Similar to human health insurance, pet insurance helps cover the cost of medical care for your pet. If your pet becomes seriously ill or injured, vet bills can quickly become expensive. Pet insurance can provide financial relief in these situations. However, coverage can differ widely between providers, so it’s essential to understand what each policy includes before making a decision.

Pet Insurance Plan Coverage

When exploring pet insurance options, you’ll generally come across three main types of plans.

Accident-Only Plan

Accident-only plans are more restrictive than accident and illness plans. They will cover the cost of treating accidental injuries, but they won’t pay for medical expenses related to illnesses like cancer or infections. Because these plans offer less coverage, they are usually more affordable than accident and illness plans. However, not all pet insurance companies offer accident-only plans.

Why opt for this coverage: In certain situations, accident-only plans may be the only available option for older pets that no longer qualify for accident and illness coverage at the time of enrollment. These plans can also be a practical choice if you’re unable to afford comprehensive accident and illness insurance but still want to have some level of emergency protection for your pet.

Accident and Illness Plan

The most common plan covers both accidents and illnesses. This means that if your dog is injured in an accident or develops a condition like a urinary tract infection, the treatment would be covered up to the policy’s coverage limit. Here are some examples of situations that an accident and illness plan may cover.

Keep in mind that accident and illness plans only cover unexpected health issues your pet may face. Routine preventive care, such as annual checkups and vaccinations, is typically not included unless you purchase an additional wellness package (which will be explained further below).

Why opt for this coverage: Accident and illness plans provide the most comprehensive protection, covering a wide range of potential health issues your pet might encounter. These plans are also highly customizable and widely offered, giving you ample flexibility to tailor the coverage to your pet’s specific needs.

Wellness Plan

Wellness or preventive care plans are usually offered as add-ons to an accident and illness policy (or occasionally an accident-only policy). These plans typically cover a specific list of routine services, such as vaccinations and checkups, and provide reimbursement up to an annual limit for each service.

Why opt for this coverage: A wellness plan can be cost-effective if you anticipate using most or all of the services it covers. However, if you don’t need all the services, you might end up paying more for the plan than you’ll receive in reimbursements. It’s important to calculate the potential savings before making a decision.

What Is Covered by Pet Insurance?

Exam Costs

Prescription Supplements and Dietary Food

If your vet prescribes specific food or supplements to address your pet’s medical condition, some plans will cover these costs. However, other plans may not cover them or may charge extra for this coverage. Find out more about how pet insurance handles prescription food and supplements.

Dental Care

To ensure your pet’s dental health is covered, review the fine print of your policy. Some insurers may cover specific issues like broken teeth or congenital dental conditions but exclude dental diseases such as gingivitis. In some cases, coverage for dental diseases might only be provided if your pet has had a recent cleaning under anesthesia. Routine dental cleanings are typically not covered by pet insurance unless you have a wellness plan.

Congenital Conditions

Pet insurance provides coverage for treatment if your furry friend becomes injured or ill. As long as the condition is included in your plan, your insurer typically reimburses costs for prescription medications, surgery, diagnostic tests, hospitalization, and emergency care. However, details of coverage details can vary considerably between plans.

Behavioral Treatment

If your vet suggests treatment for behavioral issues like aggression or compulsive behavior, some plans will cover these costs, while others may not. Additionally, some plans might offer this coverage as part of an optional package for an additional fee.

Rehab or Alternative Treatment

Some pet insurance plans include coverage for physical therapy and various alternative treatments, such as acupuncture and chiropractic care. Other plans may offer these services as an optional add-on at an additional cost. Since there is no universal definition of alternative care, it’s important to review your policy carefully to understand which specific treatments are covered for your pet.

End-of-Life Expenses

At the end of your pet’s life, you may face not only emotional challenges but also expenses related to euthanasia, cremation, or burial. Depending on your pet insurance plan, some or all of these costs may be covered.

What Is Not Covered by Pet Insurance?

Pre-existing Condition

A pre-existing condition is a medical issue your pet had before purchasing the policy or that arose during the waiting period before coverage started. Most pet insurance plans do not cover such conditions.

However, there are exceptions. For instance, AKC offers coverage for pre-existing conditions in some states after your pet has been insured for a year. Additionally, some insurers may cover curable conditions if they have been symptom-free for a specified period.

Routine Care

Routine services such as annual vaccinations, neutering, spaying, and teeth cleaning are not usually in accident and illness plans unless you purchase an additional wellness add-on.

Breeding

Costs associated with breeding or pregnancy are usually not covered by standard pet insurance plans. However, you may be able to add a rider to your policy to include coverage for these expenses.

Cosmetic Surgeries

Procedures like declawing, tail docking, or ear cropping are not usually covered by pet insurance unless they are deemed medically necessary.

Pet Liability

If your dog bites someone or causes damage to property, most pet insurance plans will not cover these situations. However, you might have coverage through your homeowners or renters insurance. These policies often include personal liability coverage that can help cover costs if you are held responsible for injuries or damage caused by your pet.

