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What does pet insurance cover and is it worth it? – USA TODAY Blueprint


Key points:

  • Coverage for accidents and injuries is one of the main reasons to get pet insurance. 
  • Pet insurance has a monthly premium, a deductible, a reimbursement level and an annual maximum coverage amount.
  • Not all insurance policies cover hereditary conditions, so it’s important to check for this if you have a breed that’s susceptible to serious genetic illnesses.
  • Pet insurance typically does not cover wellness checks and preventive care, but many plans offer an optional wellness add-on.

Pet insurance can help offset some of the costs associated with your pet’s health care, but some plans offer more comprehensive coverage than others.

Learn more about what pet insurance covers, how much it costs and how much you can expect to be reimbursed for claims. 

What is pet insurance?

Pet insurance is a kind of health insurance policy that reimburses you for a portion of your pet’s medical bills. There are several types of pet insurance, and the best one for you depends on your pet’s needs and your budget. 

The most popular type of pet insurance plan is accident and illness, which often comes with the option to add a wellness plan. Cheaper accident-only plans are also available. 

Accident and illness plans

Accident and illness plans are the most comprehensive pet insurance policies. These plans cover treatment for accidental injuries and common illnesses.

Pros 

  • Insures your pet for illnesses like cancer.
  • Covers accidental injuries like broken bones.
  • May provide the option to add wellness coverage for an additional cost.

Cons 

  • Costs more than a basic accident-only plan.

Coverage may include

  • Injury.
  • Poisoning.
  • Ingesting foreign objects.
  • Cuts and wounds.
  • Broken bones or fractures.
  • Cancer. 
  • Infectious disease.
  • Some allergies.
  • Gastrointestinal issues.
  • Hospitalization.
  • Surgery costs.
  • Lab testing and diagnostics.
  • Some prescriptions.

Typically does not cover

  • Pre-existing conditions.
  • Routine care, vaccinations or dental exams, unless these are covered by a wellness add-on.

Accident-only plans

Accident-only plans are limited to emergencies like broken bones, injury after being hit by a car, poisoning, lacerations, bites from another animal and burns. 

Pros 

  • Typically more affordable.
  • Covers surgery and hospitalization due to accidental injury.

Cons

  • Doesn’t include diagnostic testing or coverage for illnesses. 
  • Doesn’t cover allergies, gastrointestinal issues or infectious disease.
  • Typically can’t add a wellness plan to this basic policy.

Covers accidental injury

  • Car accident injury.
  • Poisoning.
  • Ingesting foreign objects.
  • Cuts and wounds.
  • Broken bones or fractures.

Does not cover illness

  • Cancer.
  • Gastrointestinal issues.
  • Allergies.
  • Diabetes.
  • Infectious disease.
  • Breed-specific, congenital or hereditary conditions.
  • Pre-existing conditions such as hip or elbow dysplasia. 

Wellness plans

Most pet insurance companies do not offer standalone wellness or routine care plans, but these can often be purchased as an add-on to an accident and illness policy. 

Pros 

  • Coverage may include vaccinations, wellness visits, dental exams and spaying/neutering.

Cons

  • Typically need to buy with an accident and illness plan.
  • May only have a small amount of coverage per item per year.

Coverage may include:

  • Check-ups.
  • Dental exams.
  • Vaccinations.
  • Microchipping.
  • Spay or neuter surgery.
  • Flea, tick and heartworm medications.
  • Blood and urine testing and analysis.

Related: Best pet insurance companies

What pet insurance covers

Pet insurance coverage will depend on the plan you purchase. If you buy a comprehensive pet insurance plan, here’s what is typically covered.

Accidents and injuries

Coverage for accidents and injuries is one of the main reasons to get pet insurance. You might have a very playful and rambunctious pup who loves to wrestle at the dog park but winds up with a torn ACL or a dog bite. Pet insurance typically covers things such as poisonings, car accidents, sprains or bites from other animals.

Illnesses

If your pet gets sick, pet insurance will likely cover a portion of the treatment. Pet insurance can help pay for curing common ailments like ear infections, diarrhea and vomiting. It may also pay for treatment for more serious illnesses, such as cancer or heart disease.

Testing

Your pet insurance can help pay for the cost of diagnostic tests like blood draws, CT scans or ultrasounds, which can add up quickly if you’re paying out of pocket.

