The essentials
- Pet insurance differs from human health insurance — Pet owners will need to pay their vet bill in its entirety before getting reimbursed later.
- Species, age, breed, and size are factored into premiums — You’ll pay more or less for your pet depending on these factors, plus any pre-existing conditions.
- Pet insurance covers unforeseen issues, not routine care — Illnesses and injuries are covered by pet insurance, while check ups and preventative shots are usually only covered by pet wellness plans.
5.36 million pets were insured across North America by their owners in 2022. Should you be signing your pet up, too?
If you’ve ever enrolled yourself in health insurance before, you know it can be confusing. The idea of registering your furry friends for a pet insurance plan probably doesn’t get you too excited, either. Nonetheless, having pet insurance can be a beneficial way to offset the high costs of veterinary care, especially in the event of an emergency.
🚨 Disclaimer: Before jumping into this, read our Pet Insurance Glossary to familiarize yourself with the terms and definitions commonly used throughout this article.
How pet insurance works
Like health insurance, pet insurance is a plan you pay into each month so you can save money on potential medical bills for your dog, cat, or other pet. Unlike health insurance, though, pet insurance typically requires you to pay these bills upfront on your own and then wait to be reimbursed after filing a claim.
The policies usually have waiting periods before they kick in, and they get more expensive the older your pet is, so it’s best to enroll your furbaby as early as possible. When purchasing a plan, it’s helpful to get quotes from multiple providers so you can weigh your best options.
Every animal is different, so you should research plans that benefit the needs of your specific pet, taking into account their age, breed, location, and any pre-existing or genetic conditions. Insurance providers also consider these factors when determining your quote. For example, pet insurance costs more in cities than it does in rural communities, as urban pets will generally be exposed to more risks.
Unfortunately, while it is on the rise, many companies still don’t offer pet insurance as a benefit to employees, leaving you to pay for the plan entirely on your own. Read on to learn how you can find the best plan for you and your pet at a rate that you can manage.
Types of pet insurance plans
Before signing up for pet insurance, you’ll want to familiarize yourself with the different types of plans available on the market. While providers will be able to present you a more detailed breakdown of what they offer, there are three main types of plans to choose from:
- Accident. This coverage will reimburse you for veterinary costs associated with accidental injuries like a fracture, bite, heatstroke, or poisoning. This is usually the least expensive type of pet insurance.
- Accident and illness. As the name suggests, this covers illnesses in addition to the aforementioned accidents, including allergies, ear infections, or arthritis, among others. This plan also typically covers certain diagnostics like X-rays, medications, and bloodwork. Though more expensive than an accident-only plan, it will likely have a lower annual deductible.
- Wellness. For routine and annual care like vaccinations, preventatives, and regular vet visits, owners can opt for wellness coverage. While this typically has no deductible and can be beneficial as an add-on to the other plans, having just a wellness plan puts you at risk of having to pay higher costs in the event your pet gets sick or hurt.
How to use your pet insurance
So you’ve enrolled in pet insurance – now what? As mentioned, pet insurance differs from health insurance in that you’ll need to pay up front for your veterinary bills, then file your claim afterward. This is a general step-by-step breakdown of the reimbursement process once you’ve reached your effective date:
- Consult your vet on costs — Whether your pet is sick, injured, or is due for a regular wellness exam, you’ll want to schedule an appointment with your veterinarian. Be clear about costs and budget ahead of time so you can manage your expectations, taking into account deductibles, reimbursement and copay rates, and annual limits.
- Pay your bill — At the end of your vet appointment, you’ll need to front the cost of your bill entirely. Depending on the nature of your visit, this can be a lot, so having a pet savings account may help you cover this fee while you wait for reimbursement.
- File a claim — To file a claim for reimbursement, you can go through your insurer’s online portal, mobile app, submit by mail, or send a fax. Be sure to get a copy of the bill from your veterinarian to upload with your claim.
- Set your reimbursement method — Once the pet insurance company approves the claim (this can take anywhere from a few days to a few months), your reimbursement can either be deposited into your account or mailed to you.
How providers calculate reimbursement
The process in which insurers calculate your reimbursement can be pretty mystifying. Are they just making up random numbers, or is there a method to their madness? To better understand this cryptic number, let’s take a look at an example of a pet insurance policy.
Example of a pet insurance policy
Bill: $5,000
Let’s say you’ve hit your effective date and get a bill for $5,000 at your first vet appointment of your insurance policy term.. How much are you getting back after you file a claim?
Deductible: $200
First things first, insured pet owners will need to hit their annual deductible before receiving any reimbursement. If your deductible is $200, this means the remaining $4,800 on the above bill is what’s being considered for reimbursement.
Reimbursement rate: 80%
You’ll also have to consider your reimbursement rate when it comes to the remaining balance. This is the percentage of money you’ll receive back from your provider after your deductible has been met, usually ranging from 75-90%, with the other percentage going towards your copay.
