January 18, 2021

What Does Pet Insurance Cover? – Forbes Advisor

By haziqbinarif


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If you have a furry, feathered or scaled friend living in your household, chances are you buy all the creature comforts to keep your best buddy in good spirits: tasty treats, fluffy beds and plenty of toys.

Aside from all the fun stuff, keeping your pet healthy is also a top priority. That means routine veterinary visits and medical treatments if your pet has a health problem.

But pet medical costs can quickly add up. A routine vet visit costs around $212 for a dog and $160 for a cat, according to the 2019-2020 American Pet Pet Products Association’s National Pet Owners Survey. And if your pet needs surgery, it costs an average of $426 for a dog and $214 for a cat, depending on the pet’s health issue.

Pet insurance is one way to offset some of the costs associated with a pet’s health care. What’s covered by a pet insurance plan will depend on your insurance company and pet.

What’s Covered by Pet insurance?

Pet insurance is a health insurance policy that pays a portion of a pet’s medical bills. You can purchase a comprehensive “nose-to-tail” policy that covers a wide range of health-related problems. For example, if you want coverage for accidents, illnesses and wellness care, Nationwide’s Whole Pet with Wellness plan covers these type of health-related problems:

  • Accidents and injuries, such as poisonings, sprains and ACL ruptures
  • Chronic illnesses such as allergies, arthritis and skin conditions
  • Common illnesses such as ear infections, vomiting and diarrhea
  • Serious illnesses such as cancer, heart disease and diabetes
  • Hereditary conditions such as hip dysplasia, eye disorders and blood disorders
  • Testing and diagnostics such as X-rays, MRIs, CT scans, blood tests and ultrasounds
  • Procedures such as surgeries, hospitalizations, nursing care, endoscopies and chemotherapy
  • Holistic and alternative procedures such as acupuncture, chiropractic and laser therapy
  • Wellness procedures such as vaccinations, flea/heartworm and spay/neuter

Comprehensive pet insurance policies will be the most expensive plans. If you don’t want a policy that covers all of the above, you can buy a policy with fewer benefits. For example, you can buy a policy that covers only accidents and illnesses, or a policy that covers only routine vet visits for checkups and vaccinations.

Buying a pet insurance plan with less coverage can be significantly cheaper. For example, Farmers Insurance sells “accident only” pet insurance with a flat rate of $6 per month for cats and $9 per month for dogs, regardless of breed. But keep in mind, with an accident-only policy, you’ll bear the full cost for any non-accident related medical expenses.

Summary Chart: What Pet Insurance Covers

Extras to Pet Insurance

You may be able to add extra per-related coverage with riders. For example, Trupanion sells a PetOwner Assistance Package which covers non-veterinary problems like advertising and rewards for lost pets, boarding fees if you are hospitalized, cremation or burial for deaths caused by an accident, and liability coverage if your pet causes property damage to others.

What’s Not Covered by Pet Insurance?

Here are some common pet insurance exclusions:

  • Pre-existing conditions. This is an injury or illness that your pet had before your coverage started. Some plans may not permanently exclude pre-existing conditions. For example, Nationwide may extend coverage if you have medical records that show your pet has been cured of a condition for at least six months.
  • Experimental treatment. This includes diagnosis and treatments that are considered experimental, investigational or not within the standard of care accepted by your state’s veterinary medical board.
  • Grooming. Pet insurance typically doesn’t cover grooming services such as baths, dips, shampoos or nail trims.
  • Behavioral training such as pet obedience training.
  • Food, dietary and nutritional supplements. Your pet’s dietary expenses are typically not covered, even if prescribed by a veterinarian.
  • Non-veterinary expenses. This includes expenses for waste disposal services, record access or copying, any license or certification and compliance with a government rule or regulation (such as dog registration).

Your pet insurance plan may have other exclusions. For example, if you bought a pet insurance policy that covers only accidents, you won’t be covered for any illness-related medical expenses.

