How does pet health insurance work?

Most pet health insurance providers operate on a reimbursement model. With this model, when your pet needs care, you can take them to the veterinary hospital as usual, pay the initial treatment invoice, submit the claim to your insurer online or through an app, and wait for reimbursement by direct deposit or a mailed check.

Some providers also offer direct pay options through which policyholders pay only their portion of the invoice (e.g., a copay fee), while the pet insurance company pays the remaining balance directly to the veterinary hospital. Although this option is more convenient, this feature is limited to certain participating veterinary practices.

Is my pet eligible for health insurance?

You must consider many factors when purchasing pet insurance, with eligibility being one of the most important. Eligibility refers to the conditions your pet must meet to be granted coverage, and you must research various policies’ eligibility requirements before you enroll. Pets’ health insurance eligibility factors usually include:

  • Age — Most pet insurance companies cover pets as young as 8 weeks, but they may not cover senior pets, or a company may offer them reduced coverage only.
  • Pre-existing health conditions — If your pet has a current or previous health problem, most pet insurance companies will consider this a pre-existing condition and refuse coverage.
  • Location — Some providers offer coverage only in certain states, so your eligibility for a specific plan may depend on where you live.
  • Species — Many pet insurance carriers cover only domestic dogs and cats, although a few options are available for exotic pets such as birds and reptiles.
  • Breed — Some companies will not cover specific dog breeds who are predisposed to certain conditions, or whom they deem ineligible for coverage.

What does pet health insurance cover?

When trying to find the best insurance policy for you and your pet, do your research, and ensure you understand the coverage. Each insurance company’s policies differ slightly, but most offer the following coverage options:

  • Accident-only coverage — This plan type covers accidental injuries (e.g., broken bones, foreign object ingestion) and other medical conditions.
  • Illness and accident coverage — This plan type usually covers diagnosis and treatment costs for conditions such as cancer, endocrine disorders, and some orthopedic injuries. 
  • Wellness coverage — Many pet insurance companies offer wellness riders that you can add to most accident and illness plans. These riders may cover preventive services such as:
    • Annual wellness exams
    • Vaccinations
    • Routine blood work
    • Spay and neuter procedures
    • Dental cleanings
    • Flea, tick, and heartworm prevention and testing

Can I afford pet health insurance?

Pet health insurance policies’ coverage varies by provider and plan. Fortunately, costs can be modified to suit your budget and your pet’s needs. Customizable factors include:

  • Monthly premiums — Calculated based on the pet’s age, breed, and location, monthly premiums can be customized to fit your budget. 
  • Deductibles — This is the required out-of-pocket cost you must pay before insurance begins paying for care. Deductibles inversely affect the premium payment. A more affordable monthly premium requires a higher deductible, and a lower deductible will have a higher monthly payment.
  • Reimbursement percentage — This is the total cost covered by pet insurance after the deductible is met. The reimbursement percentage will also affect the monthly premium.
  • Maximum payout — The maximum payout is the total amount that pet insurance will cover per year, or over a pet’s lifetime.

How do I find the best plan for my pet?

You must consider many important factors when choosing a pet insurance policy. Compare rates, read the fine print, and ensure the policy covers your pet’s specific care needs. While the process can be time-consuming, you will appreciate the peace of mind that comes with having a financial safety net to help cover your pet’s veterinary care expenses. 

By understanding how pet health insurance works, what a plan covers, and how to choose the right plan, you can ensure that your pet’s health and your finances are protected. If you have questions or need help choosing the right insurance plan for your pet, contact our Town & Country Animal Hospital PC team to discuss the details you should consider when researching pet insurance plans.