Pet Insurance: How Does It Work, & What You Need to Know to Get One

Introduction

In recent years, pet ownership has seen a significant rise, with more people welcoming furry companions into their homes. Pets are not just animals; they are family members who bring joy, companionship, and unconditional love. However, just like humans, pets can fall ill or get injured, leading to unexpected veterinary expenses. This is where pet insurance comes into play.

Pet insurance is designed to help pet owners manage the financial burden of veterinary care, ensuring that their beloved pets receive the necessary medical attention without causing financial strain.

What is Pet Insurance and How Does it Work?

Pet insurance is a type of health insurance policy designed specifically for pets. It helps cover the cost of veterinary care, including treatments for illnesses, injuries, and sometimes routine care. The basic principle of pet insurance is similar to human health insurance: you pay a monthly or annual premium, and in return, the insurance company reimburses you for a portion of your pet’s medical expenses.

When you purchase a pet insurance policy, you agree to pay a premium based on factors such as your

(1) pet’s age, (2) breed, and (3) health condition.

In the event of a veterinary visit, you typically pay the vet bill upfront and then submit a claim to your insurance provider for reimbursement. The reimbursement amount depends on your

(1) policy’s terms, including (2) deductible, (3) co-pay, and (4) coverage limits.

We will discuss these in further detail in a section below.

What is Covered by Pet Insurance?

Pet insurance policies vary widely, but most plans cover the following:

1. Accidents and Injuries: Almost all pet insurance policies provide this, the most basic level of coverage. Coverage for unexpected injuries such as broken bones, cuts, or ingestion of foreign objects. The expense of casts, surgeries, and other required procedures would be paid if your dog broke a leg while playing in the park.
2. Illnesses: Coverage for illnesses ranging from minor infections to serious diseases like cancer. For example, the cost of insulin and associated treatments would normally be paid if your cat developed diabetes.
3. Wellness coverage: Wellness coverage can be purchased separately or as an add-on from some insurance providers. This covers standard care such as immunizations, yearly physicals, prevention of fleas and ticks, heartworm medication, and dental cleanings.
4. Hereditary and congenital conditions: This includes treating ailments that your pet was born with or is susceptible to due to their breed. For example, the cost of any necessary surgery will probably be reimbursed if your purebred German shepherd develops hip dysplasia, a common hereditary ailment.
5. Hospitalization: Coverage for overnight stays and treatments in a veterinary hospital.
6. Medications: Coverage for prescription medications required for treatment.
7. Diagnostic Tests: Coverage for tests such as X-rays, blood tests, and MRIs.

What is Not Covered by Pet Insurance?

While pet insurance provides valuable financial protection, it does not cover everything. Common exclusions include:

1. Pre-existing Conditions: Any health issues your pet had before the policy’s start date are typically not covered. For instance, the expenses of continuing care and medication for your cat’s hyperthyroidism will not be covered if the problem has already been detected.
2. Elective Procedures: Non-essential procedures, such as cosmetic surgeries, are usually excluded. Ear cropping and tail docking, for instance, are typically not covered.
3. Breeding Costs: Expenses related to breeding, pregnancy, or whelping are generally not covered. Therefore, your insurer would probably not cover the expense of a cesarean section if your dog got pregnant.
4. Behavioral Issues: Treatment for behavioral problems like anxiety or violence is often excluded by policies. These expenses are frequently not reimbursed if your dog needs expert training to handle aggressive behavior.
5. Grooming and boarding: Regular grooming and boarding expenses are typically not covered by pet insurance because they have no direct connection to your pet’s health or well-being.

It’s essential to read the policy details carefully to understand what is and isn’t covered.

