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By Carla Thornton

Sampson and Lisa
Lisa Bocchiaro spent thousands of dollars trying to cure her African grey of aspergillosis.

ONE EVENING last fall, Lisa Bocchiaro noticed that her parrot, Sampson, sounded a little hoarse, as if he were coming down with a cold. At first, Bocchiaro was not too concerned. After all, Sampson was a robust bird named for his size. When he was only seven weeks old, still a pinfeathered baby, the veterinarian had pronounced him larger than 95 percent of the African grey population.

But Bocchiaro whisked Sampson to the local emergency veterinarian anyway, just in case. Little did she know it would be the beginning of a medical, financial and emotional ordeal she will never forget.

Sampson was tentatively diagnosed with aspergillosis, a fungal infection that causes respiratory problems. It was bad news on several fronts for Bocchiaro, a manicurist with severe asthma who depends on Medicaid to help her get by.

Aspergillosis, thought to be caused by environmental molds, can be extremely difficult to cure in birds. Sampson, a gift from Lisa's boyfriend, George, would have to undergo stressful treatments. Then there was the expense. On her limited income, Bocchiaro could ill afford big veterinarian bills.

Over the next two months, as Bocchiaro made the rounds of half a dozen avian vets, the bills would pile higher than she ever could have imagined.

The credit card dance
To pay for Sampson's first few visits to the doctor, Bocchiaro wrote checks totaling $838. When Sampson was referred to the well-regarded Animal Medical Center in New York and Bocchiaro had to pay $1,000 upfront, she began using a credit card.

At the hospital, Sampson underwent three surgeries to remove growths doctors thought might be blocking his airway. In between operations, Sampson breathed a special medicated mist twice a day and took massive doses of oral antifungals and antibiotics.

Sampson with shunt
Sampson's treatment included a shunt placed directly into an air sac to help him breathe.

When Sampson could no longer breathe on his own, doctors installed a shunt directly into an air sac via a hole in the bird's body. Without the shunt Sampson struggled to breathe, making terrible gurgling sounds.

As the number of surgeries grew to eight, including shunt replacements, Bocchiaro began to wonder if she was doing the right thing.

"The doctors did give me the option once to not let him wake up, but I said no, not without me there. By the time I arrived he was back up eating, playing and wanting to be held," she said.

Looking for help
It wasn't long before Bocchiaro maxed out all three of her credit cards. She had trouble coming up with the gas and parking money needed for the 110-mile daily roundtrip from New Jersey to be with Sampson, whom doctors said did better when she was there, cuddling him.

When Bocchiaro couldn't get a bank loan, she begged money from friends and relatives and anyone else she thought might help. She even e-mailed well-known MIT researcher and African grey trainer Irene Pepperberg and bird-food company founder Dr. Greg Harrison, who sent sympathetic replies.

With each surgery, Bocchiaro wondered if she was doing the right thing. But Sampson was strong, a fighter.

Because Sampson's prognosis was guarded, not "guaranteed", the animal hospital turned down Bocchiaro's request for financial aid.

The hospital did approve Bocchiaro for up to $4,000 from its line of "credit care". Bocchiaro declined at first, aghast at the finance charge of 23 percent, but finally relented. "It was a choice between taking the credit or simply letting him die," she said.

Sadly, in the end, Bocchiaro's and the doctors' best efforts were not enough. On Dec. 7, after seven weeks of treatments and 20 days in the animal hospital, Sampson died at home in Bocchiaro's arms as she sang to him, "You Are My Sunshine."

Sampson's final medical bill: almost $7,000.

Long-lasting debt
Bocchiaro cannot say enough good things about the AMC vets, who still send her sympathy cards. At one point, Bocchiaro was so afraid she couldn't afford to continue Sampson's treatment that she asked one of his doctors to adopt him.

"I broke down, and the doctor held my hand to comfort me and said yes, that they would help any way they could.

Sampson
Sampson in happier, healthier times.

"Now I know firsthand the desperation, fear, and helplessness of a mother who cannot afford to help her child," she said.

Bocchiaro also is grateful to all who have tried to help her pay Sampson's outstanding medical bills, including two nonprofit organizations, IMOM and United Animal Nations.

She is not sorry for pulling out all the stops in trying to save her pet. If any bird could have beaten aspergillosis, she says, it would have been Sampson. "He was strong, a fighter. He was healthy in every other respect."

