Essentially, when your beloved pet gets injured or sick, pet insurance helps pay the veterinary bill. However, pet insurance is more than just medical insurance for pets – it’s also peace of mind for pet parents.
How Pet Insurance Works
Here’s a general overview of how pet insurance works:
- Get Treatment
If your pet gets injured or sick, visit any licensed veterinarian in your area to get the care that they need.
- Claims and Reimbursement
After getting the treatment that your pet needs, pay the vet directly. Next, you have to submit a claim to your pet’s insurance carrier. As long as there is no pre-existing condition in the pet’s medical history, you will be reimbursed for the covered treatment by the pet insurance company.
What Pet Insurance Covers
Majority of pet insurance providers cover illnesses and injuries. However, coverage can differ depending on the pet insurance plan that you purchase. Typically, pet insurance covers the following:
- Veterinary Exam Fees
- Diagnostic Treatments
- Accidents and Injuries
- Prescription Medications
- Imaging (i.e. Ultrasound, MRI, etc.)
- Dental Treatments
What Pet Insurance Doesn’t Cover
Pet insurance usually doesn’t cover:
- Pre-Existing Conditions
- Cosmetic Procedures (i.e. tail docking, dewclaw removal, ear cropping, etc.)
- Special Diets
Factors to Be Considered
When building a personalized insurance plan for your pet, there are several factors that have to be taken into consideration. Some of these factors include:
Frequently Asked Questions (aka F.A.Q)
What is pet insurance?
Pet Insurance can cover your pet for unforeseen accidents and illnesses referred as major medical. Pet insurance can also cover foreseen or expected routine veterinary expenses referred as wellness or preventative care.
Why is it important to get pet insurance?
It is important to get pet insurance for multiple reasons. The first reason is because veterinary treatments are costly and if your pet gets sick or injured, pet insurance can help recoup most of your veterinary expenses. The second reason is for peace of mind. Knowing you have pet insurance, you can make better choices for your pet. Finally, what doctors can do for humans, veterinarians can do the same for your pets. The treatments are expensive. For example, treatments for hips dysplasia and cancer can start at 4000, and can go up from there. If your pet gets hit by a motor vehicle, treatments can start from 3000, and can go up from there. We insure our home and cars. We insure ourselves with health insurance. How about our pets? The Insured Pet recommends all pets should be insured for the reasons above.
What types of plans does pet insurance cover?
There are three types of plans pet insurance can cover. The first type of plan is for ACCIDENTS only. The second type of plan is WELLNESS, which for most pet insurance companies is an add on feature. The final type of plan is referred as MAJOR MEDICAL, which covers both unexpected illnesses and accidents. The Insured Pet recommends a major medical plan.
What is an accidents only plan?
This covers for accidents only. For example, your pet would accidentally swallow a toy, or accidentally fall down the stairs and injures its leg. There are some pet insurance companies that offer accidents only plan.
It is best to sign up for a major medical plan that covers both illnesses and accidents.
What is a wellness plan?
A wellness plan is a plan that covers expected veterinary expenses known as routine or preventative care. A wellness plan would cover vaccinations, spaying or neutering, dental cleanings, and flea and tick coverage. Most pet insurance companies offer a wellness plan as an add on feature but limited to 200- 600 dollars a year for routine care expenses. There is one company, Nationwide Pet Insurance, that offers unlimited wellness if you purchase their Whole Pet Plan.
What is a major medical plan?
A major medical plan is a plan that covers both unexpected accidents and illnesses. This plan will cover illnesses such as infections, vomiting, or diarrhea. It also covers chronic illnesses such as allergies, skin conditions, or arthritis. Hereditary and congenital conditions are also covered. On the more expensive side, cancer and surgeries are also covered. Some pet insurance companies also offer holistic and alternative therapies such as acupuncture, laser, and chiropractic therapy. The Insured Pet recommends this plan highly.
When is the best time to get pet insurance?
The best time to get pet insurance is when the pet is young and healthy and no symptoms or diagnosis have yet occurred The younger the pet, the lower the premium. Most pet insurance companies allow pets to be covered starting at 8 weeks old.
Do pet insurance companies have upper age limits?
Yes. Some companies have upper age limits. This means that some companies will not accept new enrolled pets at a certain age. These pet insurance companies usually will not accept pets aged 15 and older.
What is a pre-existing condition?