Major Elements and Key Terms of Pet Insurance

Understanding the key elements and terms of pet insurance is crucial for selecting the right policy:

1. Premium: This is how much your pet insurance policy costs each month or each year. The age, breed, and health of your pet, the type of coverage you select, your deductible, and the policy’s percentage of reimbursement are some of the variables that an insurer will use to determine your premium. For instance, a young, healthy dog may pay $20 a month for a comprehensive policy, but an elderly dog who is more prone to have health issues may pay $100 or more.
2. Deductibles: The amount you have to fork out before your pet insurance starts to pay is known as the deductible. Deductibles may be as much as $1,000. Depending on the insurance, the deductible may be imposed annually or for each incident. You only have to pay the deductible once a year if it is an annual deductible. A per-incident deductible, on the other hand, requires you to pay the deductible for every distinct disease or injury.
3. Reimbursement Level: A portion of the remaining expense will be covered by your pet insurance after your deductible has been paid. This is the degree of reimbursement, which normally falls between 70% and 90%.
4. Cap and coverage Limits: The amount that many insurance will pay out each year, for each occurrence, or during the pet’s lifetime is capped or limited. The pet owner is responsible for covering any expenses over these caps out of pocket.
5. Add-ons: For an extra fee, certain pet insurance companies provide optional add-ons. These can include coverage for alternative therapies like acupuncture or chiropractic adjustments, or wellness coverage, which covers regular care like veterinary examinations and immunizations.
6. Out-of-pocket expenses: The pet insurance policy does not cover these. They may cover the price of cosmetic operations, out-of-network or behavioral therapy, veterinary care that goes above the restrictions or limits of your coverage, or any treatments for pre-existing conditions.
7. Waiting Period: The time you must wait after purchasing a policy before coverage begins. Waiting periods vary for accidents, illnesses, and specific conditions.

What are the Types of Pet Insurance Plans?

Pet insurance plans generally fall into three categories:

1. Accident-only coverage: Compared to accident and illness plans, accident-only plans have fewer benefits. They will cover the cost of treating unintentional injuries such as those mentioned above, but they will not pay for costs associated with infections, cancer, or other diseases. Since they cover so much less than accident and illness policies, they are typically less expensive.

Following are covered in accident-only plan which are related to accidental injuries only:

• Hospitalization
• medicine
• diagnostic tests
• surgery
• other treatment

This plan does not include the following:

• Treatment for any illness, including infections and cancer.
• Pre-existing conditions.
• Cosmetic or elective procedures.
• Breeding.
• Routine care.

Why this plan will be for your pet: For pets that are too elderly to be eligible for an accident and illness coverage at the time of enrollment, accident-only plans can be their only choice. If you want emergency insurance for your pet but cannot afford accident and illness coverage, an accident-only plan can be a viable option.

2. Accident and Illness Plans: These comprehensive plans cover both accidents and illnesses, providing broader protection for your pet. The following accidents and illnesses are covered:

The following are covered in the accident and illness plan which are related to accident and illness:

• Hospitalization
• medicine
• diagnostic tests
• surgery
• other treatment for accidents and illnesses

The plan does not include the following:

• Pre-existing conditions.
• Cosmetic or elective procedures.
• Breeding.
• Routine care.

Plans for accidents and illnesses only cover medical emergencies involving your pet. Preventive care, like as yearly physicals and immunizations, will not be covered unless you purchase a wellness add-on plan.

Why this plan will be for your pet: Plans for accidents and illnesses cover the widest spectrum of potential issues for your pet. Additionally, they are the most generally accessible and adjustable, so you will have no trouble finding the coverage you require. Flexibility of the options is the key here.

3. Wellness Plans: Also known as routine care plans, these cover preventive care, such as vaccinations and annual exams. Wellness plans are often available as add-ons to accident and illness plans. Depending on the plan, following services might include:

• Wellness exams.
• Vaccinations.
• Bloodwork.
• Heartworm or FeLV/FIV test.
• Fecal or internal parasite test.
• Flea, tick and/or heartworm medication.
• Microchipping.
• Deworming.
• Dental cleaning.
• Spay or neuter surgery.

The following are covered in the accident and illness plan which are related to accident and illness:

• Vaccinations.
• Annual check-ups.
• Routing blood work and other tests.
• Flea, tick and heartworm preventives.

The plan does not include the following:

• Treatment for any accident or illness.
• Any services not listed in your policy.