And Sampson was young, with a bright future ahead of him. Only 2 1/2 years old when he died, he was still a youngster for an African grey, a breed that can live 50 years or longer.

If it would mean giving her beloved companion another chance at the long life he was meant to have, she would spend all the money again, says Bocchiaro. "I would do anything to spend more time with him. He was my world."

Instead, she faces a mountain of debt. She still owes $4400 to the hospital and her credit card companies, an amount she says will take years to pay off.

At one point, while sitting in a veterinarian's waiting room, Bocchiaro leafed through a brochure for pet insurance, but dismissed the idea after seeing that it paid only a few hundred dollars for Sampson's condition. "It's too bad all they would be willing to pay was $400," she said.

Funding the extra mile
According to a 1999 survey sponsored in part by the American Veterinary Medical Association, Americans spend in excess of $11 billion a year on veterinary care and products for their pets. The cost of veterinary medical care is rising almost 30 percent per year.

As Lisa Bocchiaro's story illustrates, those spending the big bucks on their pets aren't just dog and cat owners. Owners of birds and other small animals can be just as devoted to their pets and can wind up with vet bills just as large.

"Sampson is the only creature who ever called me 'mommy'," says Bocchiaro, who in turn often referred to the African grey as her "son."

Over the last decade, more pet-insurance companies such as PetCare, Petshealth Care Plan and Premiere Pet Insurance have stepped up to the plate to help dog and cat owners pay their vet bills.

Unfortunately, when it comes to insuring the health of birds - and other small animals considered by the veterinary community to be "exotic" pets - the pickin's are much slimmer.

Exotic and expensive
Pet insurance companies shy away from covering birds, ferrets, pigs, horses and other so-called exotics because they are expensive to insure, said Trina Peters, president of Pet Health Plus, an association for owners that helps people find health care for their pets.

"Veterinarians who treat exotics are considered specialists who may charge more for their expertise."

"The veterinarians who treat exotics are considered specialists who may charge more for their expertise and who tend to use supplies that are more expensive due to unique characteristics such as size," said Peters.

"Also, it's difficult for insurers to determine an affordable rate that will still allow them to turn a profit," she said. "Statistics are readily available for how much it costs to treat specific dog and cat conditions, so the insurance company can calculate a median cost for each condition and then develop a rate for it. But treatment costs vary so much from vet to vet on specialty animals that it is very difficult if not nearly impossible to determine effective premiums."

To see what's available for parrot owners, ParrotChronicles.com searched for companies that offer some form of health insurance for birds. We found three.

American Pet Plan and Pet Assure charge annual or monthly fees in exchange for discounts off medical treatments when you use a veterinarian in their network.

A third option is the California-based Veterinary Pet Insurance. VPI charges a monthly premium just like a human insurance company and lets you use any veterinarian you like.

All three companies cover all types of pets - not only dogs and cats, but birds, hamsters, ferrets and other "exotics."

HMO for animals
American Pet Plan operates something like an HMO for pets. There are no claim forms, deductibles or pre-existing condition restrictions to worry with. For an annual fee of $50 ($25 for each additional pet), you pay only $5 for office visits and get a 10 percent discount on prescription medication and a 20 percent discount on surgeries, lab tests and hospitalization.

American Pet Plan membership also entitles you to 10 percent off food and 20 percent off pet grooming and boarding services when you use a network member.

The good news about HMO-like plans is they don't exclude pre-existing conditions or require filing claim forms. The bad news is they lack avian veterinarians.

That's the good news. The downside to American Pet Plan is that it's tough finding veterinarians on the plan that specialize in birds.

There aren't that many vets on the American Pet Plan network to begin with - fewer than 50 when we checked, located in only seven states: Arizona, California, Florida, Ohio, Oklahoma, Tennessee and Texas.

Random calls to six clinics listed on the American Pet Plan Web site, including the two closest to us in San Jose and Stockon, Calif., turned up none with avian veterinarians - and two offices that said they had never heard of the plan.

American Pet Plan did not seem to want to discuss the availability of avian veterinarians in its network. It never answered an e-mail we sent and when we called the toll line, a representative hung up on us in mid-sentence.

Bottom line: it's unlikely bird owners will find an avian veterinarian on the American Pet Plan who will suit their needs, but there's no harm in checking out the network's much larger number of pet sitters and dog groomers to see if you can score some discounts there. Just proceed carefully - based on our experiences, the company may not excel in customer service.

