Pet insurance protects against unexpected veterinary costs and provides pet owners with invaluable peace of mind. As healthcare costs rise across the board, pet healthcare is no exception and, according to several pet insurance companies, the average amount that most people can afford for veterinary treatment at any given moment is only $1,500. Veterinarians tell our team at Pawlicy Advisor that they have difficult conversations with pet owners about the cost of care anywhere from five to ten times per day.
However, although enrollment rates have steadily increased over the last 5 years, still a large percentage of pet parents are unaware of what pet insurance is and are wondering “How does pet insurance work?”. According to the North American Pet Health Insurance Association (NAPHIA), there are 69 million pet dogs living in the US but less than 2% of them have pet insurance.
This guide will explain what the purpose of pet insurance is and what it covers. In addition, we will discuss the enrollment process, provide explanation on how pet insurance works, and much more.
Pet insurance is a form of insurance that pays, partly or in total, for veterinary treatment of the insured person's ill or injured pet.
In other words, pet insurance is a health insurance policy that covers certain veterinary costs. It gives you peace of mind that, in the event that your dog or cat has an accident, illness, or emergency, it will receive the appropriate care without facing a significant financial burden.
Did you know that every year, one in three pets requires unanticipated veterinary care? Being a pet parent means that every day is filled with surprises, and not all of them are pleasant.
If you have pet insurance, you won't have to be concerned about using high-interest credit cards, taking out loans, or worse, deciding to put your pet to sleep because you can't afford the payment.
Here are the main reasons why people get pet insurance:
What pet insurance covers depends on the type of plan you decide to enroll in.
Accident-only plans will only provide reimbursement for emergency care related to accidents , like if your pet is hurt by a car or injures themselves by falling down the stairs. This type of coverage does not cover illnesses or breed-specific issues but only physical injuries such as fractures (broken bones), burns, cuts, etc.
Accident-illness plans provide coverage for both accidents and unexpected illnesses. It is the most common choice, as it represents about 98% of plans issued² by the pet insurance industry. This type of plan won't cover preventive care or pre-existing conditions, but you can expect reimbursement for almost everything else, including treatments for viral infections, parasites, hip dysplasia, and even tooth extraction in the event of dental diseases, in some cases.
NOTE: Many pet insurance companies sell supplemental pet wellness plans , known as policy riders, that cover routine care, preventative care, checkups, and yearly vaccines, but not much else. These are usually sold as add-on features to other health insurance plans. This type of plan does not cover accidents, common injuries, or emergency treatments for illnesses.
The best pet insurance plans can provide substantial coverage for the most expensive health treatment and diagnostics.
However, depending on your insurance plan, your policy may not cover every condition/expense your pet has. This is why it's so important to find a plan that covers your pet's breed-specific health risks .
So, to sum up, pet insurance can cover:
In general, most pet insurance plans will cover medical expenses in the above categories as long as they are not related to a pre-existing condition. The details will depend on the type of coverage (see the chart below) and the provider you choose.
Some pet health insurance plans also cover:
Coverage | Accident-Only | Accident-Illness | Accident-Illness + Wellness Add-on |
---|---|---|---|
Emergency care for accidents | Yes | Yes | Yes |
Treatment & tests for injuries | Yes | Yes | Yes |
Emergency care for illnesses | No | Yes | Yes |
Treatment & tests for illnesses | No | Yes | Yes |
Breed-specific conditions | No | Yes | Yes |
Routine care | No | No | Yes |
Wellness exams | No | No | Yes |
Vaccines | No | No | Yes |
Pre-existing conditions | No | No | No |
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The most common exclusion is for pre-existing conditions, i.e. any illness or injury that occurred in your pet's medical past before the coverage began. This also applies if you cancel one policy and buy another.
