholeheartedly agree that this surgery should be covered if they are saying that the gingivostomatitis is covered. The only way that it would NOT be covered is if there was an alternate treatment advised by your vet, such as medication instead of extraction. However, after doing some research on the disease, most cats do not respond to medication and/or cleanings alone and extractions are necessary.

When you file your appeal(s) make sure to include notes from your veterinarian about why he believes this action of treatment is necessary in this particular case. 

I honestly do believe that once you file your first appeal, they will cover the cost of the treatment. As you said above, this dental is not an elective procedure being performed for preventative measures but a necessary treatment for a health condition with no known exact cause.

I'm not a lawyer but I would be really interested in how all of this turns out. I know you'll be super busy with a recovering kitty and fighting with the insurance company but if you remember to come back here and update us on the outcome, I would really appreciate it!!!

I am keeping my fingers crossed for you

his teeth are being taken out August 5, 2015. I was told that I do not need to take any time off from work but am anyways.  He will be given pain killers and I hope it is liquid form. Anyone know?   The vet is charging me $1700.00 He put down $0.00 for Xorays and $43 for blood work. I am pretty sure he is doing x-rays. I told  him the financial situation and think he just is giving me a discount.  Care Credit would not give me an increase,  I am definitely going to have the VET put that Taking the teeth out is the treatment for the gingiostomatitis.  I really hope I can get then to pay me back, My Uncle is being nice to to put this on his credit card. I am trying to pay as much as possible. 

This vet is one of the top best vets in CT and went to Cornell Univeristy. I trust his judgment. 

Legalgal97 said:

 
his teeth are being taken out August 5, 2015.....

He will be given pain killers and I hope it is liquid form. Anyone know?

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In my experience, there are a couple of things about giving any kind of meds orally to a cat...the first applies to any cat, the second to a cat with oral pain:

1. Anyone who's experienced giving oral meds to cats knows that it is difficult at the best of times, ''the best'' meaning that the cat has become accustomed to the procedure and is less resistant...you may already know this because it appears your preference is a liquid med - perhaps you feel liquid would be easier than a pill...and, even with a cat that's familiar with oral med administration, there's still most often a struggle involved. Giving oral liquid meds to a cat can pose a risk...cats are particularly susceptible to Aspiration Pneumonia (and that's often fatal) - so, the struggling cat plus one's own stress level plus the liquid can pose a real risk that might better be avoided when there's an alternative.
2. Part of all this is the inherent and necessary manipulation of the cat's mouth....doing this with a cat that's had oral surgery poses the risk of damage to the sutures - and, is certain to add to the level of oral pain.....and, if the pain gets 'ahead' of us (previous dosage has waned), the pain could be excruciating.

From experience, there are two types of post oral surgery pain meds that are ideal insofar as they eliminate all of the above:

1. Buprenorphine SR (Sustained Release) is an injectable opiod pain med that is effective for 3 days (you'll need more than 3 days pain control - see below)
2. Fenatyl ''pain patch''....again, a 3-day period of pain control

With either of these, there'll be no fuss no muss....you will need to return for a second dosing....but, that will also allow the Vet to check on the healing process....that's essential - if there are problems, they need to be corrected early. Of the two drugs, the first is the less complicated to use.

There is another type of pain med that you should know about. This is the non-steroidal anti-inflammatory type (NSAID). These have been common in human medicine for years (think aspirin, ibuprofen). Over the last few years, the drug companies have started to develop these for cats....problem is, cats are almost unique in their inability to metabolize NSAIDS. They have not evolved with the liver enzymes required for that. The consequence is that has been that some kidney damage occurs....without going into long detail, I wouldn't advise anyone to allow the use of a NSAID in a cat. Cats 'come equipped' with enough kidney cells to last a full lifetime...why would anyone risk diminishing that when there are safe effective alternatives? Two brands very commonly-used in cats are ''Metacam'' and ''Onsior''.

I said you'll  need more than 3 days pain control...here's what Cornell has to say about that:

  Once a cat gets over a full-mouth extraction—which will take between five and 10 days—it can go on to thrive very well....

Cornell CVM - Gingivostomatitis    -  (That would be a useful read for you, I think)

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 He put down $0.00 for X-rays....I am pretty sure he is doing x-rays. 

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Well, I would want to be sure X-rays are taken....it's the only way to confirm that all tooth material has been removed.

Hope something there helps !