As a pet parent who wants to purchase pet insurance that can help you offset vet bills, you might want to really know what pet insurance covers.
Actually, what pet insurance covers vary according to the provider and the plan because not all pet insurance policies are the same.
In this article, you will see a complete breakdown of what pet insurance covers and what it doesn’t cover.
Also, you’ll learn how it works, the policies involved, plans, as well as the discounts and average premiums you have to pay.
If you already know what you want your pet insurance policy to cover, then you can go ahead to read our article about these best pet insurance companies near you to get started with your insurance process.
Now, let’s get into the details of our topic.
What is Pet Insurance?
Pet insurance is a type of insurance coverage that helps you pay for your pet’s medical expenditures as well as unexpected illnesses and accidents.
It’s a type of health insurance policy that protects your pet and also prevents you from paying expensive vet costs in case of emergencies.
Basically, what a pet insurance company does is reimburse you for the cost of the vet bill after paying.
The reimbursement is made either as a fixed dollar amount or as a percentage of the procedure or service cost, depending on the policy and insurer.
Typically, reimbursements range from 70% to 90% and you can take your pet to any veterinarian of your choosing, unlike managed healthcare for people.
A common question people ask at this point is “how does pet insurance work?” Well, see the next heading.
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How Does Pet Insurance Work?
In most cases, pet insurance functions just like any other insurance plan.
Here are the ways pet insurance actually functions:
- First, you contact your preferred provider to make an appointment for your pet’s vet visit.
- Then, you take your pet in for care.
- At the end of the appointment, pay for the visit and any associated costs, or depending on the company you choose they can pay directly to your vet.
- But if not, you can send your insurer a claim and an itemized copy of your bill. You can do this with some companies using an app or email.
- Wait for your insurance company to examine your claim and pay you back for covered expenses.
- Depending on how fast your insurer processes claims, this could take a few days to a few weeks or longer.
The majority of pet insurance providers provide a variety of coverage options and will pay for a variety of treatments and operations your pet could require.
However, as each company has different exclusions, it is crucial to read the fine print before signing up.
Now, let’s find out exactly what policies pet insurance covers.
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What Policies Does Pet Insurance Cover?
There are several different pet insurance plans available that can meet different needs.
Since policies might vary, it’s crucial to confirm that you know what yours covers.
1. Lifetime pet insurance policy:
This is also known as a renewal benefits policy and this covers your pet’s medical illnesses and injuries.
Although any illness or injury your animal had before the policy started will not be covered.
This policy, however, covers your pet to a set amount each year as long as the insurance policy is still active.
Meaning your animal won’t be covered for any additional treatments it needs during that year if the overall limit is reached.
So, the entire amount of coverage under each section it covers is once again accessible when you renew your insurance.
As long as the insurance coverage is active and payments are current, there is no limit on how many times an illness or accident can be covered in this way.
2. Maximum Benefits Pet Insurance Policy:
This type of pet insurance policy is also known as per condition policy whereby the maximum amount for treating a particular illness is only available once.
This policy provides a fixed amount of money for each illness or injury treatment your cat or dog undergoes as long as the money lasts.
Also, maximum benefits policies only cover your animal for new illnesses and injuries.
This means that any illness or injury your animal had before the insurance started will not be covered.
This policy covers them for injuries and illnesses until the maximum amount is reached as long as the policy is in force and the premiums are paid.
However, once the full amount of the benefit has been reached, treatment of that particular illness or injury will not be covered again.
As a result, you will then be responsible for any ongoing treatment for that particular injury or illness.
But any unrelated illness or injury will be covered until the maximum benefit of that condition is reached.
In conclusion, if your cat or dog receives treatment for a particular condition and it appears again the policy will view it as the same condition and will not cover it.
This means that the maximum amount for a condition will only be available once for the duration of the policy, not for each time your pet has that particular illness.
If you have more than one pet, then read this complete guide about How Multi-Pet Insurance Work?
3. Time-Limited Pet Insurance Policy:
This policy is typically for 12 months and it has two parts which are:
The first one is a fixed amount that covers your cat or dog for the treatment of each illness or injury.
Then, the second is a set time period for which each treatment for injury and illness is covered.
This particular policy is similar to that of the maximum benefit policy but in this case, it deals with the period and not the amount.
Basically, the policy will cover the treatment of your cat or dog for a particular illness or injury for 12 months.
That is, it does not relate to the duration of the policy but rather, it refers to the amount of time a condition is covered for.
Also, this policy covers your cat or dog for only new medical illnesses and injuries. Hence any illness or injury they had before the policy will not be covered.
Have in mind that when the set period or fixed sum for a particular illness and injury ends, your pet will not be covered for that particular condition again.
Issuers see these as reoccurring conditions which are related to the previous illness and will treat it as one condition for the duration of the policy.
