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Pet insurance, like just about all kinds of insurance, is complicated. But getting a grasp of the basics can make it a lot easier to figure out what you need. In this article, we break down how pet insurance works, what it covers, and what to know before you buy.
Your Coverage Depends on Your Pet Insurance Policy
Basic Coverage | + Strong Coverage | |
Accident Only |
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Accident & Illness |
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Wellness Add-On |
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*For illustrative purposes only. Please review individual plans to understand what is included or not.
Accident and Illness Plans
A standard pet insurance plan covers treatment for a pet’s accidents and illnesses. Accidents and illnesses might include things like:
- Cuts, scrapes, sprains, and broken bones
- Foreign body ingestion
- Bacterial and viral infections
- Vomiting and diarrhea
- Diseases and illnesses
- Surgery
- Cancer
Some accident and illness plans are more comprehensive than others. An especially strong policy might offer coverage for the below or allow you to pay extra for it as an “add on,” while a more basic policy will cover it lightly or not at all.
- Dental care
- Prescriptions
- Alternative and holistic treatments
- Vet-recommended behavioral therapy
- Exam fees
Dental coverage varies widely between providers. A simple dental add-on will include treatment for chipped or injured teeth, while stronger plans like Fetch’s will also cover extractions and periodontal disease. For somethinga little more customizable that will allow you to pick and choose your coverage—including dental—try a free quote from Lemonade below.
Prescriptions usually include most medications—though it’s worth noting that even plans with excellent coverage treat typically dietary supplements and prescription foods as an exception, even if they’re recommended by a vet.
Alternative treatments for pets are on the rise, and they include things like hydrotherapy, acupuncture, or chiropractic care. All are sometimes recommended for dogs after serious orthopedic injuries or surgeries, and they have benefits for arthritic pets too.
Vet-recommended behavioral therapy might be recommended for pets with issues around aggression, separation, or handling. It’s typically a more involved process than training and can include medication alongside appointments with a certified applied animal behaviorist or veterinary behaviorist. More comprehensive plans, like Spot’s, typically cover this, though not all providers do.
Exam fees are another gray area. “Exam” usually refers to the diagnostic exam that happens when you bring your pet in with a complaint, not a regular wellness check. Some pet insurance companies, like Spot, cover exam fees as part of a basic accident and illness plan, while others include them as an add-on—or not at all.
Wellness add-ons
One thing you’ll notice standard accident and illness plans don’t cover is routine care. That includes things like your pet’s annual checkup, bloodwork, and preventatives like flea and tick medicine.
That’s one reason wellness add-ons are especially common. They cover a select listing of routine and preventive care treatments, which might include a stipend for things like:
- Annual checkups and wellness exams
- Vaccinations and shots
- Flea/tick and heartworm prevention
- Routine dental cleanings
- Microchipping
- Spaying/neutering
Wellness add-ons vary from provider to provider both in what they’ll cover and in how much money they’ll apportion for different kinds of preventive care.
Accident-only plans
You can also purchase more modest “accident only” pet insurance plans, which will only cover treatment for your pet’s accidents—things like a broken bone resulting from a collision, or a cut from a fight with another animal. These plans don’t cover diseases and illnesses, which can be limiting. But they’re also quite a bit more affordable than a plan with all the bells and whistles.
Accident-only plans like Prudent Pet’s are especially popular with senior pets, whose pre-existing conditions may prevent them from seeing the benefits of a more comprehensive accident and illness policy.
What Pet Insurance Doesn’t Cover
Different pet insurance providers offer different degrees of coverage, but there are some things virtually no pet insurance will cover:
- Treatment for pre-existing conditions
- Liability
- Non-RX supplements and foods
- Grooming and training
Pre-existing conditions are any health condition your pet had prior to your policy’s start date. If the condition is logged in your pet’s medical records, then it’s probable that no treatments for that condition will be covered by your insurance company.
This exclusion is often applied to bilateral conditions—that is, conditions that can occur on either side of the body. For example, if your dog was diagnosed with glaucoma in one eye before you got pet insurance, glaucoma in either eye will be considered a pre-existing condition.
Pet insurance also doesn’t cover liability—it focuses on insuring you against damage to your pet, not damage your pet inflicts.
Finally, dietary supplements and prescription foods, grooming, and basic training can all feel like necessary medical expenses for your pet, especially when your vet recommends them. But they’re also almost never covered, even with a wellness add-on.
Other limitations of pet insurance
Pet insurance also has waiting periods: lengths of time after your policy goes into effect where some kinds of treatment will not be covered. Waiting periods for accident treatment are usually just a couple days, and illnesses commonly have two-week waiting periods. But orthopedic conditions like hip dysplasia and torn cruciate ligaments often have waiting periods of six months or more. Only a few providers, like Spot, offer shorter orthopedic waiting periods.
Then there are age limits. Some pet insurance companies won’t sell policies for pets over a certain age, or they won’t cover certain kinds of treatment if you purchased your policy after your pet reached a certain age. We’ve listed the waiting periods and age limits that popular providers require in our review of the best pet insurance companies.
Finally, a lot of pet parents think that spaying and neutering will fall under the heading of “surgery,” which most pet insurance plans cover. But they’re typically categorized as part of preventive care. While some wellness add-ons will cover a portion of their cost, most standard accident and illness plans won’t cover them at all.