Hereditary conditions

Some dog and cat breeds are more susceptible to certain hereditary conditions than others. Your pet insurance may help cover treatment for conditions like hip dysplasia, eye disorders and blood disorders.

Not all insurance policies cover hereditary conditions, so it’s important to check for this if you have a breed that’s susceptible to serious genetic illnesses. You might pay more out of pocket to cover hereditary conditions, but it can be worth it if there’s a high chance of your pet developing a condition during its lifetime.

Prescription medication

If your pet is prescribed medicine, your pet insurance may help cover the cost. That could be for a temporary medication to treat an infection or a more long-term prescription for something like diabetes, a thyroid condition or anxiety.

Microchipping

Some pets are great at escaping, and one of the best ways to bring them home safely is to microchip them. Microchipping may be covered by your pet insurance.

Many animal shelters and rescues require their pets to be microchipped before they’re adopted, so if you have a rescue animal, they are likely already microchipped.

Holistic treatments

Some pets respond well to holistic or alternative treatments that your regular vet may not offer. Your pet insurance may help foot the bill for things like acupuncture or chiropractic care for your dog or cat.

This may not be covered by all insurance providers, so double-check policies before you buy if holistic treatments for your pet are important to you.

What isn’t covered by pet insurance

While coverage exclusions vary by plan and carrier, the following generally isn’t covered by pet insurance.

Pre-existing conditions

If your pet’s medical history shows a pre-existing condition — or even symptoms of a condition that was not yet diagnosed — your pet insurance will likely not cover any related illnesses or treatments. 

That’s why it’s important to take out a pet insurance policy when your pet is young and healthy, so if it does develop any major conditions the insurance will help pay for treatment.

Experimental treatment

As medicine advances for humans and animals alike, you may seek out experimental treatments if your pet is seriously ill and not responding to regular treatment.

But if you do, you’ll be on your own when it comes to paying the bill, as pet insurance generally won’t cover any treatment considered experimental or investigational.

Breeding

If you choose to breed your dog, your insurance won’t cover the associated costs.

Cosmetic surgeries

Some dog breeds traditionally have their ears or tails docked for cosmetic purposes. If you choose to do this, or to declaw a cat, your pet insurance won’t cover it.

Wellness care

Wellness checks and preventive care are typically not covered by accident and illness plans, but you can often purchase pet wellness coverage as an add-on that will help pay for those expenses.

Food and supplements

Accident and illness plans won’t cover the cost of pet food, but some wellness plans will reimburse for prescription diet food and nutritional supplements like probiotics or vitamins.

Grooming and bathing

Everyone loves a clean pet, but accident and illness plans won’t cover things like nail trims and baths — not even flea baths. If this is important to you, some wellness plan add-ons do reimburse for grooming, medicated shampoos and toenail trimming. 

Training

Most pet insurance plans don’t cover training, but there are exceptions. ASPCA will cover certain behavioral therapy programs if it’s recommended by your vet. 

If your dog needs obedience training, you can also look for wellness plans that include this coverage. The Embrace pet wellness plan, for instance, is an optional add-on that reimburses for training. 

Does pet insurance cover spaying?

Pet insurance typically doesn’t cover spaying because it falls under preventive care rather than care associated with an unexpected event like an accident or illness. However, a pet wellness or preventive care plan may cover some of the cost of spaying.

Does pet insurance cover neutering?

As with spaying, neutering isn’t typically covered by pet insurance. But a wellness or preventive care plan might offer some coverage.

Does pet insurance cover dental?

Accident and illness plans may cover some pet dental issues, such as periodontal disease. For preventative teeth cleaning, you’d need to add a wellness plan that offers coverage.

Learn more: Pet dental insurance explained

How does pet insurance work? 

Pet insurance plans are typically reimbursement based, which means you’ll pay veterinarian bills up front and then submit a claim to get some of that money back. 

Here’s how the process usually works: 

  • You take your pet to the vet for emergency surgery. 
  • You pay the vet bill. 
  • You submit a claim to your pet insurance company.
  • Your insurance company subtracts the amount of your deductible from your claim and reimburses you for a percentage of the remaining amount. 

Pet insurance deductible

Your deductible is the amount you’re required to pay before your pet insurance coverage starts. 

Here’s an example:

  • You pay $2,000 for your pet’s emergency surgery.
  • You file a claim for $2,000.
  • Your pet insurance plan has a $200 deductible with a reimbursement rate of 70%.
  • If you have not yet met your deductible, you will be reimbursed for $1,260 (70% of the $1,800 remaining after your deductible is subtracted from the claim amount).
  • If you’ve already met your deductible, you will be reimbursed $1,400 (70% of $2,000).