Why this plan will be for your pet: If you are certain that you will require all or most of the treatments included by a wellness plan, you may be able to save money. If not, the cost of the coverage can exceed the reimbursements you receive. Before you commit, do the math.

Most Common Pet Insurance Claims

Pet insurance claims can vary, but some of the most common claims include:

1. Ear Infections: A frequent issue in dogs, especially those with floppy ears.
2. Gastrointestinal Issues: Vomiting, diarrhea, and other digestive problems are common reasons for vet visits.
3. Skin Conditions: Allergies, rashes, and infections often require medical attention.
4. Urinary Tract Infections: Common in both cats and dogs, especially as they age.
5. Dental Disease: Dental cleanings and treatments for periodontal disease are common claims.
6. Eye conditions: Pets frequently suffer from eye disorders including conjunctivitis or corneal ulcers, which result in a high volume of insurance claims.
7. Orthopedic issues: Certain breeds are prone to conditions like hip dysplasia or cruciate ligament injuries, which frequently result in claims.
8. Respiratory conditions: Particularly for cats, respiratory conditions like bronchitis or asthma are frequent causes of insurance claims.
9. Cancer: Unfortunately, a variety of malignancies can also strike dogs. Treatment is frequently expensive, which results in large insurance claims.
10. Diabetes: Pets may have diabetes, much like people, which necessitates constant care and observation and frequently results in insurance claims.

How Much Does Pet Insurance Cost?

The cost of pet insurance varies based on several factors, including:

1. Pet’s Age: Older pets are more prone to health issues, leading to higher premiums.
2. Breed: Some breeds are more susceptible to certain conditions, affecting the cost.
3. Location: Veterinary costs vary by region, influencing insurance premiums.
4. Coverage Level: Higher coverage limits and lower deductibles result in higher premiums.
5. Plan Type: Comprehensive plans cost more than accident-only plans.

On average, pet insurance premiums range from $20 to $50 per month for dogs and $10 to $30 per month for cats.

Factors that Affect Pet Insurance Costs

Several factors influence the cost of pet insurance:

1. Breed-Specific Health Risks: Breeds prone to genetic conditions may have higher premiums.
2. Age of the Pet: Younger pets generally have lower premiums, while older pets may face higher costs due to increased health risks.
3. Geographic Location: Urban areas with higher veterinary costs may result in higher premiums.
4. Policy Details: The deductible, reimbursement level, and coverage limits you choose will impact the cost.
5. Insurance Provider: Different companies have varying pricing structures and discounts.

How to Find the Best Pet Insurance for You

Finding the right pet insurance involves careful consideration of your pet’s needs and your budget. Here are some steps to help you choose:

1. Assess Your Pet’s Health Needs: Consider your pet’s age, breed, and any existing health conditions.
2. Compare Plans: Research different insurance providers and compare their plans, coverage options, and costs.
3. Read Reviews: Look for customer reviews and ratings to gauge the company’s reputation and customer service.
4. Check for Exclusions: Understand what is not covered by the policy to avoid surprises later.
5. Consider the Cost: Balance the premium cost with the coverage provided to ensure it fits your budget.

Is Pet Insurance Worth It?

Pet insurance can be a valuable investment for many pet owners, providing peace of mind and financial protection. It is particularly beneficial for those with pets prone to health issues or those who want to ensure they can afford necessary treatments without financial strain. However, it’s essential to weigh the cost of premiums against potential savings on veterinary bills to determine if it’s worth it for your specific situation.

Pet Insurance Coverage by Insurance Company

Different insurance companies offer varying levels of coverage and benefits. Some well-known pet insurance providers include:

1. Healthy Paws: Known for comprehensive coverage and no annual or lifetime limits.
2. Embrace: Offers customizable plans with wellness rewards for routine care.
3. Trupanion: Provides 90% reimbursement with no payout limits and covers hereditary conditions.
4. Nationwide: Offers a range of plans, including wellness coverage and exotic pet insurance.
5. ASPCA: Provides flexible plans with options for accident-only or comprehensive coverage.

