What is pet insurance?
Pet insurance, or pet health insurance, helps cover the cost of medical expenses should your pet become ill or have an accident.
Some pet insurance companies also offer routine and wellness coverage (vaccinations, annual wellness exams, spaying/neutering, heartworm testing/medications, etc.) for an additional fee.
Pet insurance is best used for unexpected, catastrophic medical events which are difficult to budget for.
Routine and wellness procedures are not always best handled with pet insurance. Sometimes the annual cost of adding routine and wellness care to your plan ends up being more than it would cost if you paid for these procedures out of your own pocket…so make sure you do the math before you buy.
It is possible that you will pay more in premiums than you get back if your pet stays relatively healthy, therefore pet insurance (like any other insurance) should be used as a risk management tool…not as a way to save money.
Pet insurance is similar to human health insurance in that it: has premiums, deductibles, co-pays, and maximum costs; does not cover pre-existing conditions; and has waiting periods that define when coverage starts. Companies can also have different waiting periods for different medical conditions.
Pet insurance differs from human health insurance in that it is a reimbursement program. This means that you pay the vet bill up front, and then you file the claim with the pet insurance company for reimbursement. It is very different from human medical insurance where the doctor file the claim and receive the payment directly from the insurance company. This means you will have to have some means of paying the veterinary bill while you wait for reimbursement from the pet insurance company.
Another difference from human health insurance is that pet insurance companies do not use networks. You are able to visit any licensed veterinarian in the U.S. Some plans also allow for you to visit a licensed veterinarian in another country while traveling.
Selecting a pet insurance plan is an individual choice because each person has different needs depending on the pet’s breed, owner’s geographical location and the owner’s budget.
First, determine if you need pet insurance. If you can cover the “worst case scenario” costs for your geographic location out of your own pocket, then you may not need pet insurance.
If you determine that you need pet insurance, make sure the pet insurance company you choose has the following attributes:
1. Has good medical coverage.
To get the most comprehensive coverage, you want to purchase a plan that covers accidents/injuries AND illnesses. The illness part of the coverage must include:
Coverage for cancer.
Coverage for chronic disease. Chronic diseases are illnesses that have long duration and generally slow progression. Examples include cancer, heart disease, chronic kidney disease, and chronic liver disease.
Coverage for hereditary and congenital diseases.
Coverage for diseases that are common to your pet’s breed.
2. Has a good reputation.
Research a pet insurance company’s reputation using the Better Business Bureau, your state’s Department of Insurance, or by visiting
3. Has a strong underwriter.
The underwriter is the company that is financially responsible for paying your claim. Use AM Best’s website to research the strength of the underwriter.
4. Has a maximum payout limit that will cover the “worst case scenario” costs for your geographic location.
The maximum payout limit is the maximum amount of money the insurance company will reimburse you for. This payout limit can be annual, lifetime, per incident, per body system, or based on a pre-determined benefit schedule. You want to pick a maximum payout structure that will cover the “worst case scenario” costs that could happen for you.
5. Has an affordable premium.
6. Pays claims in a timely fashion.
7. Does not have unreasonable exclusions and requirements.
Exclusions are medical conditions that are not covered by the plan.
Requirements are things you must do to remain insured: e.g. annual exams, animal must reside at place of residence listed on the policy, submission of medical records, and adherence to the vaccination recommendations.
Exclusions and requirements are written in the pet insurance company’s terms and conditions. It is important that you read this document before and after you buy so that there are no surprises.
As the name implies, “Accident Only” policies cover accidents only. They do not cover medical costs caused by illnesses.
“Accident Only” policies tend to be much cheaper than comprehensive “Accident and Illness” policies because they do not cover costly illnesses. Also, as a pet ages, the number of accident related injuries decreases in comparison to the number of illness related conditions. In addition, what a pet owner considers to be an accident is not necessarily what a pet insurance company considers to be an accident. For example, some companies will not cover conditions like foreign body ingestion or cruciate injuries in their “Accident Only” policies.
If you intend to buy an “Accident Only” policy, make sure you know what you are getting for your money.
- Never buy pet insurance without doing your own research.
- Do not pick pet insurance solely based on the cost of the premium. Make sure you take into consideration the monetary and medical coverage it provides.
- Read the terms and conditions of the pet insurance plan. Make sure you understand all the exclusions and requirements listed in the policy.
- Ask the company for a list of exclusion based on your pet’s past medical history and breed. Usually you have to purchase the policy first to receive this type of review and you will have to submit medical records. Also, not all pet insurance companies offer this option…but if they do, it will give you a list of the exclusions you can expect based on your pet’s prior history. If you don’t like what is on the list, you can cancel the policy with the money back guarantee period.
- Do not wait until your pet has an illness or injury before you buy pet insurance as it will be considered a pre-existing condition and will not be covered by your policy.
- Know which states are covered by the plan. Not all pet insurance companies are licensed to sell insurance in all states…therefore before buying a pet insurance plan, make sure the company sells plans in your state and any state you may be thinking of moving to. Also, make sure the coverage will be the same in the new state.
- If you have to switch pet insurance companies, any medical conditions your pet had under the old company may be considered pre-existing by the new company.
- Know the enrollment age range of the plan. This is the age your pet must be to sign up for a new policy. There is usually a low end and a high end. There can be one range for dogs and one range for cats. There can also be ranges for certain breeds.
- Make sure you ask the company how and when your premium can increase.
- Make sure you understand what the company’s waiting periods are as it will vary from company to company.
- Make sure you understand the company’s bilateral conditions policy. A bilateral condition is any condition that can happen on both sides of the body. Some companies have restrictions on how much they will cover for these types of conditions. Examples of bilateral conditions include, but are not limited to hip dysplasia and cruciate injuries.
- Pet insurance companies are businesses. As businesses, one of their top priorities will be to make a profit. They can and may change your rates and terms to meet that top priority. A change of business ownership or underwriter can also be a catalyst for changes in your rates and terms. When you purchase pet insurance, make sure you have a realistic understanding of this and how it can affect you.