A pre-existing condition is a symptom or diagnosis noted on the health record of the pet prior to enrollment or during the waiting period after enrollment. A pre-existing condition is usually not covered by any of the pet insurance companies.
*However, some companies recognize a pre-existing condition no longer pre-existing if the condition has been “cured” and no treatment or symptoms have occurred within the last 12 months, or a few even 6 months.
What are hereditary conditions?
A hereditary condition is passed down from the pet’s parents. Examples of hereditary conditions can include hip dysplasia, epilepsy, cherry eye, and elongated palate. Most pet insurance can cover a hereditary condition as long as the diagnosis or symptoms occurred after the pet has enrolled with pet insurance, and met the waiting period requirements.
What are congenital conditions?
An example of a congenital condition would be a liver disease, heart defect, or any birth defect. Most pet insurance companies can cover congenital conditions as long as diagnosis or symptoms occurred after the pet enrolled with the pet insurance company, and met the waiting period requirements.
What is a waiting period?
A waiting period is a specific amount of time that has to pass before some or all of the pet’s health care coverage can begin.
Most pet insurance companies have a waiting period for accidents after the pet owner enrolls their pet. If for example, the pet swallows a toy during the waiting period and received veterinary treatment, the treatment would not be covered because the incident occurred during the waiting period. However, if the incident occurred after the waiting period, and there was no history of the pet swallowing a toy prior to enrollment, then the treatment could be covered.
This is the same for illnesses. Most pet insurance have a waiting period for illnesses ranging from 14 to 30 days. If the pet were to become ill or would develop symptoms of an illness during the waiting period, and is noted on the pet’s health record, then treatment would not be covered because the illness or symptoms occurred during the waiting period. Moreover, any symptoms or diagnosis on the pet’s health record that occurs on the waiting period will be considered a pre-existing condition.
*All pet insurance companies have different waiting periods. Waiting periods for accidents range from no wait to 14 days. Waiting periods for illnesses range from 14 to 30 days. There are usually no waiting periods for wellness coverage. Please check The Insured Pet’s pet insurance reviews on the waiting periods of each pet insurance company.
What is the average monthly cost of pet insurance?
The cost of pet insurance varies. The monthly premium is based on 5 factors:
- The BREED of the pet. A mixed-breed cost less. A purebred would cost more
- The AGE of the pet. The younger the pet, the lower the monthly premium.
- The ZIPCODE. Yes, the zip code where the pet resides matters. A pet residing in New York City would cost more than a pet living in Hannibal, Missouri.
- The SELECTED COVERAGE. The deductible and reimbursement percentage chosen matters. The higher the deductible, the lower the monthly premium. The lower the reimbursement percentage, the lower the premium.
- Some pet insurance companies are just higher than others.
After obtaining quotes from all the insurance companies, the monthly cost for dogs and cats can range from a low $10 a month for a young puppy or kitten to over $100 a month or an older dog or cat.
The monthly cost for cats ranges from $10 (young mixed breed kitten) to over 100 (for older purebreed Persian cat).
To get a gauge on the monthly premiums of dogs and cats from the top pet insurance companies, please check out The Insured Pet’s Side by Side Comparison.
What is a deductible, and how types of deductible are there?
A deductible is the first amount of a claim that you pay before the pet insurance pays out.
There are three types of deductibles:
The first type of deductible is called the ANNUAL DEDUCTIBLE. This deductible has to be met once per year before payout begins, then resets the following year. Most pet insurance companies operate using the annual deductible. This deductible is good if you were to file many claims for your pet during the year.
The second type to deductible is called the PER CONDITION DEDUCTIBLE. This deductible only has to be met once during the lifetime of the pet. This deductible is good for chronic issues because treatments are ongoing for the lifetime of the pet. However, if your pet has multiple new conditions during the year, you have to meet a deductible for each one before pet insurance can pay out.
The final type of deductible is called the PER INCIDENT DEDUCTIBLE. This deductible has to be met for every incident that occurs before the pet insurance company pay out.
How does an annual deductible work?
Specifically, if you purchased an insurance plan with an annual deductible policy, you have to satisfy a specific dollar amount per year before the insurance company pays anything.
For example, if you chose an insurance plan with a $100 deductible with 90 percent coverage, and the first veterinary bill is $1000, you would receive 800.00 back. Then if the next bill was another 1000, you would receive $900.00.
