Do the words “health insurance” send shivers down your spine? There is perhaps no other phrase in the English language that inspires more fear, anger and confusion (except maybe “no WiFi”). Figuring it out for yourself is hard enough let alone figuring it out for your pet too. Maybe that’s why only 3.1 million dogs and cats were insured in the U.S. in 2020 out of a total of 135 million who live in homes. But guess what—you’re a pet parent now. Time to put on those big girl or big boy pants and learn all about pet health insurance: what it is, what it covers and what it costs.
For starters, pet health insurance can cut the costs of your vet bills, especially the most expensive and unexpected ones. That’s why the American Veterinary Medical Association (AVMA) endorses pet health insurance, as long as the policy covers what you need it to (more on that later).
Feeling overwhelmed already? Don’t stress. We’re breaking it all down for you with the help of our experts so you can decide what’s best for you and your pet.
What Is Pet Insurance?
Pet health insurance is like the human kind with two key differences, says Paul Reynolds, insurance editor for Money.com:
- Most pet insurance policies don’t cover preventative or routine care, unless you specifically sign up for a wellness plan, which is pricier. That means you are responsible for paying for checkups, vaccines and even dental care.
- Instead of paying co-pays at the vet (like you do at human M.D. visits), you usually pay the vet up-front for the procedure and get reimbursed by the insurance company after you file the paperwork.
What Does Pet Insurance Cover?
So what exactly does cat or dog insurance cover? That depends on the type of insurance you end up buying. There are three types:
- Accident only: These policies cover those unexpected injuries, including poisoning, car or other vehicle injuries (being hit by a car, being in a crash), broken bones, sprains and cuts, and swallowing objects (like rocks or squeaky toys). They’ll usually cover diagnostic tests (like ultrasounds) and surgeries.
- Accident and illness: These policies cover those unexpected injuries as well as certain diseases and conditions, including cancer, infections, bloat and other GI illnesses, diabetes and arthritis. They’ll also cover medical tests, surgeries, and prescriptions and some of them cover alternative therapies (like acupuncture).
- Wellness policies: Here’s where you’ll get reimbursed for routine vet visits, vaccinations, spaying/neutering operations, and routine labs.
Most pet parents choose accident and illness plans or sometimes accident-only coverage. These policies will help offset the cost of those expensive vet bills if your pet scarfs down a poisonous plant or gets cancer.
How Much Is a Pet Insurance Plan?
The cost of pet health insurance depends on your pet. On average, premiums are $50 a month for dogs and $28 for cats if you get an accident and illness plan, according to the North American Pet Health Insurance Association (NAPHIA). If it’s accident only, then you’ll pay around $18 a month for your dog and $13 for your kitty. Stand-alone wellness plans have similar premiums to accident and illness coverage, ranging from $20 to $50 a month on average.
Accident & Illness
Unexpected injuries and certain diseases and conditions
Routine visits and health care
But that’s the average premium. So how much does pet insurance really cost? Here are other factors that weigh in:
- A deductible. This is the money you have to spend first before you get reimbursed. This can range from $200 to $1,000. In general, the higher the deductible, the lower your premium.
- Reimbursement rates. This is the percentage you’ll get back from the insurance company. Pet insurance reimbursement won’t cover 100%, but you can shop around for plans that cover anywhere from 70% to 90%. Again, the more money you get back after a procedure, the more expensive the plan will likely be.
- A cap on coverage. This is the yearly limit the insurance company will pay. Some policies cap the dollar amount at $5,000, others at $30,000. The higher the yearly cap, the more expensive the premium (and plan).
- Your pet’s breed. Pedigreed pups and felines sometimes come with hereditary health issues—elbow dysplasia for Golden Retrievers and Labrador Retrievers, hip dysplasia in German Shepherds and Maine Coon cats, spinal conditions for Bulldogs, for instance. Insurance companies are aware of these hereditary conditions and will charge higher premiums to cover purebred pets. This is true for accidents as well. “Labrador Retrievers are notorious for eating crazy stuff and so their premiums tend to be higher because there’s a higher chance that they’re going to have to have an operation to take it out,” says Reynolds.
- Where you live. City dwellers tend to pay more than pet owners who live more rural areas.
- Your pet’s age. The older the pet, the higher the premium if you have accident and illness insurance. That’s because older pets are more likely to get cancer, arthritis or other age-related ailments. Some plans also have an age limit and either won’t cover older pets (typically starting at 10 years of age) or may only offer accident insurance.
How Does Pet Health Insurance Work?
When your pet gets sick or has some type of accident, you’ll file a claim with the pet insurance company. The insurance company determines if it’s an incident that’s covered by your plan, and will pay you back toward the money you spent on the vet bill.
This is where the pet insurance deductible and reimbursement amounts come in. So if you have a deductible of, say, $500 and you’re reimbursed at 80%, you might get back $320 from a $900 bill.
There are other things to be aware of too before you can receive money from a claim. Consider these “ifs”:
If your pet has a pre-existing condition. All pet insurance plans have one thing in common: They don’t cover pre-existing conditions. That’s a medical condition or symptom that your pet had before the cat or dog insurance plan went into effect. And companies check your pet’s medical records very carefully.
Don’t think you can game the system, either. You usually have to fill out a questionnaire specifying any medical problems or symptoms your pet has had in the past six months or year, says Reynolds. If you fudge the answers, and your dog needs to get a tumor removed, the insurance company will ask the vet to provide medical records—and turn down the claim if the vet discovered a mass during a previous exam.
