What does pet insurance cover?

Just as the cost of health care for humans has risen over the past few decades, the cost of caring for our pets has also increased. Veterinary medicine has advanced with new, more technologically centered equipment, facilities, and training to bring the highest quality of care to our pets. These advances help show why pet insurance is important.

Like health insurance for humans, pet insurance covers some or most of the costs of caring for your pets.

Diagnosing, treating, and managing your pet’s illnesses and injuries and keeping them safe and fit takes dedication. Providing the level of care necessary for pets to continue being happy household members for many years uses resources not available until recently. This higher level of care means greater expenses for pet owners.

Pet insurance can help. It can defray the cost of high veterinary bills, pay for needed medication, and help with the expenses of other services needed to keep your pet healthy. 

Why pet insurance is important

Pet insurance is a unique, specialized product that reimburses pet owners for veterinary charges as well as related expenses like medication, special foods, vitamins, and medical devices.

Pet owners can choose from these three main categories of pet insurance coverage:

Wellness coverage: 

This level of coverage includes vaccinations, tests, X-rays, and dental care. Like with health insurance for humans, this level of care is sometimes called routine or preventive care. 

Accident only: 

This coverage goes into effect only when your pet is injured or has an accident-related medical condition.

Accident and illness:  

This level of pet insurance is sometimes bundled with wellness coverage. It is the most comprehensive type of insurance for your pet. Accident and illness policies cover unexpected emergencies and injuries, treatments for sicknesses and diseases, and any other changes to your pet’s normal state.

Pet owners should investigate the diverse types of pet insurance and select the policy that best fits the needs of their pets and their budget. 

Why should I get pet insurance?

If you have had a pet who was injured in an accident, developed a chronic condition like diabetes or kidney disease, or contracted a common pet illness like kennel cough or the flu, you know that a trip, or many trips, to the vet can get quite expensive.

Having pet insurance can help defray much of the cost of those trips to get your pet back to optimal health. Some of the advantages of having pet insurance include:

• Protects your budget from unexpected veterinary bills

• Allows you to get optimal care from your vet

• Avoids euthanasia when required medical care is not affordable

• Avoids placing financial limits on the value of a pet’s life

• Gives pet owners the ability to pay for needed treatments

• Avoids taking out loans or using credit cards to pay for pet care

• Helps pets live longer, healthier lives

What factors should I consider when shopping for a pet insurance policy?

Like shopping for your own health insurance, there are many factors to consider when selecting a policy to cover your pet’s health care needs.

Age

Your pets age impacts the cost and levels of insurance coverage. Most policies do not cover newborn pet care but will cover after about seven weeks of age and some plans have upper age limits

As your pet ages, your deductibles and copays may also increase because an older pet is more likely to develop conditions that are expensive to treat. 

Breed

Certain breeds of pets are more likely to get particular health problems. Some breeds of dogs are likely to develop diabetes, for example. Make sure to investigate the health risks that are common to your pet’s breed when shopping for pet insurance.

Policies for purebred and pedigree dogs and cats may be more expensive than those for mixed breeds. Mixed breed pets are less likely to fall into the high-risk category for health conditions. 

Species

Dogs and cats are the most common species that pet insurance plans cover. If you have an exotic pet, like a bird, reptile, rabbit, or ferret, you will have fewer choices to have your pet covered. Policies for these pets are out there, but you may have to look a little harder to find one.

Location

Pet insurance regulations vary from state to state. Regulators determine the types of coverage that can be sold and any terms and conditions that must be part of each policy. 

Treatment costs

Talk with your veterinarian about the costs of treatments for any conditions commonly associated with your pet’s breed. This might help you decide what level of coverage your pet needs. Some policies have limits on the amount of benefits available. If you know ahead of time that your pet is likely to need expensive treatments, you can opt for a higher level of coverage.

Waiting periods

Most pet insurance policies have a waiting period—a time before the policy will pay for pet care—that ranges between 10 and 30 days from the date you buy the policy. The policy pays for claims related only to conditions that appear after the waiting period is over.

Pre-existing conditions

Insurance companies may request a pet’s medical history when writing a new policy. Conditions that existed or were diagnosed prior to the starting date of the policy may not be covered.

Chronic health conditions

Ongoing health problems, like diabetes or cancer, are considered chronic conditions. These require more frequent visits to the vet and medications that can be quite expensive. Ask about coverage for chronic conditions as the amount and type of insurance varies among plans. 

Premiums and co-pays

The cost of pet insurance begins with premiums. This is the amount you must pay, either monthly or annually, to ensure the policy is in place for your pet’s care. The premium can vary according to your location, the breed of your pet, its gender and its age. 

The co-pay is the amount you must pay at each visit for pet care. A common co-pay is one where the policy reimburses the pet owner for 80 % of the total fees, meaning that there is a 20% co-pay that comes out of the owner’s pocket. 

What services do pet insurance policies exclude?

Exclusions from coverage for pet insurance are common in most accident and illness policies. Become familiar with the exclusion section of your pet’s policy to avoid unpleasant surprises when trying to file a claim. Some common exclusions include the following conditions:

Pre-existing conditions

These include any health problems that are in your pet’s medical history prior to the start of the policy. For example, if the vet diagnosed your pet with a kidney disease before the policy went into effect, treatment for that condition would be excluded.

Pregnancy or birth

Pet insurance policies usually do not cover any prenatal or newborn pet care. 

Wellness coverage 

Unless the policy has specific wellness coverage, items like routine and preventive care, worm, tick, and flea treatments, grooming, and vaccinations are not covered.

How to choose pet insurance

When shopping for a pet insurance policy, consider the following questions:

• Can I pick my own veterinarian, specialists, and facilities?

• Does the insurance policy dictate the veterinarian’s fees?

• Is the policy approved by the state insurance regulatory board?

• Do only licensed veterinarians assist with claims?

• Is the policy clear about limits, costs, optional coverage, terms and conditions, co-pays, deductibles, and exclusions?

• Is the policy clear about fee reimbursement processes?

Any policy you choose should reveal all the policy details such as premium amounts, if premiums go up as your pet ages, limitations and exclusions to the policy, emergency care policies, and if extensive claims will cause an increase in premiums. 

Do not forget to ask about available add-ons. Some companies offer additional coverage for dental care and travel insurance. Discuss pre-existing condition clauses. If your cat has diabetes, for example, ask if the policy covers the cost of daily medications for that condition.

If your breed is considered a high risk for certain conditions, ask the insurance company about any limitations on coverage. 

If you have multiple pets, some companies offer discounts on policies that cover more than one animal.

How does pet insurance pay for my pet’s care?

Most pet insurance policies reimburse the policy holder for veterinary care. You pay the veterinarian’s bill up front. After you, or in some cases the vet’s staff, file the claim, the insurance company sends you a reimbursement payment for the portion of the charges that are eligible. 

When buying the policy, find out the typical time it takes for reimbursements to be processed and sent to you. If you need help paying the up-front costs, ask your vet’s office about payment plans or if they accept credit cards. 

To avoid stress when a pet is sick or injured, know your financial obligations ahead of time so you and your vet can concentrate on caring for your pet, not in paying the bill.

This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.