Other Common Pet Insurance Exclusions:
💡 NOTE: Although no pet health insurance providers cover pre-existing conditions, some providers will cover curable health conditions after a certain waiting period with no recurring symptoms. Also, pets with a pre-existing condition are still eligible for insurance, their coverage would only exclude the specific condition that already exists.
There are other types of insurance products that cover other types of pet expenses. Here are a few to keep in mind:
Learn More: What Types of Pet Insurance Do I Need?
Wondering “How does pet insurance work?”. We'll break down the general overview of how pet health insurance works in 5 steps:
Not all providers are the same. The majority of pet insurance policies typically pay for unexpected illnesses, accidents, surgeries, medications, tests, and diagnostics, as well as the costs of emergency care and exams. However, not all costs in those categories often qualify for reimbursement. The type of pet insurance coverage and the company you select will determine the specifics of your pet insurance policy.
The first thing you need to do is select your type of coverage then customize plan by choosing from the different deductibles, reimbursement limits, and payout limits.
The deductible is the portion of the veterinary bill you're responsible for before your plan's reimbursement kicks in. Most pet insurance companies use an annual deductible. Some insurance companies offer a per-incident deductible, meaning if the same injury occurs more than once in future years, the deductible will no longer apply.
Reimbursement rate is the amount a pet insurance company pays you back for the cost of care. The most comprehensive pet health coverage will reimburse 80% to 100% of your total vet bill (after your deductible is met).
Limits are something you should consider when choosing a plan, especially as you anticipate how much and what type of care your pets might need for their ages and conditions:
Pro tip: Researching breed requirements before choosing a pet insurance can be helpful. Consider the conditions your pet is most likely to experience over the course of their lifetime, and then check to see if they are covered. Keep in mind that each animal is unique, and their age, breed, and lifestyle will influence the health issues they are most prone to.
Some pet insurance providers require exams or medical records prior to enrolling your pet in a pet insurance policy.
Depending on the policy, some insurance companies may not cover older animals, while the majority do not cover animals that are younger than eight weeks old.
Finally, since some providers only offer coverage in certain states, your eligibility to enroll may be based on where you live.
Be sure to compare these requirements before choosing a plan.
Learn More: How to Compare Pet Insurance Plans
On a month-to-month basis, pet insurance works most like renter's insurance. You pay a monthly premium to your insurer for coverage.
Your premium is the fee you must pay each month (or year) to keep your insurance policy active. A higher monthly premium typically means you're paying for more coverage, so you shouldn't always go for the plan that has the lowest premium. Still, a plan with a low premium might be your best option if you're on a tight budget.
Some pet insurance providers also have one-time enrollment fee and/or monthly transaction fees which can be waived if you decide to pay annually.
💡 PRO TIP: If you need to save on monthly costs (your premium), you customize your plan and lower the reimbursement rate, lower the limit, or raise the deductible. Some insurers will increase your premium as your pet ages or after you have filed a claim. Pawlicy Advisor provides a Lifetime Pricing Score to help predict such costs.
Most insurers impose waiting periods for each type of claim that the policy covers. Illnesses typically have a longer waiting period (usually two weeks) than accidents (usually several days). The longest waiting periods are usually reserved for specific conditions like orthopedic problems and cruciate ligament issues, requiring six months or more before coverage begins.
Once the mandatory waiting period has passed, you can visit the vet as you normally would. You can benefit from your coverage at any licensed vet clinic or animal hospital in the U.S, and some providers will even cover your pet when traveling outside the country.
You will need to pay for the visit upfront at the time of service (this counts toward your deductible) and get reimbursed later after you submit a claim.
If your pet requires treatment for a covered illness, accident, or procedure, you will pay the veterinarian directly and file a claim with your pet insurance provider. Be sure to file your claim within the designated window (usually 60 to 270 days after the treatment).
Pet insurance companies offer different options/methods to file claims, including email, mail, fax, online portals, mobile apps.
Insurance companies may need paperwork or a medical history review from your veterinarian to process your claim, so be sure to save all receipts and documentation you receive from your vet appointment.