Big Bird's insurance policy
Pet Assure, based in Dover, N.J., works something like American Pet Plan. It, too, requires that you use one of its network veterinarians. On the bright side, there are no deductibles, health restrictions, or paperwork to hassle with. Any type and age of pet, including those with pre-existing conditions, is eligible.

Pet Assure boasts 70,000 policies, including several with well-known corporations such as Sesame Street and GMAC Mortgage, who offer it as an employee benefit.

THE FOLLOWING plans cover not only dogs and cats, but birds and other small pets.

AMERICAN PET PLAN
.
Pro: Works like an HMO, so you don't have to fuss with claim forms or worry about pre-existing conditions. Costs only $50 a year per pet. In return, you pay only $5 for office visits and get 20 percent off medical procedures and 10 percent off prescription medications. Discounts are also available on pet sitting and dog grooming.
Con: Must choose from extremely limited network of veterinarians, most of whom do not specialize in birds.

PET ASSURE

Pro: Works like a discount service, so no need to fuss with claim forms or pre-existing conditions. Price reasonable at $99 a year per pet. In return, subscribers get a 25 percent discount from participating veterinarians and on a variety of other services from pet sitting to pet caskets. Has a much larger network of veterinarians from which to choose than American Pet Plan.
Con: As with American Pet Plan, network of providers does not appear to include many avian veterinarians.

VETERINARY PET INSURANCE

Pro: Your best bet for insuring your bird's health. Annual cost can be as low as $84 for one small bird. You can continue to use your favorite avian veterinarian.
Con: Many of the same headaches as human insurance policies, including the need to file claims and kick in a $50 deductible and an additional 10 percent copayment. Does not cover pre-existing conditions or prescriptions, and there's a $2,000 annual per-incident cap.

-- C.T.

Pet Assure costs a little more than American Pet Plan at $99 a year and does not offer APP's $5 office visit. However, Pet Assure does get you 25 percent off everything else and its network of participating veterinarians is much larger at 2,500, so you have a better chance of finding an avian vet.

Pet Assure also works with a wider variety of merchants, ranging from pet food companies to magazine publishers, all of whom give discounts up to 20 percent to Pet Assure subscribers.

Unfortunately, we had trouble finding an avian veterinarian with Pet Assure, too.

Our search at Pet Assure's Web site for a participating vet in our area turned up three within 16 miles, a good start. However, things went downhill from there. One clinic did not see birds. Another veterinarian was willing to see birds but admitted he did not know much about them. The third veterinarian was on a month-long vacation and no one on his staff could confirm his Pet Assure membership.

When we turned to Pet Assure for a bird-owning policyholder to interview, a representative promised to call back but never did, despite our repeated attempts to contact her.

Bottom line: Judging from the benefits it offers and the size of its network, Pet Assure may be a stronger, more reliable option than American Pet Plan - if you can find an avian vet. Avid consumers of dog grooming and other pet-related products and services might have better luck.

Any veterinarian you want
Founded in 1980, Veterinary Pet Insurance is the oldest and largest pet-insurance company in the United States. The company says it has sold over 1 million policies for all types of pets. However, it has covered birds and other small animals (21 types in all, including rabbits, hamsters, mice and ferrets) only since 2000.

The most alluring aspect of VPI is that, unlike American Pet Plan and Pet Assure, it lets you use any veterinarian you want. Its only enrollment restrictions for birds are that they must be at least three months old and in the owner's possession for at least sixty days.

Bill and Alfie
Even small birds can be expensive to take to the veterinarian. It cost Bill Selby and his wife, Chris Okon, of San Francisco a total of $2500 to save Alfie the cockatiel from a kidney infection.

The VPI avian benefits schedule lists 242 conditions ranging from relatively minor problems such as delayed molt to cancer and even self-mutilation. The company says it covers thousands of additional bird illnesses.

The monthly avian premiums are based on size: $7 for small birds weighing 50 grams or less (finches, canaries, love birds, parakeets); $10 for medium birds weighing between 50 grams and 300 grams (cockatiels, conures, pionus); and $13 for large birds weighing from 301 grams to 10 kilograms (macaws and cockatoos). Extra-large non-parrot birds, such as ostriches and emus, cost $16 a month to insure.

It's fast and easy to get an online premium quote at the VPI Web site. Just type in your zip code, bird's name, age, breed and date you got it, and the site calculates a monthly premium.