The exception: Some insurance companies will cover the cost of treating conditions that your pet had before, like UTIs or ear infections, as long as your pet was cured at least six months to a year before the plan goes into effect. This is known as cured pre-existing conditions.
If there’s a waiting period before your plan kicks in. Typically, you need to wait at least two weeks after the dog or cat insurance plan starts before the company reimburses you for illness-related treatments, but some companies may have a 30-day period. That protects the insurance company in case there’s no medical record of the problem, says Reynolds. For instance, if your dog suddenly starts limping and you rush out to buy insurance in case he needs a leg operation, you’ll have to wait two weeks after the plan starts to have the surgery in order for it to be covered.
The exception: The waiting period is generally shorter for accidental injuries, but again it depends on the plan. Some plans have a 48-hour one, some a two-week period. Do your homework.
- If your plan has a deductible for each condition. “Say your pet has kidney disease, lymphoma and thyroid disease,” says Dr. Hohenhaus. “There’s a deductible for each one of those conditions instead of just one.”
- If your plan covers follow-up recheck visits. Vets typically want to see your dog or cat a few weeks after treating your pet, even if your furball is symptom free, says Dr. Hohenhaus. Some insurance companies don’t cover those visits.
The bottom line, says Dr. Hohenhaus: “What is included in the policy is as important as what is excluded in the policy”—so pay attention to both.
Some categories to check on when you’re shopping around for plans:
- Vet exam fees (routines are usually not covered; some cover the illness exam fee)
- Hereditary conditions and hip dysplasia
- Wellness plan (can be included, extra or not offered)
- Emergency/hospital care
- Prescription medications
- Cancer treatments
- Specialty care
- Holistic therapy (check to see what’s covered: some insurance companies cover chiropractic care or acupuncture, some don’t)
- Chronic conditions (Are they covered for life?)
- Diagnostic testing (X-rays, MRIs, CT scans, ultrasound, blood work)
- Ligament and knee conditions (Check orthopedic waiting periods: some insurance have 6-month waits)
- Rehabilitation, prosthetic devices, physical therapy
- Non-routine dental (a cracked or broken tooth)
Where Do You Get Pet Health Insurance?
So you’ve decided you want to buy pet insurance. Here’s where to go to buy it:
Head online. Googling “pet insurance” will turn up a number of results, including national insurance companies that also sell pet insurance.
Ask your vet. Yours might be happy to give you guidance or at least steer you to the companies their office deals with the most. The AVMA also keeps a short list that can help get you started.
But even if you get recommendations, it pays to do the research and do some comparison-shopping for the best pet health insurance for your furry family member. Here’s how:
- Use the “Get a quote” button on the pet insurance provider’s home page. Once you fill out information, like your pet’s age and your zip code and email, you’ll be presented with plan options. There might be just one set plan, several set plans or an option to customize. If you can customize the plan, you can select different options to see how each change affects the monthly premium.
- Be on the lookout for important information, like how long the waiting period is or how restrictive the exclusions list is, advises Reynolds. You also want to make sure the insurance company lets you keep seeing your vet (most do).
- Figure out your budget. Add up all the money you’ll spend a year, including the deductible, the premiums and the amount you’ll need to pay even after the insurance company reimburses you.
- Compare and contrast your top picks by finding out:
- How fast do they repay claims?
- How difficult is it to file a claim?
- Do they have good customer service? Is it available 24/7?
- Is there an app available?
- Is their website easy to use?
- What’s their rating from the Better Business Bureau?
- Can you make changes to your plan?
- Do they offer a money-back guarantee?
In the end, the best dog insurance or insurance for cats is the one that will give you peace of mind.
Pet Health Insurance FAQs
Is pet insurance worth it?
A:No one can answer that question except you. But here are some questions to consider to make your decision a bit easier:
- How much risk am I willing to live with? “If your pet has a normal medical life—they get sick occasionally with something that is not life-threatening or requires surgery—then you will not recoup the money that you paid on pet insurance,” says Paul Reynolds, who’s crunched the numbers. The trouble is, you don’t know what the future holds. If your pet gets cancer, swallows a spoon (yes, it happens!) or gets hit by a car, pet insurance can help you pay the surgery or chemo bills.
- Do I have savings? Are you someone who puts money aside every month? If so, then maybe that’s a better way for you to budget for vet care. “If you aren’t a good saver, pet insurance is a way to force you to have the resources to take care of your pet,” notes Dr. Hohenhaus.
- Would I do anything to save my pet regardless of how sick or old they are? If your answer is yes, then pet insurance makes sense. Even if you answer no, think how you’ll feel if your furry friend gets really ill or hurt and you’re forced to make a tough call just because you don’t have the funds to pay for a life-saving treatment. That’s a decision no pet parent (or vet) wants to have to make.
The bottom line: Having pet insurance can help you pay the vet bills in case something serious happens to your pet.
When’s the best time to enroll in pet insurance?
Are dogs more expensive to insure than cats?
If I don’t have insurance, are there ways to lower my vet bills?
“The veterinarian will say, ‘Here’s what’s wrong with your pet, here’s what I need to do and here’s how much it’s going to cost,’” says Dr. Hohenhaus. And then you have to be upfront with your vet and say if you can do that. That’s called spectrum of care, she adds: “What options does the veterinarian see for managing this particular pet’s condition or conditions? And then which option fits best with the family’s situation.” That can include your finances and whether you have the time and ability to bring your furry friend back and forth for treatment.
Vets may hate having to euthanize pets they think they can save, but they also hate making pet parents spend money they don’t have, says Dr. Hohenhaus.
The post Pet Health Insurance: What Every Pet Parent Needs to Know appeared first on BeChewy.