What Is Pet Health Insurance
Pet health insurance is a policy that comes with a monthly premium. If your pet is sick or injured, you foot the bill upfront and submit a claim to the insurance agency for reimbursement. Depending on the policy, you may also need to pay a deductible and a percentage of the bill and policies typically exclude certain illnesses and preexisting conditions.
While the monthly premiums can add up to a few hundred dollars per year, the benefit of pet insurance is that cost will be less of a factor when deciding whether to go through with a major procedure. Illness and injury treatments can cost pet owners hundreds or thousands of dollars.
Without insurance, pet owners may be faced with a tough decision if they can’t afford a large vet bill.
But if you put $30 to $40 a month toward a pet health care plan, you can reduce your out-of-pocket costs considerably.
Once You Choose A Provider You’re Pretty Much Stuck With Them
Once you’ve selected a pet insurance policy, you’re typically locked into that provider for as long as you want insurance because it will be very hard to find a better deal elsewhere.;
This is mainly because your pet will age and may develop a pre-existing condition that won’t be covered by most pet insurance policies.
It’s very difficult to shop around for a better deal the way you can with health or travel insurance
Pet insurance providers currently have no legal obligation to maintain the competitiveness of your policy and can make any changes they like when you renew annually .;
It’s very difficult to shop around for a better deal the way you can with health or travel insurance.
Read more: Do you need pet insurance?
Which Surgeries Aren’t Covered
Pet insurance typically won’t cover surgeries for pre-existing conditions, as defined by your insurer. For pre-existing conditions, you may be able to set up a financing option with your veterinarian if you can’t afford the cost of procedures out of pocket.
Many pet insurance policies also won’t cover elective surgeries such as spaying and neutering. Because spaying and neutering are relatively common veterinary surgical procedures, they tend to be less expensive. Some preventative surgeries may also be excluded from coverage if they aren’t deemed life-saving or medically necessary.
Prophylactic procedures are common preventative pet surgeries that reduce the risk of complications from other disorders. In some high-risk dog breeds, for example, gastropexy surgery may be recommended to eliminate the risk of gastric dilatation. In many cases, prophylactic procedures will not be covered by pet insurance plans, even if a vet recommends them for your pet.
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The Exclusions You Should Be Aware Of:
- How soon can you claim?
- Neutering, spaying and basic treatments
- Pre-existing conditions
- Information updates
Choosing pet insurance is no easy task. With so many different policy types and cover levels out there, its no wonder that people opt for the cheapest and give up reading the terms and conditions altogether.
We’ve designed our policy documents to be easy to understand so you know exactly what is and isn’t covered.
What Factors Determine The Cost Of Pet Insurance
The size, breed, age, and geographic location of your pet all influence the cost of your insurance policy. The length of your policy and the company offering your plan also play a role. Finally, you get to determine what type of policy works best for you by selecting a quote that makes sense for your budget.
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Death By Accident Or Illness
If your pet dies you can get back the cost of what you paid for it or what it could sell for.;
Most pet insurance policies have an age limit – typically of eight to eleven years for a cat and five to nine years for a dog – after which insurers will not pay out, or you’ll have to make a contribution to costs.;
Questions You Still Might Have About Pet Insurance Exclusions
Can you lie on your pet insurance?
You should avoid lying on your pet insurance at all costs. If your insurer finds out that you have lied about your pet or its health, your policy will be voided and you won’t receive a refund.
What pet insurance covers pre-existing conditions?
Some insurers, such as Vets Choice, assess pre-existing conditions on a case-by-case basis. This means that if your pet’s pre-existing conditions are fully cured and no longer impact their health, your pet may be able to receive full insurance cover. Even if you can’t get cover for a pre-existing condition, you should still be able to find a policy that covers your pet for any illnesses or injuries outside of this condition.
Can I get pet insurance if my dog is already sick?
Yes. If your dog is sick or has a pre-existing health condition, you can still get pet insurance. However, your policy probably won’t cover that particular condition your dog is suffering from or will charge higher premiums to compensate for the risk of coverage.
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Whats Not Covered By Pet Insurance
Here are some common pet insurance exclusions:
- Pre-existing conditions. This is an injury or illness that your pet had before your coverage started. Some plans may not permanently exclude pre-existing conditions. For example, Nationwide may extend coverage if you have medical records that show your pet has been cured of a condition for at least six months.
- Experimental treatment. This includes diagnosis and treatments that are considered experimental, investigational or not within the standard of care accepted by your states veterinary medical board.
- Grooming. Pet insurance typically doesnt cover grooming services such as baths, dips, shampoos or nail trims.
- Behavioral training such as pet obedience training.
- Food, dietary and nutritional supplements. Your pets dietary expenses are typically not covered, even if prescribed by a veterinarian.
- Non-veterinary expenses. This includes expenses for waste disposal services, record access or copying, any license or certification and compliance with a government rule or regulation .