Although the site asks for it, the age of a bird does not matter. (When we boosted the age of our test bird by several decades, the premium remained the same - not bad, we thought, for a 60-year-old budgie.)

Overall, bird owners pay slightly less than cat and dog owners - an average of $10 a month compared with $11.29 for a four-year-old canine or feline. Routine checkups and grooming are covered by a separate optional well-care policy that costs another $8.25 a month, the same as for dogs and cats.

How VPI works
The downside to VPI is that it involves just as much red tape as some human insurance policies and is not as flexible.

For instance, the only prescription medication VPI pays for is preventive flea control, not applicable to birds. VPI is quick to point out that it does not cover pre-existing, hereditary or congenital conditions, not so unusual. However, we found it slightly troublesome that representatives of the company could not give us any examples of hereditary or congenital conditions in birds. They said VPI would defer to the veterinarian's opinion.

Instead of reimbursing a certain percentage of your vet bill - say, 80 percent - VPI pays a preset amount for each condition. VPI applies a $50 deductible for each incident and deducts another 10 percent copayment.

For instance, VPI's maximum benefit for conjunctivitis is $200. After the deductible and copayment, your maximum reimbursement would be $135.

To get paid, you have to file a claim form including your doctor's signature and any applicable medical records, and wait for VPI to send a reimbursement check.

A gambling proposition
Like any insurance policy, VPI's is a game of odds. On one hand, a policy could pay off handsomely - say, for example, the budgie you just insured for $7 a month required surgery for pancreatic cancer, which is eligible for $1120 in benefits. At the other extreme, you could pay premiums for years and never recover a cent.

The best thing about VPI is that you get to choose the veterinarian you want.

To see how VPI stacks up against the real world of avian medical bills, we decided to test it with four hypothetical situations. We randomly selected four health problems that could afflict a pet bird: a broken blood feather, lead poisoning, constricted toe syndrome, and Psittacine Beak and Feather Disease.

We asked three avian vets to quote treatment fees for each condition. Then we averaged the vets' fees and compared the averages with VPI's reimbursement. (In each case we used VPI's reimbursement for a primary condition, which pays more than a secondary condition.)

In all but one of our four scenarios, VPI shone, covering charges for the condition and then some. The overage didn't completely cover each imaginary vet visit because most vets charge an additional $50 for office time, but it came fairly close.

For our broken blood feather, VPI paid $27 ($80 minus $50 and another $3), compared with our average bill of $15. VPI also covered the diagnosis of PBFD, an untreatable disease, with a payment of $207 ($280 minus $50 and another $39), compared with our average cost of $150.

For our bird with constricted toe syndrome, VPI paid a generous $184.50 ($255 minus $50 and another $20.50), compared with our average fee of $175.

VPI did not completely cover our average charge for lead poisoning ($485), but it did put a dent in it with a benefit of $351 ($440 minus $50 and another $39).

If you're big on frequent checkups for your bird, you might consider adding VPI's $99-a-year well-care policy. It partially covers the hands-on exam, complete blood count, culture, fecal test, parasite treatment and grooming and should pay for itself with one office visit.

Where you could really come out ahead is if you wind up getting these tests done more than once a year. Then you could get up to $189 in well-care benefits, twice as much as the policy costs. It's a pity, although not surprising, that VPI offers well-care only as a rider policy.

Catastrophic shortfall
While it delivered in our test scenarios, VPI is not a panacea. If your bird should suffer a catastrophic illness, you could still wind up with a gut-wrenching vet bill.

VPI is not a panacea. You could still wind up with a sickening vet bill.

The reason: although VPI will reimburse up to $7,000 a year for an insured bird, it caps the payout for one incident at $2,000. In other words, if your bird's illness turns out to be an expensive doozie, you could still get stuck with a big vet bill. Only a series of unrelated serious illnesses or injuries in one year - an unlikely scenario - would allow you to collect the $7,000 maximum.

Take, for example, Lisa Bocchiaro, who spent almost $7,000 in two months trying to cure her African grey Sampson of aspergillosis. The good news is VPI would have paid for a lot more of Sampson's treatment than Bocchiaro thought it would. The $400 amount quoted in VPI's brochure and benefits schedule is for aspergillosis as a primary condition. According to a company rep, VPI would have covered hundreds of dollars more in secondary benefits for such things as Sampson's air sac shunts. Somewhat oddly, difficulty breathing is considered a secondary condition of aspergillosis.

On the downside, Bocchiaro would have been subject to VPI's $2,000 per-incident cap. She still would have had to pay almost $5,000 of the bill herself.

