What Is Pet Insurance

What Is Pet Insurance – Pet insurance is designed to cover the medical expenses of pets and, in some cases, additional costs. Usually, pet insurance plans function on a reimbursement basis, meaning you initially pay for your pet’s veterinary bills and then submit a claim to the insurance provider. A few companies offer the convenience of direct payment to the vet, helping you minimize out-of-pocket expenses.

Before the coverage begins, a deductible is often required. For instance, you might be responsible for the initial $500 in veterinary expenses before the pet insurance takes over.

Once you have paid your deductible, pet insurance may not cover the full extent of your veterinary bills. You have the flexibility to select your reimbursement level, with common options being 70%, 80%, or 90% of your veterinary expenses.

The coverage provided by pet insurance depends on the specific plan you choose. Pet insurance plans fall into three categories:

  1. Accident and illness plans (the most prevalent)
  2. Accident-only plans
  3. Wellness plans that include routine care like vaccinations, often available as an add-on

Accident and illness plans generally include injuries or illnesses such as broken bones, cancer, hereditary conditions, congenital conditions, and more. In contrast, accident-only plans exclusively cover issues stemming from accidents, such as a broken bone.

READ: Is Pet Insurance Tax Deductible?

Many pet insurance policies allow you to supplement your coverage with a routine wellness plan. This addition helps offset expenses related to your pet’s annual wellness check-up, vaccinations, heartworm treatment, and other routine care procedures essential for maintaining your pet’s well-being.

Note that pet insurance may not cover pre-existing conditions, which are ailments your pet had prior to the policy’s commencement, including any applicable waiting periods.

What is Not Included in Pet Insurance?

Pet insurance policies often come with several exclusions that are important to understand. These are some common exceptions in pet insurance policies:

  1. Boarding and kennel fees: Most plans do not cover the cost of boarding and kenneling. However, certain insurers might cover these expenses if you are hospitalized. An example is Trupanion’s Pet Owner Assistance Package, which includes this coverage.
  2. Breeding costs: Expenses related to breeding are not covered.
  3. Exam fees: Some insurers may not cover veterinary exam fees, even if they are related to an accident or illness. Also, most policies do not cover your pet’s annual wellness exam unless you purchase a separate wellness plan.
  4. Expenses unrelated to veterinarian care: Costs such as taxes or administrative fees charged by your veterinarian are generally not covered.
  5. Food and supplements: Regular pet food and supplements, like vitamins, are not covered by pet insurance. However, some plans may cover prescription pet food.
  6. Grooming: Expenses for grooming, nail trimming, and shampooing are usually excluded.
  7. Lost or stolen pets: Most plans do not cover the costs associated with lost or stolen pets but some insurers offer optional coverage for expenses like advertising and rewards, such as the Extra Care Pack from Figo pet insurance.
  8. Pre-existing conditions: Injuries and illnesses that occur before the start of your pet insurance coverage are not covered. Some insurers may extend coverage to “curable” pre-existing conditions, such as an ear infection, provided your pet remains symptom-free and treatment-free for a specified period, like 180 days. Conditions recurring after 180 days are treated as new issues.
  9. Preventative and elective procedures: Pet insurance does not cover procedures like declawing, ear cropping, and tail docking.
  10. Vaccines: Standard pet insurance plans usually do not include coverage for vaccines and booster shots but many policies allow you to add a wellness plan if you want vaccine coverage.

READ: 10 Best Pet Insurance For Dogs In United States 2023

It is important to note that your policy may require you to follow your veterinarian’s recommended care guidelines. For instance, if your vet advises a dental cleaning due to dental issues and you do not proceed with it, you might not be covered for subsequent veterinary expenses related to dental illnesses.

Different Types of Pet Insurance Plans

Comparing pet insurance plans can be challenging due to variations in coverage, exclusions, and pricing. To find the most suitable pet insurance for your needs, select the appropriate pet insurance plan type. Decide whether you want comprehensive pet insurance that covers a wide range of health-related issues, including wellness, or if you prefer an accident-only plan that focuses on injuries. Consider what level of coverage aligns with your preferences and budget.