Policyholders are usually reimbursed via check or direct bank deposit but some providers will offer to pay the veterinarian directly.
If your claim is approved, you will get reimbursed at the rate set in policy (up until to the annual/lifetime limit) after deductible is met. On average, policyholders get reimbursed within 5 to 9 days after submitting a claim.
Pet insurance payout offsets cost of vet bills and can be used in conjunction with veterinary financing options.
In most cases, yes, you will need to pay your vet upfront for the treatment, unless your provider offers vet direct pay. This counts toward your deductible but once the deductible is met, you are still responsible for the insurance copayment (typically 10-30% of total vet bill, depending on your chosen reimbursement rate).
Due to the fact that pets are legally considered property, pet health insurance is more similar to renters insurance or car insurance, rather than human health insurance. In practice, this means that you can enroll or change your coverage at any time, and your coverage will work at any vet. In contrast, human insurance plans involve a network of hospitals and doctors, typically known as a Preferred Provider Organization (PPO) or Health Management Organization (HMO).
Pet insurance also has much cheaper premiums. Most health insurance plans for humans cost $300+ per month but with pet insurance, these premiums average about $28 a month for cats and $48 a month for dogs.
Another distinction is that pet insurance uses a "fee-for-service" basis, whereas human health insurance plans use a "managed care" model. Essentially, this means that your practitioner will receive direct payment from human health insurance companies (once you cover your deductible). On the other hand, pet insurance companies will reimburse you for claimed expenses on covered medical costs if your deductible is met but you must first pay the whole veterinary bill in order to be able to submit a claim.
Finally, an insurance provider for pets can refuse to cover a pet's pre-existing condition. As of 2014, due to changes in healthcare law, human health insurance providers in the US are no longer able to refuse coverage of pre-existing diseases.
Learn More: What's The Difference Between Pet Insurance & Health Insurance?
Pet insurance is generally affordable. The average monthly premium in 2021 was $28.57 for a cat and $48.66 for a dog³, but it's important to recognize that there's a wide range in pet insurance pricing (many see rates as low as $12/mo, others might see rates as high as $100/mo) depending on a few key factors.
You can save on pet insurance by enrolling when your pets are still young, as your monthly premiums are guaranteed to be lower. Some pet insurance providers will also give you a discount on your bill if you agree to make annual payments instead of monthly payments. Others offer discounts if you insure multiple pets under the same provider.
Another way to keep your premiums low is to select a higher deductible, but keep in mind that you’ll have to reach that deductible by paying out-of-pocket before your insurance plan begins to reimburse your veterinary costs.
Similarly, you can keep costs down if select a lower reimbursement rate or a lower coverage limit, but this will limit the amount you receive from your insurer if your pet gets seriously ill or injured.
Learn More: The Average Cost of Pet Insurance in 2022
There are three ways to enroll in pet insurance:
Through the provider companies.
💡 NOTE: Wellness plans can be acquired as add-ons should you purchase accident-illness coverage through a top provider on Pawlicy Advisor's marketplace. You can also get a Wellness Plan as a separate enrollment through a dedicated wellness provider or your local veterinary clinic.
As pet parents, we know searching for pet insurance is complicated. We know that review sites don't provide enough information. We also know having to submit a quote form with "every" "single" "provider" is a horrible user experience.
Instead, pet parents can use Pawlicy Advisor to see pet insurance quotes from top providers, custom comparison charts, and ranked based on breed-specific health risks and lifetime pricing - all in one place.
Review aggregators can be a great tool for understanding context on customer service experiences - however, they should not be the deciding factor in your evaluation.
Simple review sites don't provide pet parents with transparency on policy details, breed exclusions, and lifetime costs. Negative reviews don't necessarily mean that the provider or the plan is a poor choice, rather, it's quite possible that the plan was a bad fit for the individual reviewer.