4. Accidents-Only Pet Insurance Policy:
This policy only covers new injuries and pays a certain amount to assist with the cost of your pet’s care.
As a result, any injuries they sustained prior to the start of the policy will not be covered.
Accident-only policies may sometimes include an amount towards the cost of emergency treatment for an illness.
In addition, accident policies do have a 12-monthly time limit. Thus it covers treatment by a vet for 12 months, starting from the day the vet care begins per condition.
So, you must renew your policy at the end of the policy period and keep your payments current to ensure your pet remains covered.
Especially if the coverage is for a 12-month treatment period or your pet’s treatment will last past your renewal date.
Continue reading as we learn about what pet insurance covers and doesn’t cover.
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What Does a Standard Pet Insurance Cover?
Pet insurance essentially pays for your pet’s medical expenses, depending on what the insurance provider is willing to offer.
1. Death By Accident or Illness Policy:
As a matter of fact, whenever your pet dies, you can get back the cost of what you paid for it or the amount you can sell.
However, some pet insurance companies have an age limit which they can pay for eight to eleven years for a cat and five to nine years for a dog.
After this year they will not pay or it might result in you making a contribution to costs.
In the case of illness, they also repay you for any cost you incur whenever your pet is I’ll up your annual coverage limit.
Below are some examples of the illness and common conditions that pet insurance companies cover:
- Digestive illnesses
- Chronic conditions
- Hereditary conditions
- Congenital conditions
- Dental illness
- Hip dysplasia
- Heart disease
2. Missing Pet Policy
Most pet insurance companies also contribute to the cost of putting up a poster and paying for a reward if your pet goes missing.
3. Cattery and Kennel Fees
If ever you get sick or hospitalized and there is no one to look after your animal, pet insurance providers will assist you in paying for your pet to be in a cattery or a kennel
However, for this to effectively take place you will have to be in the hospital for at least two to four days.
4. Euthanasia, Cremation, and Burial
Some pet insurance companies may cover the cost of euthanizing, cremating, or burying your pooch.
5. Overseas Travel Policy
Most insurance companies’ policies do cover the cost for your pooch in cases of illness, accident, or needing veterinary treatment when abroad.
Again, they also cover canceled flight and lodging expenses in a situation whereby you have to postpone a vacation due to your pet falling seriously ill before you are scheduled to leave.
Now we know the things that pet insurance does cover, let’s learn about the things they don’t cover.
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What Does Pet Insurance Not Cover?
There are also some things that pet insurance companies do not cover regardless of the type of plan you paid for.
Here are some of the conditions and illnesses that pet insurance policies don’t cover:
1. Pre-existing illness or injury
This is a situation whereby your pet already had a medical condition prior to you taking an insurance policy.
These are chronic conditions like heart abnormalities or hip dysplasia that are seen as pre-existing conditions.
2. Waiting Period:
Illnesses that start within the first 10 to 14 days of your pet insurance coverage are often not covered by most pet insurance providers.
There won’t be a “gap” in your coverage because some companies will waive this fee if you transfer from another insurance.
3. Experimental treatment:
These are diagnoses and therapies that are considered experimental, investigations or not up to the veterinary medical board of your state’s approved standards of practice.
That said here are some other conditions:
- Non-veterinary expenses.
- Issues related to breeding or pregnancy
- Food, dietary and nutritional supplements
- Preventative care
- Non-veterinary expenses
- Routine and preventative treatment
- Elective procedures like ear clipping and tail docking
What Coverage Does Pet Insurance Cover?
There are a few different types of pet insurance plans and discounts available.
1. Accidents-only Coverage
This plan exclusively covers medical pet emergencies. For example, if your furry friend accidentally swallows something they weren’t supposed to or got hit by a car.
All you have to do is file for a claim and get reimbursed after paying the vet bill.
Other types of emergencies include:
- Lacerations and abrasions
- Burn injuries
- Abnormal bloat
- Cruciate ligament tears
2. Accidents and Illness Coverage:
This kind of insurance typically pays vet bills for common illnesses, hereditary conditions, and serious illnesses.
It includes the cost of emergency vet visits together with standard veterinary care required to treat common health problems in pets.
For instance, diagnostic tests, lab work, physical examinations, and similar essential services such as:
- Biopsies, lab work, and other diagnostic tests
- Intradermal skin or RAST allergy testing
- MRIs, CT scans, X-rays, and ultrasounds
- Chronic conditions — epilepsy, diabetes, allergies, etc.
- Cancer treatment — radiation, stem-cell therapy, and chemotherapy
- Hospitalization and surgery
3. Pet Wellness Coverage:
After selecting your desired level of coverage, you can then opt for a wellness program for pets, which will act as a “rider” on top of your insurance policy, if you choose to sign up.