Pet insurance can be categorized into these plan types:

  1. Comprehensive Coverage: Often referred to as a nose-to-tail policy, this type usually includes coverage for accidents, injuries, serious or chronic illnesses, hereditary conditions, diagnostic tests, surgeries, treatments, and wellness aspects like routine veterinary checkups and vaccinations.
  2. Accident and Illness Coverage: This policy covers veterinary expenses related to accidents (e.g., ACL rupture) and various illnesses, including common ailments, hereditary conditions, and severe illnesses like cancer. It does not cover wellness exams such as routine vet visits, flea and heartworm prevention, or vaccinations. However, you can often add a wellness plan for comprehensive coverage.
  3. Accident-Only Coverage: This policy covers veterinary bills solely for injuries resulting from accidents and does not cover expenses related to illnesses.
  4. Pet Wellness Coverage: This plan addresses wellness-related medical costs, such as routine vet checkups, flea and heartworm prevention, and vaccinations. Wellness benefits can often be added to an accident and illness plan.

When purchasing a pet insurance policy, you will usually need to choose an annual maximum, a deductible, and a reimbursement rate.

  • Annual Maximum Coverage: You will have the option to select an annual maximum payout limit. This limit represents the maximum amount the pet insurance plan will pay out within a year. Many pet insurance plans offer choices ranging from $5,000 to unlimited payouts. Opting for an unlimited payout will increase the premium cost but ensures you will not exceed your annual maximum if your pet requires costly treatments.
  • Deductible: Selecting a higher deductible will lower your monthly pet insurance premium. Common deductible options include $100, $250, and $500. Once your deductible is met, you can submit vet bills to your pet insurance provider for reimbursement. Some plans, like Trupanion, feature a unique lifetime per-condition deductible, where you pay a deductible once for each new condition without an annual reset.
  • Reimbursement Percentage: At the time of plan purchase, you will choose a reimbursement level, with lower reimbursement levels resulting in lower pet insurance premiums. The most common reimbursement choices are 70%, 80%, or 90%.

Understanding Pet Insurance Waiting Periods

 A waiting period refers to the duration between the policy purchase date and when coverage becomes effective. Waiting periods are standard in every pet insurance policy, so it is important to find one that aligns with your comfort level. For example, Embrace offers a short two-day waiting period for accident coverage, while other plans like ASPCA Pet Health Insurance have a longer 14-day waiting period.

READ: Pet Insurance For Older Dogs With Pre Existing Conditions

Be attentive to special waiting periods for specific conditions, such as cruciate ligament issues. For instance, Embrace imposes a six-month waiting period for orthopedic conditions in dogs, whereas ASPCA’s plan does not have a waiting period for orthopedic conditions or any other specific issues.

Pet Insurance Discounts

Pet insurance discounts are a great way to save on your policy. Here are some common types of discounts:

  1. Multipet Discount: Many insurers offer a discount if you insure more than one pet.
  2. Spay/Neuter Discount: Some insurers provide discounts to pet owners who have their pets spayed or neutered.
  3. Annual Payment Discount: You can often reduce costs by paying your annual premium in a single bulk sum.
  4. Military Discount: Certain insurers offer discounts for military members and veterans.
  5. Workplace Group Discount: Some employers offer pet insurance as a voluntary benefit, which may qualify you for a 5% to 10% discount.
  6. Bundle Discount: You can receive up to a 10% discount when bundling Lemonade pet insurance with a Lemonade renters or homeowners insurance policy.

Additional Considerations When Comparing Pet Insurance Plans:

Here are two more factors to take into consideration when choosing a pet insurance plan:

  1. Exam Fees: When you visit the veterinarian for an accident or illness, you incur an exam fee, which can cost $100 or more depending on the veterinarian and the type of visit. Ensure that the policy covers these exam fees, as not all plans do.
  2. Benefits: Seek out additional benefits, such as access to a 24-hour vet helpline for nighttime emergencies. For example, Nationwide pet insurance members enjoy preferred pricing on pet prescriptions at any Walmart pharmacy.



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