Your pet insurance plan may have other exclusions. For example, if you bought a pet insurance policy that covers only accidents, you wont be covered for any illness-related medical expenses.
How Does The Reimbursement Work
We offer two kinds of reimbursement so you can choose what works best for your budget.
Our Whole Pet plan reimburses a percentage of what you paid your veterinarian.* Our Major Medical plan and Pet Wellness plan reimburse according to a benefit schedule, which caps reimbursement at a set amount for each condition or service.
With all our plans, simply pay your veterinarian at the time of treatment, and then send us the invoice. We’ll send you a reimbursement check less any applicable deductible.**
* Items such as grooming, tax, waste disposal, boarding, wellness or pre-existing conditions are not eligible for coverage. See policy documents for a complete list of exclusions.** For eligible conditions.
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Exclusions That Apply To Pet Insurance Options And Extras
Pet insurance extras aren’t treatments, and instead have different exclusions which may apply.
- Emergency boarding cannot be claimed if there’s someone else who can reasonably take care of the animal.
- Euthanasia cover will only be paid if deemed necessary and humane as the result of an illness or injury covered by your policy.
- Overseas pet insurance will not cover you for costs relating to your pet’s return to Australia, or while your pet is not under your direct care.
How Pet Insurance Covers Knee Ligaments
Fido wakes up in the morning feeling excited to go to the dog park and meet new friends. His owner watches him as he runs around chasing other dogs. Hes having a great time;but eventually is ready to head home. When he leaves the park, his owner notices that he is limping. His owner waits to see if it heals on its own, and although it looks better after a few days, she decides to take him to the vet anyway.
The vet tells the owner that Fido has a tear in whats called a Cranial Cruciate Ligament, where the ligament that stabilizes the knee joint tears or ruptures. This can occur through a sudden injury or over time with symptoms appearing suddenly. ;Although common, it can be very painful for the dog. The vet recommends that Fido have surgery, and now the owner must make a decision on what to do.
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Pet Health Insurance Coverage Types
Investopedia: What types of coverage are available? We see the terms “wellness, accident, and accident plus illness.” What do those mean?
Kenney: Though accident-only policies are available from some companies, the coverage is limited. It covers things like fractures, lacerations, etc. It doesn’t cover illnesses like infections, diabetes, allergies, etc. To get broad coverage of most things that could happen to a pet, choose a policy that covers both accidents and illnesses.
Wellness care coverage is offered by many companiesusually as an add-on rider. Wellness care costs are predictable and easier to budget for. You know you’re going to pay for at least some wellness care services every year, and you usually know about how much it’s going to cost and when it is due.
In my opinion, wellness care coverage rarely makes sense. Most people are already paying for this out of pocket. The exceptions are in a puppy/kitten where several wellness visits are going to be required, spay/neuter may be needed, or in senior pets when semiannual exams are recommended, teeth cleaning needed more often, and wellness lab testing is needed.
Accidents and illnesses, on the other hand, are unexpected events. You dont know when such an event will occur or how much it will cost. Not uncommonly, these events are expensivesometimes even thousands of dollars.;
Investopedia: Does the age or health of a pet affect what types of coverage are available for a pet?
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Pet Insurance Plan Exclusions
We’re all about helping protect your pet from unexpected accidents and illnesses and you from the financial burdens of their treatment.
The Healthy Paws plan does not cover the following:
- Pre-existing conditions
- The examination fee
- Pre-existing cruciate ligament injury has a bilateral exclusion. If the cruciate ligament on one leg is injured prior to enrollment or during the 15-day waiting period, then the cruciate ligament on the other leg is excluded from coverage. This is the only bilateral exclusion.
- Preventative care
- Preventive healthcare including vaccinations or titer test, flea control, heartworm medication, de-worming, nail trim, and grooming.
- Parasite control including but not limited to internal and external parasites for which readily available prophylactic treatments are available.
- Dental health care, however if injury to teeth is caused by an accident, the plan does cover the cost of extraction and/or reconstruction of damaged teeth.
- Spaying and neutering.
- Anal gland expression.
The plan does not reimburse the costs, fees or expenses associated for elective procedures, boarding, behavioral modification, training, therapy or medications for behavioral modification. Please see for more information on exclusions.
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Myth #7it Takes A Long Time To Get Reimbursed
We have a dedicated team who is committed to processing claims as quickly as possible. It can help to use our app for claim submission, which is the fastest way to get your claims in to us. You can also sign up for direct deposit. This way, your reimbursement is directly deposited into your selected bank account and you can avoid having to wait for a check in the mail. It also means you wont have to deposit the check, which takes time whether you use your banks app or take a trip to your local branch.
How Much Does Treatment Cost
If the owner does decide to move forward with surgery, the range in cost can be anywhere from $1,200 to $4,600. Outside of surgery, you can expect to spend about $300 for the initial vet visit and then a follow-up visit to make sure the surgery went well. Below is a breakdown of what to keep in mind when deciding if you want to pay for surgery.
