What Does Pet Insurance Cover? Understanding Pet Insurance Coverage Options

What does pet insurance cover?

A good pet insurance plan covers many or most veterinary services, but the exact level of coverage depends on your plan.

Some pet insurance plans are comprehensive, covering everything from hip dysplasia and dental extractions to cancer and heart conditions. Others are somewhat limited. For example, you may have an accident-only plan instead of a plan that covers illness-related surgery and medications. Some pet insurance companies even offer wellness plans, giving you coverage for routine care.

What does accident-and-illness pet insurance cover?

Accident-and-illness insurance, sometimes called illness coverage or A&I coverage, is the most comprehensive type of pet insurance available. It covers vet bills arising from a wide variety of illnesses and accidental injuries.

A&I insurance typically covers the following:

• Allergies
• Arthritis
• Birth defects
• Broken bones
• Cancer
• Diabetes
• Ear and skin infections
• Emergency care
• Epilepsy
• Heart disease
• Hospitalization
• Ligament and tendon injuries
• Surgery
• Alternative medical treatments, such as acupuncture

Think of this type of pet insurance as “nose-to-tail” coverage.

Here’s an example of how accident-and-illness insurance works in real life. Your cat, Frankie, develops a lump on his back. Your vet removes the lump, sends it for a biopsy and then later informs you that Frankie has cancer. An accident-and-illness policy would cover some of the costs associated with treating the cancer, such as surgery or chemotherapy.

Some comprehensive plans even include a benefit that pays out if your pet is lost or stolen. For example, if your dog runs away after a visitor leaves the back door open, you may be eligible for a lump-sum payment.

What is covered by accident-only insurance?

An accident-only plan doesn’t cover the cost of diagnosing and treating illnesses.

It only covers expenses related to accidental injuries, such as:

• Animal or bug bites
• Broken bones
• Lacerations
• Poisoning

For example, if your dog injures its paw while jumping into a creek to retrieve a stick, your insurance company would pay for X-rays, bandages and other injury-related expenses.

What is covered by pet insurance wellness plans?

Some pet insurance companies offer standalone wellness plans, while others offer add-ons only.

A wellness plan covers vet bills associated with routine and preventative care, such as:

• Annual check-ups
• Blood and urine tests
• Deworming
• Exam fees
• Heartworm tests and treatment
• Flea and tick treatment
• Microchipping
• Nail trimming
• Routine dental care
• Spaying/Neutering
• Vaccines
• Wellness visits

What’s not covered by pet insurance?

Even the most comprehensive pet insurance plans don’t cover everything.

To ensure you’re prepared for every contingency, it’s important to understand what pet insurance policies cover and don’t cover.

Here are some of the most common exclusions.

How does pet insurance work?

The most common type of pet insurance requires you to submit your own claims and then wait for reimbursement. If you have this type of pet insurance, you have to pay your vet expenses upfront.

The second type of pet health insurance pays your vet directly. Instead of paying upfront and waiting for your insurer to reimburse you, the insurer pays your vet at the point of service or reimburses your vet for each filed claim.

To understand how pet insurance works, it’s important to familiarize yourself with common insurance terms. We’ll take a closer look at some terms below.

Policy limits

One of the most common limits is the annual limit, which limits the amount of money paid out each calendar year. For example, if your pet has $13,000 in veterinary expenses in a single year and your pet insurance has an annual limit of $10,000, you’ll have to pay the last $3,000 worth of veterinary bills on your own.

Some companies have per-condition limits, which are the maximum amounts paid to treat covered conditions. For example, your policy may have a limit of $5,000 for diabetes treatment. Once you reach that limit, you’ll have to pay any diabetes-related expenses out of your own pocket.

Your pet insurance may even have a per-incident limit, which limits the maximum amount of coverage available for veterinary expenses arising from a single event. For example, if your policy has a limit of $3,000 per incident, your insurer will only pay the first $3,000 of expenses arising from a single auto accident.

Reimbursement rate

The reimbursement rate is the percentage of eligible veterinary expenses covered by a health insurance policy for pets. For example, if your plan has a 90% reimbursement rate, it will reimburse you or your vet for 90% of each bill, less any copays or deductibles. This doesn’t include pre-existing conditions or other excluded expenses.

Copayments

Like human health insurance, health insurance for pets often requires you to make a co-pay every time you incur veterinary expenses. A co-pay is a fixed amount of money you pay for each visit. For example, your insurance company may require you to pay $15 for every veterinary visit.

Deductibles

A deductible is the amount of money you have to pay out of pocket before your insurance company pays for anything. If you have a policy with a $500 deductible, that means you have to pay $500 worth of vet bills before you’re eligible for reimbursement.

Pre-existing conditions

As noted previously, most policies exclude pre-existing conditions, or medical conditions that are diagnosed before your coverage goes into effect.

Waiting periods

When you sign up for pet insurance, you may have a waiting period, which is the amount of time that passes between the date you buy your policy and the date the coverage goes into effect. Insurance providers have waiting periods to prevent customers from submitting claims as soon as they sign up for coverage. Most companies have a waiting period of 14 days, but you may have to wait a little longer depending on the terms of your policy. If fast coverage is crucial for your pet we recommend comparing pet insurance with the fastest coverage options.

How much does pet insurance cost?

Pet insurance costs around $19 per month for cats and $30 per month for dogs.

Remember, this is just an average. Your costs may be higher or lower depending on the level of coverage you select.

The following factors also affect the cost of pet health insurance:

• Age: It typically costs more to buy insurance for an older pet than it does to buy insurance for a puppy or kitten.
• Location: Some cities have higher costs of living than others. If you live in one of those cities, you may pay more for pet insurance than someone who lives in an area with lower average costs.
• Species: Cat insurance typically costs less than dog insurance. You may also pay more for exotic pet insurance to cover a rabbit or bird.
• Breed: Some breeds are prone to health problems. If your pet is one of those breeds, your pet insurance premium may be higher than average.
• Level of coverage: Pet insurance companies charge more for accident-and-illness plans than they do for accident-only coverage.

To compare policies and prices, try using our online comparison tool. This way, you can get a clear view of your options and how much they cost.

You can also check out our guide to cheap pet insurance to learn how to lower your monthly premiums.

Is pet insurance worth it?

Pet insurance is worth it as long as you have enough vet expenses to justify the cost of maintaining coverage. That said, finding the right pet insurance plan is key.

If your pet is healthy and you only visit the vet for routine medical care, you may end up spending more on pet insurance than you do on veterinary expenses. This is especially true if your plan has a high deductible or low coverage limit.

That said, you never know when your pet might develop a serious illness or injury. It’s good to have pet insurance in place so that you don’t have to worry about paying a large bill out of your own pocket.