Pet insurance coverage limits

Pet insurance policies may have one or all of the following caps or limits. 

  • Maximum incident benefit cap determines the most money you will be reimbursed for a certain type of incident. 
  • Maximum annual benefit is the most you can be reimbursed in a year for your pet. Some companies offer plans with unlimited annual coverage.
  • Lifetime limit cap is the total amount of money you can be reimbursed over your pet’s lifetime.

How much does pet insurance cost?

Pet insurance costs about $55 per month for an unlimited accident and illness plan for dogs, according to our analysis of rates. The average cost of pet insurance for a cat for the same plan is about $47 per month.

How much you pay for pet insurance will depend on the type of pet insurance plan and coverage levels you choose, your ZIP code and your pet’s breed, age and gender.  

Average monthly cost of pet insurance

We analyzed rates from Petinsurer.com to find the average monthly cost for top pet insurance companies’ accident and illness plans with unlimited reimbursement (or the highest level offered by that company), a $500 deductible and a 90% reimbursement level. 

Choosing a pet insurance company

Here are steps to help you find the best pet insurance company for your needs and budget.

Decide if you want a comprehensive plan

Before shopping for pet insurance, decide how much coverage you’d like.

  • Accident-only plan. If you’re willing to pay out of pocket for illnesses and routine care, you might consider a bare-bones accident-only policy. This will only cover treatment for accidental injuries, such as broken bones and bites. 
  • Accident and illness plan. This more comprehensive insurance will cover most diagnostics and treatments for both accidental injury and illness. If you’re willing to spend a bit more each month, you could opt to add a wellness plan. This can cover the costs of routine veterinary visits, vaccines and heartworm and flea prevention.

Determine how much you’d like to be reimbursed

After deciding on the type of policy that’s right for you and your pet, you’ll have a few more choices to make. 

  • Maximum annual coverage. Choosing a low annual coverage cap, such as $2,500, may mean cheaper monthly premiums, but a higher or unlimited cap could save you a lot of money in the long run if your pet has an expensive year for medical care. 
  • Deductible. This is the amount of money you need to pay out of pocket before your pet insurance coverage begins. Deductible choices may range from $50 to $1,000, depending on the plan. A lower deductible means paying a higher premium, but you’ll get more back when you file a claim. 
  • Reimbursement level. Determine how much you want to be reimbursed after you meet your deductible. Reimbursement choices are often 60%, 70%, 80%, 90% and sometimes even 100%. The higher your reimbursement rate, the higher your premium.

Understand waiting periods

All pet insurance policies have a waiting period before coverage begins. If you need your pet to be insured quickly, look for a company that provides a short waiting period. 

MetLife and Figo offer accident-only coverage with just a one-day waiting period, but most insurance companies have a two-week waiting period for illnesses. 

Most pet insurance companies have a six-month waiting period for ligament issues and other conditions, like hip dysplasia. Pumpkin and Spot only have a 14-day waiting period for these conditions. 

Some companies will waive waiting periods if your pet has a veterinary exam with a clean bill of health within the first 30 days of your plan.

Check for discounts

Some insurance companies offer discounts, which could include:

  • Lump sum annual pay. 
  • Spay/neuter.
  • Insuring more than one pet.
  • Military/veteran.
  • Occupational.
  • Bundling with another insurance policy.

Learn more: Best cheap pet insurance

Frequently asked questions (FAQs)

Most pet insurance will not cover pre-existing conditions, so it’s best to get your pet insured while it’s still healthy.

If you own a specific breed that is prone to pre-existing conditions like hip dysplasia, consider purchasing insurance while your pet is young.

Some insurance companies will cover an animal’s pre-existing condition if it is deemed curable, while others will offer coverage for pre-existing conditions on a limited or temporary basis or require a waiting period.

You may be asked to provide proof that your pet has been cleared of a pre-existing condition for at least six months prior to enrolling.

ManyPets has the best pet insurance for affordable rates, according to our analysis of pet insurance companies. Other companies that receive our top rating are Embrace, Pets Best and Spot.

A pet insurance deductible is the amount you’re required to pay before your insurance coverage begins. Deductibles vary by company and by policy, but choices may range from $50 to $1,000. Trupanion offers pet insurance with no deductible.



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