A Beginner’s Guide to Pet Health Insurance

Every year, more than one in three pets will fall ill or get injured. And although veterinarians can do amazing things, the fact remains that an unplanned surgery or a trip to the emergency room can run into the hundreds or thousands of dollars in a very short amount of time.

But many of us are not financially prepared to afford the level of care that modern veterinary medicine can provide in treating our pets. With pet health insurance, pet parents never have to choose between an expensive but necessary treatment and a pet’s life.

The Basics

Most pet health insurance plans have a few basics in common. You can see any licensed veterinarian, including specialists and emergency veterinarians. You pay your vet first and then are reimbursed. Pre-existing conditions are excluded from coverage.

There are notable differences in pet insurance plans that can affect how much you are reimbursed. For example, are any limits or caps applied per incident, per year, or over the pet’s lifetime? These can impact your ability to get reimbursed. Also look for exclusions of hereditary and congenital conditions as these are often the most costly to treat. Do you research and you’ll find the right plan for you and your pet.

What Does Pet Health Insurance Cover?

Most pet insurance plans provide coverage for treating accidents and illnesses. Services covered include:

  • Diagnosing the condition including x-rays, ultrasounds and blood tests
  • Surgery and surgical supplies
  • Hospitalization and nursing care
  • Prescription medications and drugs

Some pet insurance plans also provide coverage for:

  • Treatment for hereditary and congenital conditions, often the most expensive to treat
  • Chronic and recurring conditions including cancer care
  • Alternative therapies such as acupuncture, holistic therapies, and homeopathic therapies

There may be limited coverage for prescription foods and behavioral therapies, depending on the particular plan.

You may also be able to purchase routine care coverage that reimburses you for vaccinations, office visits, and spaying or neutering (not recommended as it will usually reduce coverage for the more expensive accidents and illnesses).

What Does Pet Health Insurance Not Cover?

Pet insurance usually does not pay for:

  • Pre-existing conditions
  • Cosmetic, elective, or preventive procedures such as tail docking, ear cropping, or declawing (except where medically necessary)
  • Veterinary fees related to pregnancy, whelping, or breeding
  • Experimental treatments
  • Orthodontic and endodontic procedures such as root canals or crowns
  • Preventative dental care

Will Insurance Cover a Condition My Pet Already Has?

A pre-existing condition is one that your pet had, was diagnosed with, or showed symptoms of before being enrolled with your pet insurance plan. Unfortunately, no pet insurance company covers pre-existing conditions, although you may still be able to get coverage for other conditions. It’s usually best to enroll your pet when they are young and before she or he develops any kind of major condition or illness.

Getting Value From Pet Insurance

Using your pet insurance plan is pretty easy.

  1. Make sure your plan reimburses you based on your actual bill. Be careful of companies that use fixed benefits or hidden terms, like usual and customary fees, that reduce your reimbursement percentage and amount.
  2. There should be no restrictions on coverage for hereditary or congenital conditions. These are often the most expensive to treat.
  3. Look for plans without caps on claims. A $1,500 per incident claim limit may leave you with a large bill to still pay.

Lastly, check review sites for feedback from existing pet insurance policyholders to see who is happiest with their service and plan.

Article courtesy of Healthy Paws Pet Insurance & Foundation.