Doing this will provide financial benefits on preventive care such as annual checkups, required for your pet.
- Flea/tick prevention
- Professional dental cleaning
- Spay/neuter surgery
- Fecal and routine blood tests
- Grooming and nail trims
- Preventative dental care
- Medicated shampoos
- Hip dysplasia exams, radiographs, or other OFA testing
- Routine anal gland expression
- Wearable pet activity monitors
- Reiki, massage therapy, acupuncture
- Cremation or burial
What Plans And Discounts Does Pet Insurance Cover?
When you purchase a pet insurance policy, you’ll usually select an annual maximum, a deductible, and a reimbursement level.
1. Premium Payments:
In order for you to keep your policy active you will have to pay a monthly premium.
This cost is generally based on several factors which are:
- Your pet’s age, breed, and gender
- Coverage amount
- Your zip code
- The type of insurance company you choose
Deductible is the amount of the vet bills that you are to pay before your pet insurance coverage starts.
For instance, an insurance company might give you options to choose from $250, $500, and $800 deductible.
It’s important to note that choosing a smaller deductible will increase the monthly cost of your policy.
So, the best advice: don’t choose a deductible that is too high or too low, stay on the average level.
3. Reimbursement Percentages
This reimbursement level is basically the amount your insurance company will reimburse you as well as the portion of the vet bill you must pay.
If, for instance, you choose a 70% reimbursement level, you will be responsible for 30% of the vet cost.
Now, it’s important to note that choosing a lower reimbursement level will reduce your monthly cost but you will have to pay more vet bills.
4. Annual Maximum Coverage Limit:
Some pet insurance companies have a certain annual coverage limit they can attain to a policy.
What this means is that they can only pay claims up to a certain amount in a year.
So, if you choose a $5000 coverage limit and exceed this amount in a year, you will pay the vet bills out of your pocket for the rest of the year.
Although, there are some pet plans that offer unlimited coverage options.
Pet Insurance Discounts
Below are some common discounts you should look out for:
- Annual Pay Discount: You’ll be able to save money if you can afford to pay your premium annually rather than on a monthly basis.
- Bundle Discount: you get a lower price when you bundle with renters or homeowners insurance policies under the same provider.
- Employee Benefit Discount: Some companies might decide to offer pet insurance discounts voluntarily and ranging from 5% to 10%
- Multi-pet Discount: many pet insurance companies offer discounts when you insure more than one animal with them.
- Military Discount: Being a former or active duty military member offers you a discount on some insurance policies.
- Spay/Neuter Discount: when you spay or neuter your animal before enrolling for an insurance policy, this will attract a premium discount from your issuer.
One excellent way to assist with pet care expenses is through pet insurance.
By understanding how the plan works and the different types of coverage, plans, and discounts that are offered, you can make the best decision.
You don’t have to wait, just go find the best pet insurance company for your furry friend right away!
Frequently Asked Questions
Does Pet Insurance Cover Pre-Existing Conditions?
In general, pre-existing conditions are not covered by pet insurance.
Any injury or illness that your pet develops before coverage takes effect and/or during a waiting period is referred to by insurers as a pre-existing condition.
After a policy is purchased, the majority of insurers impose a waiting period during which the coverage may be restricted. Depending on the business, this may be a few weeks, 180 days, or even longer.
Does Pet Insurance Cover Spaying And Neutering?
Spaying and neutering are not covered by pet insurance. However, depending on the specifics of the policy, you might be qualified for reimbursement for these procedures if you purchase a wellness plan, up to a specific limit.
Does Pet Insurance Cover Dental Extractions?
Although pet insurance typically does not cover procedures like teeth cleanings, it might be if an accident damage a tooth and the veterinarian determines that the removal is medically necessary.
However, for information on coverage, check your policy.
Does Pet Insurance Cover Pregnancy Or Breeding Services?
While some insurance providers provide an optional rider or policy add-on, for cat and dog breeders that covers some parts of pregnancy, pet insurance does not cover either pregnancy or breeding services.
Does Pet Insurance Cover Annual Vet Visits?
Exam fees are often excluded from a typical plan, but other components of your pet’s visit to the veterinarian, like testing and treatment for an illness or injury, may be covered by your pet insurance plan.
Think about purchasing a pet wellness plan if you want coverage that pays for exams.
Up to a specified limit, a wellness plan often pays for routine veterinary visits, exam costs, and preventative care.
Does Pet Insurance Cover Surgery?
Depending on your plan, pet insurance may cover surgical procedures.
If you buy accident-only coverage, it will likely pay for covered accident-related injuries that require surgery, such as bone fractures.
A comprehensive plan, which covers both accidents and illnesses, usually pays for a broader range of surgical procedures.