The advantage with an annual deductible is that once that particular dollar amount deductible is met, you will no longer have to meet another deductible during the year regardless how many claims you file.
How does a per condition deductible work?
Specifically, if you purchased an insurance plan with a per condition deductible, you have to satisfy a specific dollar amount just once during the lifetime of the pet before the insurance pays anything.
For example, if you chose an insurance plan with a $100 per condition deductible with 90 percent coverage, and the first veterinary bill is $1000, and the treatment was for an ear infection, you would receive 800.00 back. If you receive another bill for an ear infection treatment for $1000, you would then get 900.00 back. Once that particular condition is met, there would be no more deductibles for that condition for the lifetime of the pet.
Say the third bill is for $1000 for a cherry eye surgery. This treatment is not for ear infection where the deductible for that condition has already been met. Since this is a new condition, a deductible for that condition now has to be met. So with a $100 deductible, and 90 percent coverage, you would get 800 back.
The advantage of a per condition deductible is you only pay once for that particular condition for the lifetime of the pet. This would be an ideal for a pet who suffers a chronic issue like allergies at an early age and continues for the lifetime of the pet.
How does a per incident deductible work?
Specifically, if you purchased an insurance plan with a per incident deductible, you would have to satisfy a specific dollar amount for every incident that occurs with your pet.
For example, if you chose an insurance plan with a $100 per incident deductible, with 90 percent coverage, and the first bill is 1000, you would get 800 back. If the second bill is 1000, and the treatment is for the same issue, another deductible would have to be met, and you would get $800.00 back again. With the annual deductible or with the per condition deductible deductible, you would get $900 back.
What does reimbursement percentage mean?
The reimbursement percentage is the amount the pet insurance company will pay on the total bills submitted that is eligible for coverage. The reimbursement percentage ranges from 60% to 100% coverage.
For example, if you chose 80 percent reimbursement option, the pet insurance company will cover 80 percent of the bill minus any deductible amount you may be owing.
Does pet insurance cover spaying or neutering?
Yes, if a pet owner purchases a wellness plan, spaying or neutered is usually covered.
Does pet insurance cover surgery?
Yes, if a pet owner purchases a major medical plan, all types of surgeries can be covered except sterilization or umbilical hernia repair, which are surgical procedures covered under a wellness plan.
Does pet insurance cover holistic or alternative treatments.
Yes, there are some pet insurance companies that offer holistic treatments such as acupuncture, or alternative treatments like laser therapy inclusive in the monthly premium.
Some pet insurance companies cover holistic or alternative treatments at an extra charge or separate rider.
Does pet insurance cover dental?
Yes, under a wellness plan, routine dental cleanings may be covered.
Under a major medical plan, dental disease/illness may be covered. Some pet insurance companies exclude dental disease/illness coverage like periodontal disease or gingivitis, but most cover dental injuries such as a tooth extraction or dental injury.
Does pet insurance cover shots or vaccinations?
Yes, shots or vaccinations would be covered if a pet owner were to purchase a wellness plan.
Does pet insurance cover X-rays?
Yes. Pet insurance can cover x-rays that are required by the vet as part of treatment for an illness or accident. However, if x-ray hasn’t been recommended by the vet and you are only ordering it to check your pet for a certain issue, pet insurance may not cover it.
What is bilateral condition coverage?
A bilateral condition is a medical condition which can happen on both sides of the body, such as hip and elbow dysplasia, cruciate ligament issues, cataracts, locating patellas, and knees.
Some pet insurance companies exclude bilateral conditions, and group them as one issue. Therefore, it is important that you understand the bilateral condition policy of any pet insurance before you intend to buy.
For example, if a pet has a cruciate injury on his left knee that is pre-existing and then gets a cruciate injury on the right knee two years later, some companies will bundle this right knee injury with the left knee injury and declare this pre-existing, and thereby no coverage for the right knee.
There are a few pet insurance companies that do not exclude bilateral conditions.
Does pet insurance cover euthanasia?
Yes. Some pet insurance companies cover euthanasia if it is medically necessary.
Is there Pet Insurance for exotics? How about horses?
Yes. Nationwide Pet Insurance covers exotics. In some states, ASPCA Pet Insurance covers horses.
Can law enforcement dogs be insured?
Yes, some pet insurance companies insure law enforcement dogs. A few pet insurance companies that do are Pet’s Best, Nationwide, or ASPCA.