VPI does not mention the per-incident annual cap in its print materials or on its Web site.

Big flocks mean big premiums
Another thing to keep in mind is that while the monthly premiums don't add up to much for one bird, multiple-bird households can quickly generate big VPI bills.

For example, two cockatiels, an Amazon and a macaw would cost over $500 a year to insure (including a modest discount for multiple pets). If you added VPI's well-care policy, the bill would come to over $900 a year for the four birds.

Despite the cost, some multiple-bird owners like the safety net a VPI policy can provide.

Christine Okon, a San Francisco massage therapist, hopes that insuring her birds under VPI will pay off in the long run.

Before getting VPI, Okon and her husband, Bill Selby, endured some hefty vet bills that began when they adopted a cockatiel from a local bird rescue group. The bird, which was found flying free, developed a kidney infection soon after the adoption.

"Alfie appeared chipper at first, but almost immediately showed signs of being sick," said Okon. "Dr. (Lynne) Dustin (of San Francisco Bay Area Bird Hospital) pulled him through." Alfie's vet bill: $2500.

Ralston
Okon and Selby's green budgie Ralston ran up $407 at the vet's when she became egg-bound.

A year later, one of the four babies Alfie had with his new mate, Tookie, split open her keel after taking a hard fall on the floor. Emergency surgery to repair the injury: $332.

"We thought wow, wish we had insurance," said Okon.

Ralston the egg-bound budgie
Since taking out VPI's avian policy on four of her six cockatiels and three of her four budgies (she dropped coverage on the remaining three after VPI rejected claims on pre-existing conditions), Okon has paid $732.24 a year in premiums. That amount does not include the well-care policy, which would cost almost $700 a year more.

So far, Okon has filed several claims and VPI has partially reimbursed her for some, including one for an infection five of the birds came down with.

However, the biggest reimbursement so far has been only a modest payout for Okon's egg-bound budgie Ralston, who had to have two eggs surgically removed.

Ralston required hospitalization and two followup checkups, totaling $407. After VPI applied the allowed amounts under its benefits schedule and took the $50 deductible and 10 percent copayment, Okon received $141.

It took Okon about a month to get that reimbursement, longer than usual, she says, because VPI did not notify her it needed some additional information. She had to call them to straighten out the matter "or I would still be waiting."

Pleased overall
Despite this claim hassle and the fact that she has paid out hundreds of dollars more than she has gotten back, Okon thinks VPI is worth it.

Chris and 'tiels
Chris Okon has insured seven of her birds, including four cockatiels and three budgies, with VPI.

"Owning birds can be very expensive," she said. "If you really want to take care of them you have to bite the bullet and pay those vet bills.

"Unfortunately, there's a lot of mystery or lack of research for many bird conditions. Avian species are not as well researched as mammals. When a doctor is trying to determine a cause there may be lots of tests and they're expensive.

"I would strongly advise anyone with a brand-new bird to get insurance before creating a track record," said Okon. Itís really hard if you adopt a bird that has a pre-existing condition like a kidney ailment."

Okon's only real complaint about VPI is the birthday cards the company sends out to patients. "They have a picture of dogs and cats - no birds," she said wryly.

To insure or not?
The bottom line: VPI is a proven supplier of health insurance for all types of pets, and that alone is good news for bird owners seeking elusive coverage. If your bird needs expensive treatments that VPI reimburses generously, the insurance could save you hundreds of dollars.

On the downside, if your bird suffers a condition that costs thousands of dollars to treat, or VPI decides to exclude a condition on grounds of pre-existence or for another reason, you may find your policy of cold comfort.

"I would strongly recommend getting insurance before creating a track record. It's really hard if your bird has a pre-existing condition."

What would we do? If we had one bird, especially a small one, we might consider gambling on VPI for $84 a year. After all, a little bird can cost just as much to treat as a big one.

But if we had multiple birds, we would probably pass on VPI. Unlike with humans, insuring a pet's health is not one of life's mandatory expenses. Birds will never need a $100,000 heart transplant or months of rehabilitation after an automobile accident.

Until a wider selection of insurance options for exotics come along, you, too, might want to take the money you would spend on premiums and sock it away in a CD instead. With luck, you'll have the extra cash for those future rainy days in your bird's medical future. With even better luck, the rainy days will never come - and you will still have your money.

ParrotChronicles.com. Published 2003.


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