Does Pet Insurance Cover Pet Liability?

What happens if your dog bites someone or destroys someone else’s property? Generally, those types of incidents are covered by your homeowners insurance. For example, if your dog bites someone and you’re sued, your home liability insurance will pay for medical expenses and even a legal defense.

You may be able to get some liability coverage through your pet insurance company. For example, we analyzed a policy that covers property damage to others, up to $25,000.

How Does Pet Insurance Work?

Pet insurance plans are typically reimbursement-based, meaning you’ll pay up front for your pet’s medical expenses. You can take your pet to a licensed veterinarian of your choice and then submit a claim to get reimbursed for problems that are covered under the pet insurance plan.

Here’s an example of how a pet insurance claim would work:

  • You take your pet to the veterinarian for a routine checkup
  • You pay the veterinarian bill
  • You submit a claim to your pet insurance company, which includes a copy of the vet’s invoice and medical records
  • Your pet insurance company will review your claim based on the policy. If routine vet visits are covered, your insurer will process the claim and send you reimbursement

Generally, pet insurance isn’t like health insurance for people, meaning you don’t have to worry about going to an “in-network” veterinarian. You usually can go to the vet of your choice, with some exceptions. For example, Liberty Mutual has a pet insurance policy that uses in-network vets. One benefit from a plan like this is that you’ll only pay your deductible or copayment to an in-network vet for covered services. But if you opt to use an out-of-network vet, you’ll have to have to pay the total cost for the covered services and then submit a claim for reimbursement.

How Much Does Pet Insurance Cost?

The cost of pet insurance is going to depend on several factors, including:

  • The type, gender and breed of animal. Some breeds are predisposed to certain illnesses, which typically costs more to insure. For example, large dog breeds are more prone to heart and hip issues and have higher medication costs.
  • The pet’s age. As your pet gets older, it is more likely to become ill, which will translate into higher pet insurance premiums at policy renewal times. Some insurance companies, such as Trupanion, will not raise the premium as the pet gets older.
  • Pre-existing conditions. But if your pet has suffered a previous injury or illness, your insurer might still cover them if they have been cured.
  • Your location. Areas with higher veterinary costs will affect the plan price.
  • Coverage types. You’ll pay more for a comprehensive plan that covers accidents, illness and wellness compared to a plan that covers only routine vet visits.
  • Deductible and reimbursement level. You’ll pay more for having a lower deductible and higher reimbursement level. For example, a plan that offers 90% reimbursement will cost more than a policy with 70% reimbursement.

Generally, it’s more expensive to insure a dog than a cat. The average annual premium for accident and illness coverage for a dog in 2019 was about $585 versus $350 for a cat, according to the North American Pet Health Insurance Association.

Average Pet Insurance Premiums

Is Pet Insurance Worth It?

Routine vet bills and medical expenses related to accidents and illness can be costly, and pet insurance can be a good way to help offset some of these costs.

For example, if your playful pooch chases a ball a little too hard and tears their hind ACL, the medical expenses associated with surgery could run you thousands of dollars. If you had accident coverage with a $100 deductible and 90% reimbursement level, a $3,000 surgery would end up only costing you $400 out-of-pocket ($100 deductible + 10% cost of surgery = $400).

But while pet insurance can end up saving you big time in case of a serious accident or injury, it’s also an expense you want to consider. If you paid an average $500 per year for accident and illness coverage over a 10-year period, you would pay $5,000 in pet insurance premiums. Some pet owners might prefer setting aside money in a savings account for a pet’s medical needs.

If keeping aside thousands of dollars in savings for your pet isn’t feasible, then pet insurance can be a good way to avoid plunking down your credit card for a major bill because of an unexpected injury or illness.

While the cost of pet insurance will vary depending on several factors like your pet’s age, breed and your coverage selections, the good news is you can typically find a policy that covers certain medical expenses and fits within your budget.



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