Similarly, good reviews don't offer much information. Every provider has good reviews. The number of reviews is more correlated review collection efforts or brand awareness, rather than how “good” an insurance option is.
Pawlicy Advisor analyzes your pet's health risks, coverage options on the market, and price differences to recommend a policy that will save you substantial money and frustration over your pet's lifetime.
See more 5-star reviews on Facebook and Google.
Fill out one form to run an analysis across hundreds of policy variations from top providers and compare plans in custom comparison charts.
Our goal is to transform the pet insurance industry and enable more people to get their pets the affordable care they need.
🧡 RESOURCES:
Read through these additional questions to find out more about pet insurance or check out our FAQ page.
Pet insurance is health insurance for your pet. It covers (reimburses) the costs of treating unexpected injuries and illnesses, so you don't have to worry as much about expensive vet bills. Unlike human health insurance, you can use your benefits at any vet or animal hospital.
One out of three pets will need emergency treatment, and most Americans can't afford unexpected veterinary bills. Pet insurance is worth it because it helps you afford these costs, so your pet always gets the care they need.
After paying a vet bill, you can submit a claim for reimbursement to your insurance provider. Most pet insurance companies let you submit claims online, by phone, or by mail.
The deductible is the portion of the bill you're responsible for before you can start being reimbursed for veterinary costs. Most plans come with an annual deductible. For example, if your annual deductible is $1,000, you'll need to pay for $1,000 in veterinary costs each year before you can start getting reimbursed for veterinary costs.
Every pet and pet parent has unique needs, but the most popular type of pet insurance is called an accident-illness plan. This type of plan covers the most expensive injuries and illnesses, and it's generally affordable for most pet parents.
When shopping on Pawlicy Advisor, rest assured we only work with the best providers in the industry - and our algorithm will analyze hundreds of options to help you compare the best dog & cat insurance plans based on breed, location, age, lifetime savings, and more.
The average cost for the most common pet insurance plans (accident-illness plans) is $28.57 for cats and $48.66 for dogs. This coverage reimburses emergency care as well as treatments and tests for unexpected accidents and illnesses like cancer, poisoning, foriegn ojbect injestion, surgery, X-rays, glaucoma, and more.
The size, breed, age, and geographic location of your pet all influence the cost of your insurance policy. The length of your policy and the company offering your plan also play a role. Finally, you get to determine what type of policy works best for you by selecting a quote that makes sense for your budget.
There's no "one-size-fits-all" solution for pet insurance, and many providers allow you to customize your plan to accommodate your personal needs and preferences. While sites like Pawlicy Advisor can help you pick a great pet insurance plan from the start, life happens and things can change, so you might want to change your plan after purchasing. Depending on your provider, this may be possible; however, you may be required to wait until your policy renewal to add or drop coverage to your plan for the following period.
After you purchase insurance, there will be a waiting period in which some coverage is restricted. Waiting periods are determined by the pet insurance company, so it's important to check before you sign up. Most waiting periods last only 14 days.
Pet insurance doesn't pay your veterinarian directly. Instead, your provider will reimburse YOU for your veterinary costs after you pay your vet and submit a claim to the insurance company. This way, you don't have to worry about whether your vet takes a certain policy or not — you can use any veterinarian you like!
Most pet health insurance policies don't cover neutering, but some pet wellness plans will cover it.
Some pet insurance plans are transferrable to a new owner. Contact your pet insurance provider to learn more about their transfer policies.
Yes. A pet insurance company might cancel your policy if you don't pay your monthly premiums. In addition, some pet insurance policies may drop levels of coverage after your pet reaches a certain age.
Yes. Most providers allow you to cancel your pet insurance policy at any time
If your pet insurance plan covers prescription medications, then it should cover antibiotics, unless they are prescribed to treat a pre-existing condition.
You can use most pet insurance plans at any veterinarian you choose. However, if you decide to move to a new state, your policy may change based on state laws and other factors.
