Pet insurance is designed to help pet parents deal with unexpected veterinary expenses, giving them peace of mind about their furry companion’s health. But what exactly does pet insurance cover? From routine checkups to emergency treatment, pet insurance varies greatly depending on the plan and insurance company you choose.
It’s helpful to know the common types of coverage available so you can make an informed decision about protecting your pet. Whether you want coverage for accidents, illnesses, or preventative care, it’s important to understand what your insurance covers to ensure your pet receives the proper care.
Types of pet insurance coverage
There are three main types of pet insurance, each offering different levels of coverage. Understanding these will help you choose the best plan for your pet’s needs and budget.
Accident only compensation
Accident-only plans cover expenses related to injuries caused by accidents. This includes broken bones, cuts, poisoning, and ingestion of foreign objects. Accident-only plans are usually more affordable, but do not cover illness or preventive care.
Accident and illness compensation
This is the most common type of pet insurance. It covers both accidents and illnesses, including illnesses such as cancer, infectious diseases, and genetic disorders. These plans are more comprehensive and slightly more expensive than accident-only plans.
Wellness guarantee
Wellness plans, also known as preventive care plans, cover routine and preventive care. These plans may include vaccinations, annual checkups, flea and tick prevention, and dental cleanings. Some pet insurance companies offer health insurance in addition to accident and illness plans.
Coverage varies by provider, but common services typically included in wellness plans include:
- Annual health checkup
- dental treatment
- Microchip installation
- Prevention of pests (fleas, ticks, heartworms)
- Regular blood tests and diagnosis
- Spay/neuter surgery
- vaccination
| Accident plan | Accident and illness planning | wellness | |
|---|---|---|---|
| *In the case of accident-specific insurance, pet insurance only covers medication and treatment due to accidents and illnesses covered by insurance. | |||
| Acupuncture, chiropractor, physical therapy | ✓ | ✓ | × |
| Fractures, lacerations, ligament tears | ✓ | ✓ | × |
| Common illnesses such as vomiting, diarrhea, and eye and ear infections | × | ✓ | × |
| Diagnostics such as X-rays, CT scans, ultrasounds, blood tests, etc. | ✓ | ✓ | × |
| Poisoning, ingestion of foreign substances | ✓ | ✓ | × |
| Prescription drugs for infections, pain, and inflammation | ✓ | ✓ | × |
| Procedures such as surgery, chemotherapy, and colonoscopies | ✓ | ✓ | × |
| Regular checkups, vaccinations, pest prevention | × | × | ✓ |
| Serious illnesses such as cancer, diabetes, and heart disease | × | ✓ | × |
Pet insurance coverage details
Pet insurance coverage varies widely depending on your provider and the specific plan you choose. Despite these differences, most insurance policies offer protection for a variety of treatments and procedures.
accident
Accident compensation is a staple of pet insurance. This includes injuries from car accidents, falls, and bites from other animals. Treatment for these injuries may include first aid, surgery, hospitalization, and medications necessary for the healing process.
The types of accidents include:
- Wounds from bee stings or bites from other animals
- eye injury
- Ingestion of foreign objects, poisons, or exposure to toxins
- laceration
- sprains and fractures
- ACL tear (anterior cruciate ligament)
chronic disease
Chronic conditions such as allergies, arthritis, and diabetes require ongoing treatment and medication. Pet insurance can help manage the costs of these long-term conditions and make it easier for pet owners to provide ongoing care.
emergency medical care
Emergency veterinary care can be cost-prohibitive. Pet insurance covers emergency visits, treatments, and surgeries, giving you peace of mind during stressful situations.
diagnostic test
Pet insurance often covers the cost of diagnostic tests such as blood tests, X-rays, MRIs, and ultrasounds. These tests are essential to accurately diagnose the condition and plan appropriate treatment.
Genetic and congenital diseases
Some breeds are predisposed to genetic and congenital diseases such as hip dysplasia and heart disease. Comprehensive pet insurance plans often cover these conditions, but some plans may have a waiting period before coverage begins.
disease
Most pet insurance plans cover a variety of illnesses, from mild infections to serious illnesses such as cancer. Insurance typically covers diagnosis, medications, and treatments such as chemotherapy and surgery.
