An Emotional Support Animal (ESA) is a pet, prescribed by a licensed provider to a patient for their mental health, which provides emotional support to the individual. ESAs can be different types of pets, most commonly dogs and cats, and any age or breed. What they all have in common is they comfort their owners with companionship and improve their quality of life. 

Emotional support animals are now a big business, and medical billing has latched onto its coat tails. I have seen many advertisements for various ESA opportunities, and on one site I searched for an ESA of my own, I learned that it would cost me approximately $200 for an ESA. The reason for the cost is the requirement to visit a doctor or social worker (provider) and go over an established set of questions to determine if I qualify for an ESA. In some cases, the provider doesn’t even have to see the patient in person-it can be done via a telehealth visit.  

When my wife recently passed away, I became very depressed, so I made an appointment to see my Primary Care Provider (PCP). During the visit, she recommended I obtain an emotional support animal. She took out her tablet and showed a letter that her lawyer drafted and said a letter would be sent to me within 24 hours to support my need for an ESA. The next day, the letter arrived approving one, so I made a copy and gave it to my landlord. That weekend, my children took me to our local animal shelter to adopt an appropriate animal (in my case, a cat). The cat that I chose was about to be put down because she had been there way past the time limit for the shelter and would normally have an adoption fee of $10. However, the shelter waived that fee for her. So, that day, my new friend, Birdie the cat, came home with me. Her original owner was also a senior citizen but had passed away, leaving Birdie to find herself in the shelter. Like me, Birdie is older-so I didn’t change her name. Birdie is 10 years old in human years, around 60 in cat years, and her company has helped me in ways I cannot explain. In the morning, I change her water, give her fresh food, and clean her litter box. Because she spent so much time in the shelter, she has become semi-feral, but she is slowly coming around and learning that my apartment is her new home, and I am her new companion. Having an ESA-her company and my responsibilities of taking care of her-is helping significantly with my depression, and I don’t feel so lonely anymore.

When I went to see my PCP, her recommendation for an emotional support animal and the ESA letter was paid for by Medicare and my secondary insurance. My provider is now recommending an ESA to other patients who are like me, since ESAs are known to improve the patient’s mental health, and because my provider’s patients are Medicare patients, she has now been able to increase her practice revenue for her senior Medicare patients. Emotional support animals can make huge impacts on one’s health, so prescribing them can be a huge success. And Birdie is a lot like me-she never gives up, and she never surrenders. 

Steve Verno