-Acupuncture and massage
Where Pet Insurance Can Be Used
Investopedia: Do most vets accept pet insurance? If so, from all companies?
Kenney: Unlike human healthcare, at this time there aren’t any networks where vets accept only certain insurer’s policy. You can generally use your pet insurance at any licensed veterinarian including university, emergency, or specialty hospitals.
Investopedia: Are pet insurance premiums deductible under any circumstance?
Kenney: Right now I don’t know of any scenario where that is possible.
Investopedia: Can any pet be insured? Who insures pets other than dogs and cats? Is that insurance more expensive?
Kenney: As I said some companies have age restrictions on which pets can be insured, and some won’t offer illness coverage on pets with certain chronic conditions.
Nationwide insures exotic pets like pocket pets, reptiles, birds, and so forth, but most;pet insurance offerings are limited to dogs and cats. I’m not sure about the costs to insure an exotic pet because when I checked you had to call Nationwide to get a quote.
Okay Okay Tell Me More About Pet Insurance Add
Wow, glad you asked! Lemonade currently offers two add-ons to our coverage, a vet visit fees add-on and a physical therapy add-on. If you add our physical therapy add-on to your base policy well be able to reimburse you for treatments related to functionality issues. What does that mean? Lets say your energetic Pomeranian sprains her knee while running to greet you at the door. Your base policy covers necessary X-rays and surgery. But doesnt your dog deserve extra? With the physical therapy add-one, shell be able to recover in styleincluding perks like acupuncture and hydrotherapy.;
Bonus: With the vet visit add-on well also help pay for vet visit fees that are charged for accidents and illnesses .
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How Does A Pet Insurance Deductible Work
The deductible is the portion of the bill youre responsible for before you can start being reimbursed for veterinary costs. Most plans come with an annual deductible. For example, if your annual deductible is $1,000, youll need to pay for $1,000 in veterinary costs each year before you can start getting reimbursed for veterinary costs.
Office Visits & Exam Fees
Most vets charge a flat fee whenever you bring your pet in for a consultation or exam. That fee is usually in addition to whatever diagnostic test or treatment your vet might perform. Pet insurance plans with payout limits will cover this fee. However, pet insurance plans that donât have limits on payouts will not cover this fee. This is important to know so you’re not surprised! But this exclusion on unlimited plans is fair.
Why is this fair?Because itâs reasonable cost-sharing between you, as a responsible pet owner, and the insurance company, which wants to offer plans at affordable premiums. By making the pet owner responsible for the exam/consultation fee, it encourages pet owners to take their pets to the vet only when itâs reasonable to seek vet care. Not every little sniffle or sneeze requires you to see the doctor; itâs the same with your pet. But if vet office visits were covered on plans without limits, some anxious owners might be inclined to take their pet to the vet even when itâs unnecessary. This would drive up the cost of insurance for everybody!
If you didnât read the previous section about what to make sure your policy includes, hereâs a reminder:
accidents & illnesses
cancer and chronic diseases
Make sure these are included in your policyâs coverage.
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Will Pet Insurance Cover Cataracts
Pet insurance will not cover the diagnostics or treatment for pre-existing conditions. This means if the cataracts or the cause of the cataracts were evident prior to the start of your policy, it will not be covered. That is why itâs so important to protect your pet as soon as possible.
Pet insurance providers will pick up the costs after you enroll and the waiting periods have passed, but make sure you find the most comprehensive coverage. If you have a breed that has a higher risk of cataracts, you may want to find a provider that has hereditary condition protection. Itâs important to be aware of common costs associated with the condition and see what each provider will cover before enrolling.
In most cases, cataracts cannot be prevented. However monitoring for symptoms of vision loss or eye changes at home combined with regular veterinary exams will allow you and your veterinarian to detect a problem at first sight.
*Davidson MG, Nelms SR : Diseases of the Canine Lens and Cataract Formation. Veterinary Ophthalmology, 4 ed. Blackwell, Ames IA 2007 pp. 859-887.
**Maggs, D, Miller, P, Ofri, R : Slatterâs Fundamentals of Veterinary Ophthalmology, 4 ed. St. Louis, MO 2008.
â;Collins, BK : The Blind Cat. . Waltham Feline Medicine Symposium, 1997. Cote, E : Clinical Veterinary Advisor: Dogs and Cats, St. Louis, MO 2007 pp. 182-184.
Myth #1its Not Worth The Money
You might feel this way until you get hit with an unexpected and expensive veterinary bill. Just a simple accident like your pet swallowing a toy can cost hundreds or even thousands of dollars to treat.
Part of the reason veterinary care can be so expensive is that there are lots of advanced treatments available for pets these days. For instance, pets can benefit from chemotherapy, radiation, MRI, and laser treatments. This is great news for our pets, but these services can come with high price tags.
Pet insurance can help you focus on your pets care with less worry about the cost. Its also easier to budget for a monthly premium than a bill that comes out of the blue.
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