Illnesses include:
- allergy
- arthritis
- cancer
- diabetes
- diarrhea and/or vomiting
- heart disease
- kidney disease
- liver failure
- skin condition
- thyroid disease
- urinary tract infection
prescription drugs
Many pet insurance plans cover the cost of your pet’s medications, such as antibiotics, painkillers, and treatments for chronic conditions.
Not covered by pet insurance
While pet insurance offers a wide range of coverage, there are some common exclusions to be aware of.
behavioral therapy
Behavioral conditions such as destructive biting, excessive licking, and hair pulling can harm your furkid and cause stress to your family. Few pet insurance companies will cover medical and treatment costs related to behavioral issues unless you opt for additional benefits.
breeding and pregnancy
After researching good pet insurance companies, we couldn’t find any that covered costs related to breeding, pregnancy, and birth in their standard policies. However, AKC and Trupanion will reimburse these costs if you add a breeding rider to your policy.
beauty treatment
Cosmetic procedures such as tail docking, ear clipping, and nail removal are not considered medically necessary and are therefore generally not covered by pet insurance.
existing symptoms
In the context of pet insurance, a pre-existing condition is an illness, injury or health problem that your pet exhibits or has been diagnosed with before the policy begins. These conditions are usually excluded from coverage. This means that the treatments associated with them will not be reimbursed by your insurance company.
There are some exceptions. Some providers may cover pre-existing conditions that are curable after a specified waiting period, but this varies by insurance.
Routine and preventive care
Routine and preventive care includes annual exams, dental cleanings, and vaccinations. Insurance typically does not cover these costs unless you have a wellness plan.
How to understand the cost of pet insurance coverage
As you consider your pet insurance options, you may come across terms such as “deductible,” “coinsurance,” and “reimbursement rate.” Understanding these concepts is important to choosing the right plan and managing your expectations regarding out-of-pocket costs.
coinsurance
Coinsurance is another way to calculate reimbursement rates. Coinsurance is the percentage of the veterinarian’s bill that you are responsible for paying after meeting your deductible. Basically, the treatment costs are split 50-50 between you and the insurance company.
For example, if your coinsurance is 20 percent, you will pay 20 percent of your claim and your insurance will cover the remaining 80 percent. On a $500 vet bill, you would include the $100 deductible and pay 20 percent of the remaining $400, or $80.
Deductible amount
Your pet insurance deductible is the amount you pay out-of-pocket before your insurance policy starts reimbursing your veterinary expenses. Essentially, it’s your financial contribution to your pet’s medical care.
Once you meet your deductible, your insurance policy will cover eligible expenses according to the terms of your plan.
Deductibles can be either per accident or annually. Per-accident deductibles require you to pay a deductible for each new condition or accident. Your annual deductible, on the other hand, only resets once a year, regardless of the number of accidents that occur.
pet insurance premium
Pet insurance premiums vary widely depending on several factors.
- year: Older pets usually have higher insurance premiums due to increased health risks.
- breeding: Some breeds are more prone to certain health problems and therefore cost more to insure.
- coverage level: Comprehensive plans with higher coverage limits and lower deductibles are more expensive.
- position: Veterinarian costs vary by location and will affect your insurance premium.
An accident-only plan costs $17 per month for dogs and $10 per month for cats. Accident and illness plans average $57 per month for dogs and $32 per month for cats. For a comprehensive plan that includes health insurance, expect to pay an additional $10 to $25 per month.
Redemption rate
In pet insurance, the reimbursement rate is the portion of the veterinarian’s bill that the insurance company reimburses after meeting the deductible. This percentage directly affects your out-of-pocket costs.
For example, let’s say you have a $500 vet bill with a $100 deductible. After paying your deductible, you’re left with $400. With an 80% refund rate, you’ll get $320 back.
conclusion
Pet insurance provides invaluable support in managing your pet’s medical costs. From accidents and illnesses to health care, understanding what pet insurance covers can help you make informed choices and choose the plan and insurance company that fits your pet’s unique needs. You can.
Coverage details vary by provider. It’s important to carefully check your policy for exclusions and additional costs to avoid surprises when making a claim. With the right coverage, you can focus on providing the best care for your four-legged friend without worrying about cost.