You can get pet insurance by contacting any pet insurance company directly. The easiest way to get it is to search for a plan on Pawlicy Advisor and sign up online.
Many pet parents must make decisions about their pet's care based on cost. However, pet insurance helps by reducing financial risk and ensures your pet can always have access to quality care at an affordable rate.
Most pet owners get pet insurance for peace of mind. It protects them against the financial risk of expensive veterinary service often required for sick or injured pets.
Most pet insurance plans won't cover the cost of spaying, but a pet wellness plan can cover the procedure.
Yes. A comprehensive accident-and-illness pet insurance plan should cover most surgeries. However, it will not cover elective surgeries or surgeries to treat a pet's pre-existing conditions.
Neither accident-and-illness plans nor accident-only plans cover vaccinations, but you can get them covered under a pet wellness plan as an add-on feature.
Many pet insurance plans cover the cost of hip dysplasia, but you may be subject to a waiting period post-enrollment for coverage to begin.
Yes. Many pet insurance plans cover prescription medications.
Yes. Many pet insurance plans cover hernia surgeries, but they won't cover hernia surgery if the hernia is a pre-existing condition.
You can submit a claim for reimbursement after paying your veterinarian for their services. However, some policies may require you to wait a certain number of days after your policy activates before you can submit a claim.
If your pet passes away, many pet insurance companies will backdate your premiums and refund you. However, no pet insurance plan will cover treatment provided before your policy enrollment date.
Pet insurance works a lot like car insurance. It's designed to protect you from financial risk by reimbursing you for planned and unplanned vet costs.
Pet insurance can cover a heart murmur, but not if it's a pre-existing condition. If your pet develops a heart murmur after your effective policy date, then your insurance should cover it.
References:
PetKeen, “Top 20 Pet Spending Statistics To Know In 2022: Who’s Spending The Most On Their Pets?”, Accessed on October 12, 2022
Today’s Veterinary Business, “Insured pet population grows by 18%”, Accessed on October 12, 2022
NAPHIA, “State of the Industry Report 2022, Section 3: Average Premiums”, Accessed on October 12, 2022
Instead, pet parents can use Pawlicy Advisor to see pet insurance quotes from top providers, custom comparison charts, and ranked based on breed-specific health risks and lifetime pricing - all in one place.
Review aggregators can be a great tool for understanding context on customer service experiences - however, they should not be the deciding factor in your evaluation.
Simple review sites don’t provide pet parents with transparency on policy details, breed exclusions, and lifetime costs. Negative reviews don’t necessarily mean that the provider or the plan is a poor choice, rather, it’s quite possible that the plan was a bad fit for the individual reviewer.
Similarly, good reviews don’t offer much information. Every provider has good reviews. The number of reviews is more correlated review collection efforts or brand awareness, rather than how “good” an insurance option is.
Pawlicy Advisor analyzes your pet’s health risks, coverage options on the market, and price differences to recommend a policy that will save you substantial money and frustration over your pet’s lifetime.
See more 5-star reviews on Facebook and Google.
Fill out one form to run an analysis across hundreds of policy variations from top providers and compare plans in custom comparison charts.
Our goal is to transform the pet insurance industry and enable more people to get their pets the affordable care they need.
🧡 RESOURCES:
Let's analyze your pet's breed, age, and location to find the right coverage and the best savings. Ready?
Analyze My PetThe pet insurance marketplace endorsed by veterinarians, at Pawlicy Advisor we make buying the best pet insurance easier. By comparing personalized coverage and pricing differences we can save you a ton of money, up to 83% in some instances!
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Kari Steere is a licensed P&C insurance agent in all 50 states and has focused entirely on pet insurance since 2019. As an animal lover with a rescued Terrier named Barry, when she's not helping pet owners find the perfect plan on Pawlicy Advisor, she runs a ranch in Oregon and rehabilitates any animals that come across her path.