Pet Insurer	Accident & Illness	Accident-only	Wellness
AKC	✅	✅	✅
ASPCA	✅	✅	✅
Embrace	✅	✅	✅
Fetch	✅		✅
Figo	✅		✅
Hartville	✅	✅	✅
Healthy Paws	✅
Lemonade	✅		✅
Liberty Mutual	✅	✅	✅
ManyPets	✅		✅
MetLife	✅		✅
Nationwide	✅	✅	✅
Pets Best	✅	✅	✅
Pumpkin	✅		✅
Spot	✅	✅	✅
Trupanion	✅

Most Insured Pet Breeds for Cats and Dogs

Certain breeds are more commonly insured due to their popularity and potential health risks. For dogs, popular insured breeds include:

1. Labrador Retriever: Known for their friendly nature but prone to hip dysplasia.
2. French Bulldog: Popular but susceptible to respiratory issues.
3. German Shepherd: Prone to joint problems and skin conditions.
4. Mixed
5. Golden retriever
6. Goldendoodle
7. Chihuahua
8. Yorkshire terrier
9. Shih Tzu

For cats, common insured breeds include:

1. Maine Coon: Large and friendly, but prone to heart disease.
2. Siamese: Known for their vocal nature and potential respiratory issues.
3. Persian: Prone to kidney disease and respiratory problems.
4. Mixed breed
5. Domestic shorthairs
6. Domestic medium hair
7. Domestic longhair
8. Ragdoll
9. American shorthair (purebred)

Key Takeaways

• Pet insurance helps manage the cost of veterinary care, providing financial protection for unexpected medical expenses.
• Coverage varies by policy, with options for accidents, illnesses, and routine care.
• Understanding policy terms, exclusions, and costs is crucial for selecting the right plan.
• Research and compare different insurance providers to find the best coverage for your pet’s needs.
• Pet insurance can be a worthwhile investment, especially for breeds prone to health issues.

Frequently Asked Questions

Q1: Can I get pet insurance for an older pet?
A1: Yes, many insurance companies offer coverage for older pets, but premiums may be higher due to increased health risks.

Q2: Does pet insurance cover spaying or neutering?
A2: Spaying and neutering are typically not covered under standard policies but may be included in wellness plans.

Q3: How soon can I use my pet insurance after purchasing a policy?
A3: Most policies have a waiting period before coverage begins, ranging from a few days for accidents to several weeks for illnesses.

Q4: Can I use any veterinarian with pet insurance?
A4: Most pet insurance plans allow you to visit any licensed veterinarian, but it’s essential to verify this with your provider.

Q5: Is there a limit to how many claims I can make?
A5: Some policies have annual or lifetime limits on claims, while others offer unlimited coverage. Check your policy details for specific limits.

Q6: Does pet insurance only cover cats and dogs?
A6: Dogs and cats are not the only pets covered by pet insurance. A wide range of other pets, such as birds, rabbits, and exotic animals like reptiles, are also covered by many insurance companies. Be cautious to thoroughly investigate providers before purchasing a policy, though, as the costs and coverage options may differ greatly depending on the provider and pet type.

Q7: At what age should you get your dog or cat pet insurance?
A7: Getting pet insurance for your dog or cat as soon as possible is the best course of action, preferably when they are still pups or kittens. As early as eight weeks of age is when the majority of insurers will let you begin an insurance. A wider choice of coverage and cheaper premiums may be available if you insure your pet early in life.

Q8: Is pet insurance expensive?
A8: The breed, age, and health of the pet, as well as the type of coverage selected, can all have a significant impact on the price of pet insurance. Pet insurance often costs between $10 and $100 a month. Although it could appear like an extra price, it is crucial to take into account the possible financial burden of covering unforeseen veterinary bills out of pocket, which in the event of a serious illness or injury might often outweigh the cost of monthly premiums.

Q9: Is pet insurance tax deductible?
A9: Except in cases where the pet is a licensed service animal, pet insurance is normally not tax deductible. The cost of service animals, including insurance, may be deducted from medical expenditures. However, regulations might change, so it is wise to speak with a tax expert about your particular situation.