How Pet Insurance Works?

Once you purchase a pet insurance plan, there is usually a waiting period before coverage starts. Coverage for accidental injuries often begins after just a few days, while the waiting period for illness coverage is generally longer, such as 14 or 15 days.

Orthopedic conditions, such as hip dysplasia or cruciate ligament issues, may also require waiting periods of several months to a year. During these waiting periods, the plan will not cover any treatments, and any issues that develop will be classified as pre-existing conditions in the future.

Most pet insurance plans let you take your pet to any licensed veterinarian for treatment, so you don’t need to worry about in-network clinics. Typically, you will pay the vet bill upfront and then submit your receipt to the insurance company for reimbursement. However, some insurers may offer direct payment to your vet, reducing the amount you need to pay out-of-pocket. Here are a few factors that could influence how much of your vet bill your insurer will cover:

Annual Coverage

Most plans allow you to select an annual coverage limit, which is the maximum amount your plan will reimburse for veterinary expenses in a year. This limit is often a fixed sum, such as $2,500 or $10,000. If your vet bills exceed this amount, you will need to pay the difference yourself. Many insurers offer an unlimited coverage option, though it may come with a higher cost. Additionally, some companies set lifetime or per-incident coverage limits.

Reimbursement Level

Even after meeting your deductible, you may not receive full coverage for your vet expenses. Most plans include a reimbursement percentage, typically 70%, 80%, or 90%. Here’s an example scenario:

Spotty the dog swallows a sock and requires surgery to have it removed. With a pet insurance plan that has a $500 annual deductible and a 90% reimbursement rate, and since this is your first vet visit of the year, the process would work as follows: The $1,500 surgery bill would first have the $500 deductible subtracted, leaving $1,000. The insurer would then reimburse 90% of this remaining amount, which equals $900.

If Spotty required additional follow-up treatment within the same policy term, your insurer would cover 90% of the costs since the deductible has already been met.

Keep in mind that many pet insurers apply the reimbursement rate before the deductible. In the scenario above, the insurer would first deduct the 10% of the bill you are responsible for, which is $150, leaving a remaining vet bill of $1,350 ($1,500 – $150). Then, the $500 deductible would be subtracted from this amount, resulting in a total reimbursement of $850.

Who Is Eligible for Pet Insurance?

Most pet insurance providers cover only dogs and cats. However, ASPCA also offers coverage for horses, and Nationwide provides plans for birds, snakes, rabbits, and other exotic animals. Additionally, some insurers have age restrictions for new pets, often requiring puppies and kittens to be at least 6 to 10 weeks old.

While some plans do not impose maximum age limits, others may restrict coverage for older pets or set age limits for first-time enrollment, usually between 8 and 14 years. Once enrolled, most plans offer coverage for your pet’s lifetime, provided you continue to pay the premiums. Additionally, some plans may require your pet to have had a recent veterinary visit or to undergo an exam before offering a policy.

Is Pet Insurance Necessary?

There is no legal requirement to purchase pet insurance. Many people choose to pay their vet bills out-of-pocket rather than buy insurance. For pets that remain generally healthy, this approach is often more cost-effective than obtaining insurance.

However, pet insurance can be a significant money-saver if your pet develops a serious illness or requires costly surgery. In some situations, it may even help you avoid the difficult choice between euthanasia and accumulating debt to cover treatment costs.

The Cost of Pet Insurance

According to the North American Pet Health Insurance Association, the average annual cost for a pet insurance policy covering accidents and illnesses was approximately $676 for dogs and $383 for cats in 2023. For accident-only plans, the average annual premium was $204 for dogs and $116 for cats.

Pet insurance prices are influenced by several factors:

• Age and breed: Older pets generally have higher premiums, and some breeds are more expensive to insure due to their predisposition to health issues.
• ZIP code: Insurance costs can be higher in areas with expensive veterinary care.
• Type and Amount of Coverage: Policies with more extensive coverage typically cost more.
• Deductible and Reimbursement Level: Plans with lower reimbursement levels and higher deductibles usually have lower premiums.
• Provider: Prices can vary significantly between different insurance providers.

How to Get Your Pets Covered?

Determine the type and amount of coverage you need before obtaining pet insurance quotes from multiple companies. Most major pet insurers offer online quotes and allow you to customize your coverage. Ensure that the policies you compare have similar reimbursement levels, deductibles, and coverage limits to ensure a fair comparison of prices.

Before purchasing a policy, carefully review the fine print to ensure you understand all restrictions and exclusions. Many pet insurers provide sample policies on their websites. Unlike other types of insurance, where shopping around annually can save money, pet insurance is typically a long-term commitment. As your pet ages, they may develop pre-existing conditions that won’t be covered if you switch plans. Therefore, it’s important to choose a company and coverage level that you’ll be satisfied with for the long term.