Can you change pet insurance companies?
Yes. However, please note that if you change pet insurance companies, a majority of policies will not allow you to make a claim for the same condition. For instance, if your pet has already been treated for arthritis and you want to switch to a different insurance company, the new insurer will treat arthritis as a pre-existing condition and will exclude it from coverage.
Usually, once you start with a pet insurance company and filed claims with that pet insurance company, it is hard to transfer to a new pet insurance company knowing that the medical history of your will follow with the next company. So it is important you start off with the right pet insurance for your pet. The Insured Pet is here to help you make the right choice.
Is a wellness exam required prior to signing up with a pet insurance company?
No, most pet insurance companies do not require a wellness exam prior to sign up. However, in order to evaluate the pet’s baseline of health, most pet insurance companies require the pet to get a wellness exam before they can pay out a claim.
*Some pet insurance companies require the pet to get a wellness exam every year. Some companies will deny a claim if the pet has no record of a wellness exam within the last 12 months. Please check The Insured Pet’s individual pet insurance reviews on enrollment requirements.
How do I file a claim?
Depending on the pet insurance company, the options available for filing a claim are by website portal, emailing, faxing, mailing, or by mobile app – just snap a picture of paid invoice, answer a few questions, and then press submit.
Then, the pet insurance company will then call the pet owner’s veterinarian and request past medical records. Most pet insurance request the past 2 years’ history, and a few might ask for more than 2 years.
Depending on the insurance company and complexity of claim, reimbursement can take from 5 to 30 days.
Some pet insurance companies have a time line for filing claims. Make sure you file accordingly, or the claim may not be eligible for reimbursement.
What happens if my claim gets denied?
If your claim gets denied, it is not the end of the road. You can always appeal the decision.
Most pet insurance companies will deny a claim if that particular claim had a pre-existing history on the pet’s record prior to enrollment, or during the waiting period.
Or sometimes, the claims department did not get all the support documents and based on what they had, they denied the claim.
If your claim was denied and you feel you have a legitimate claim, you can have your veterinarian write a letter to the pet insurance company, and appeal the decision. Your veterinarian has to write a letter explaining why the claim denied was not pre-existing or related to a prior condition that occurred in the pet’s history.
Do pet insurance companies offer discounts?
Depending on the pet insurance company, there are discounts for multiple pets, if you work at veterinary clinic, if your pet was rescued from an animal shelter, if you choose to pay annually vs monthly, or if your family is from the military.
Most pet insurance let you know the discounts available prior to purchasing online.
Can I go to any veterinarian?
Yes, you can go to any licensed veterinarian in the United States. Some pet insurance companies will cover treatments if you travel and your pet receives veterinary treatment in Canada or Puerto Rico.
Will I be sent any information about my pet insurance plan?
Depending on the pet insurance company, some will provide pet coverage information by email, by regular mail, or by logging on company website portal.
Can I cancel my plan?
Yes, you can. Depending on the company, most have a 10-30-day free look. If you enroll, and you do not file a claim, and you feel the pet insurance was not the right choice within the 10-30-day free look period, the pet insurance company will allow you to cancel the policy for a full refund.
Also, most pet insurance will let you cancel anytime. If you paid for the month, and you cancel midway, any unused premium will usually be refunded.
However, to cancel the plan, it is best you email the company to notify the cancellation, and follow up with a phone call if no reply was received.
What is direct vet pay?
The traditional way is to pay the veterinary bill at checkout. Then, you file a claim with the pet insurance company and show proof of a paid invoice. Depending on the complexity of claim, reimbursement may take 5 to 30 days.
With direct vet pay, you only pay the portion of your bill and any deductible amount owing at checkout.
For example, if your bill was $1000.00, and your deductible is $100.00 with 90 percent coverage, you would only pay your portion, $200 (the deductible if still owing, and 10 percent of the bill), while the pet insurance company will pay $800.00 directly to your veterinarian at checkout.
This payout agreement has to be approved with the veterinary clinic prior to treatment. Two pet insurance companies, Trupanion and Pets Best, offer direct vet pay as a payment option.
What are the benefits of using The Insured Pet website?
The Insured Pet is your one stop for pet insurance. In one stop, you can learn and compare all the pet insurance companies that offer the best plans, and from there, you can then confidently choose the best pet insurance that can best protect you and your pet. At The Insured Pet, Insuring Your Pet is Now Made Simple.