16th April 2006, 08:52 PM
Heart enlargement diagnosis/implications
Because Zack is a cavalier, before i got him, i made sure he would be covered by health insurance for MVD because i'm not well off enough to be able to afford treatment and testing out of pocket. I got a policy that covers everything.
The policy did not cover any illness in the first 30 days and would not cover any illness that was noted in the first 30 days.
Zack had diarrhea, and then later, vomiting, during the first month i had him, which was during the first 30 days of the insurance, and i took him to many vet visits and to the emergency room for those gastrointestinal symptoms. These symptoms and treatment were noted in his medical records, and submitted to the insurance company. Any diarrhea related to what he had in the first 30 days is now excluded from coverage. That was to be expected.
When i had him at the emergency room, they did abdominal xrays. The ER vet showed me what appeared to be a small foreign body in zack's stomach. He then said that Zack had an "enlarged heart" and he pointed to a bulge on the side of the heart. In his notes, he reported the GI symptoms, the foreign body and 'heart enlargement'. He said the next day they would call me after having the radiologist read the xrays, to give me her report.
The attendiing vet called me the next morning and said the radiologist had read the xrays and did see the foreign body, and said that i should take Zack right away to his regular vet for follow up xrays to see if the foreign body had moved. I said "What about his heart?" The vet said "Oh, his heart is fine. The bulge was just caused by the position he was in when xrayed." I was glad to hear that.
In the notes submitted to the insurance, on the first day, the vet writes "enlarged heart." In his notes of the following day, he summarizes the radiologist's reading and says "heart likely within normal limits."
After the 30 days, when the plan was fully in effect, i called the insurance company to ask about any exclusions on the diarrhea. I was told Zack has a permanent exclusion related to enlarged heart.
I have been trying to straighten this out. I told the insurance company what happened, how apparently the first doctor made a mistake in his reading and the radiologists said the heart was normal and i was told there was nothing to worry about. I was asked to get a letter from the radiologist. She wrote a letter saying that abdominal xrays were taken and that abdominal xrays can't allow evaluation of heart size or shape.
The insurance company told me that this was not what was needed to remove the exclusion. They said that the radiologist had not ruled out an enlarged heart and that i would have to take him to have thoracic xrays done at my expense to rule out enlarged heart.
After this, the radiologist called the insurance company and was asked for a second letter. In her second letter she said that when zack was examined in the ER, no abnormalities in heart sounds, rhythm or pulse were identified. She then states that i would like 'enlarged heart' removed from Zack's records.
I'm now waiting for the insurance company vet to read these letters and come to a decision about whether to remove the permanent exclusion.
I know that MVD doesn't show up or develop until later. I'm wondering if it did show up later, might the insurance exclude it from coverage based on this erroneous enlarged heart diagnosis?
I find it very upsetting that i might have to pay hundreds of dollars for more xrays or an ultrasound to prove that Zack doesn't have an enlarged heart. What would be the simplest cheapest diagnostic method of assessing heart shape and size? I contacted a local cardiologist, Dr Barrett, and was told that what they would do for this purpose is an ultrasound that costs $500-$600. I already am in debt for $1100 from Zack's vet bills in the first month i had him for something that probably could've been cured with a simple cheap deworming medication given near the beginning of his symptoms. I am paying a high monthly premium for this very thorough insurance coverage.
If they refuse to ever remove the exclusion for 'heart enlargement,' what sort of conditions or symptoms down the line might they refuse to cover because they might be related to this supposed heart enlargement?
This is scary for me.