How Pet Insurance Works: Premiums, Limits, and Deductibles
Pet insurance is similar to human health insurance in a lot of ways. You’ll pay a monthly premium, and your vet bills will be partly or fully covered at your established reimbursement rate by your insurance company once you’ve paid out a certain amount on your own (the deductible). Eligible vet bills will be covered until you hit your policy’s limit.
Premiums are what you pay
Premiums can range widely from pet to pet—anywhere from $10 to $100 or more per month. Here are some factors that determine what you pay:
- Your pet’s species and breed. Dogs are generally more expensive to insure than cats, and within species, some breeds are more expensive than others.
- Your pet’s age. Older pets tend to face higher premiums than younger ones.
- Your location. The cost of veterinary care varies wildly from state to state—and with it the cost of pet insurance.
- Your plan. When you sign up for pet insurance, you can often choose between a range of policies with different degrees of coverage. A plan with less coverage will mean lower premiums, while add-ons will make your premiums more expensive.
- Customizations. On enrolling in pet insurance, you can often customize your deductible and reimbursement rates. A high deductible and lower reimbursement rate will mean lower premiums, and vice versa.
It’s also important to know that your premiums will change over the course of your pet’s life. The older a pet gets, the higher the premiums. You might also see things get more or less expensive with the cost of veterinary care in your state.
Limits are the most your insurance company pays
Next, you’ll want to consider limits—the maximum amount your pet insurance company can ever pay out. Limits come in two flavors: annual and lifetime. An annual limit is the most your pet insurance company will ever pay out in a year, and a lifetime limit is the most they’ll pay out over the course of your pet’s lifetime.
When you sign up for pet insurance, you’ll often be offered a choice of several annual limits. Common options are $5,000, $10,000, and unlimited. The lower your limit, the cheaper your premiums will be.
Reimbursement rates are the percentage of the bill your insurance company pays
Unlike human health care, most pet insurance works by reimbursing you, not your vet, for your pet’s healthcare. After you’ve paid your vet, you’ll submit a claim to your pet insurance company, who will then pay you. A few providers offer direct vet pay, which means your insurance company will pay your vet instead of you—but it’s not the norm.
As a result, your reimbursement rate is the percentage of an eligible vet bill your pet insurance company will pay you. Most pet insurance companies will offer you a choice of several reimbursement rates. Common options are 70%, 80%, and 90%, with a few companies even offering 100% reimbursement—which means you pay nothing at all for accident and illness treatment once your deductible is met.
Lower reimbursement rates typically come with lower premiums, while higher ones can be more expensive.
Deductibles are what you pay first
Your deductible is the amount of money you will need to pay out every year on eligible vet expenses before your pet insurance plan kicks in.
Just like premiums and reimbursement rates, deductibles can vary. A low deductible might be anywhere from $300 to $500, while a high deductible could be $1,000 or more. The premiums for a policy with a high deductible will be cheaper than those for a low-deductible plan.
Note that routine vet visits won’t count toward your deductible spending—you’ll have to shell out your deductible in accident and illness spending before your pet insurance company will start paying claims at your policy’s reimbursement rate.
What Kind of Pet Insurance Policy Should I Get?
One of the major advantages of pet insurance is that it can let you say yes to care for your pet that might be cost-prohibitive otherwise, like a $4,000 surgery, or $10,000 cancer treatment. It can also help you defray smaller vet expenses, like scrapes, UTIs, and ear infections.
But what kind of care your pet is likely to need will shape what kind of policy you find most rewarding. Here are some basic guidelines to consider:
- If you have a young pet, consider policies with 24/7 vet helplines or extra-strong wellness add-ons to help you get through that tough first year.
- If you have a senior pet, avoid plans with age limits and especially long waiting periods, and consider those that have good coverage for physical and alternative therapies, like Spot.
- If you have a pet with a lot of pre-existing conditions, consider an accident-only plan like Prudent Pet’s, or opt for a provider that offers a transparency report for pre-existing conditions. They can let you know early on what won’t be covered.
- If you’re worried about reimbursement, consider a pet insurance company that offers direct vet pay, and follow up with your vet to make sure they’re able to participate.
Feeling uncertain? For more on how to choose a provider and a plan, check out “How To Choose the Right Insurance for Your Pet.” Or forge ahead and read up on what some of the best pet insurance companies can offer.
Further Reading
- The Best Pet Insurance: A Pet Parent’s Guide
- Is Pet Insurance Worth It? How To Know If It’s a Good Deal for Your Pet
- How To Choose the Right Insurance for Your Pet
- How Much Does Pet Insurance Cost?
- Pet Insurance and Pre-Existing Conditions—What To Know Before You Buy
- The Best Pet Insurance Wellness Plans: How Preventive Care Add-Ons Work
- What To Know About Waiting Periods and Pet Insurance
- What Are Pet Insurance Deductibles, and How Do You Pick One?
- When Should You Get Pet Insurance?
- Savings Account Versus Pet Insurance: Which Is Better?
Insurance advice, products, and links contained in this article are currently intended for and only available in the states where Rover Pet Insurance Services, LLC is currently licensed as an insurance producer. As we expand our licensing to other states we will update our websites and links.
If you are located in a state in which we are not currently licensed, but would like to learn more about pet insurance products available in your state, you may contact a licensed insurance agent or broker in your state.
The information provided below is offered for educational and informational purposes only. If you have questions regarding particular plans, you should reach out to your insurance company for more information.