If your reimbursement rate is 80%, then your insurance will reimburse you 80% of that remaining $4,800, which is $3,840. The other 20%, or $960, is your copay. This means you’re paying $1,160 total (your deductible plus your copay).
Annual limit: $10,000
Your provider will also have a cap on the maximum amount of reimbursements you will be eligible for in one policy term. If your annual limit is $10,000, then the $3,840 you were reimbursed will be subtracted from this limit, leaving you with $6,160 of potential future reimbursements until the cap resets in your next policy term.
👉 Insurance providers may also have per-incident limits, which are caps they have on certain incidents or illnesses. This figure is the maximum amount of money your insurer will reimburse you for a specific health problem.
How much pet insurance costs
Now that we’ve covered reimbursements, let’s discuss how much you’ll be paying for the pet insurance plan itself. On average, monthly premiums have been rising each year. But quotes vary based on a number of factors, starting with species.
Pet insurance for dogs is considered more expensive than most other pets. Dog owners paid an average of $16.70 a month for accident-only coverage and $53.34 a month for accident and illness coverage in 2022, according to NAPHIA. On the other hand, cat owners paid $10.18 and $32.25, respectively. Coverage for exotic pets like horses, birds, or reptiles is less common but still available!
Insurers will also be taking age, breed, and existing conditions into consideration when determining your monthly premium. For example, a healthy golden retriever puppy won’t cost as much to insure as a senior bulldog with a breathing problem. Size also plays a role, as large pets tend to have higher premiums than small pets because of their shorter life expectancy.
What pet insurance covers
What your pet insurance does (and doesn’t) cover depends on the provider and plan you select. Understanding what the market typically offers for certain procedures and medications can help you find the best option for your individual pet. As you set out to insure your favorite furball, here’s what you can expect from different veterinary services.
| Treatment/Service | Accident-only plan | Accident and illness plan | Wellness plan |
|---|---|---|---|
| Routine check up | No | No | Yes |
| Vaccines | No | No | Yes |
| Spay and neuter | No | No | Yes |
| Dental | No - unless it’s an injury or disease | No - unless it’s an injury or disease | Yes |
| Medication | Yes - unless to treat a pre-existing condition or is preventative | Yes - unless to treat a pre-existing condition or is preventative | Yes - preventative only |
| Pre-existing conditions | No | No | No |
| X-rays | No | Yes | No |
| Surgery | Yes - unless related to an illness or pre-existing condition | Yes - unless related to a pre-existing condition | No |
| Infections | Yes - only if it’s related to an injury | Yes | No |
| Euthanasia/Cremation | Depends on provider | Depends on provider | No |
With the basics out of the way, let’s dive a little more into each subject to work out the details.
Vaccines
Though vaccinating your pet is extremely important to protect them from harmful and potentially lethal diseases, vaccines are not covered by pet insurance. Owners looking to be reimbursed for vaccines like distemper and rabies will need to opt-in for a wellness plan.
A wellness plan, sometimes called a preventative care plan or routine care plan, is designed to cover expected costs like immunization or regular check-ups, as opposed to pet insurance which covers unexpected illnesses or incidents. Wellness plans may be offered as an add-on to accident or accident and illness pet insurance plans, but in some cases, you’ll need to enroll in wellness coverage separately.
Spay and neuter
Unfortunately, spaying and neutering is also not covered by most pet insurance because it’s considered an elective procedure. While costs vary, spaying is typically more expensive than neutering. Size also is a factor, with larger breeds costing more to fix than smaller ones. You’ll also want to consider location, as different places have different prices for the surgery.
For example, an animal hospital may charge $300-$600 for spaying and $200-$400 for neutering on average, while a spay-and-neuter-specific clinic can cost $50-$240 for spaying and $30-$175 for neutering. A wellness plan will typically cover this expense but likely isn’t worth it for sterilization coverage alone as it’s only a one-time procedure.
Dental
While dental care is usually covered by pet insurance, there are several factors to be aware of. For starters, dental isn’t separate insurance for pets as it is for humans, and will likely be included in your main insurance plan. You’ll also want to consider what kind of dental care you’re looking to get insured. Pet insurance usually provides coverage for unforeseen dental problems, like a chipped tooth, root canal, or gum disease. Routine and preventative care like teeth cleanings are not commonly reimbursed by pet insurance but will be covered by a wellness plan.
Medication
When it comes to your pets’ medication, you can rest assured that they will be covered for any prescriptions related to an illness or injury covered by your plan. For example, if your pet insurance covers ear infections and your vet prescribes an antibiotic to treat it, you can file a claim for reimbursement on the cost of the antibiotic.
Other prescriptions typically covered by pet insurance providers include medicine for anxiety, seizures, and diabetes. Routine over-the-counter medicines like flea and tick preventative or anti-inflammatories are not covered by pet insurance but are included in wellness plans.
Regular vet visits
Pet insurance doesn’t cover routine vet visits, but wellness plans do. Exam services included in wellness coverage include immunizations, microchipping, preventatives, dental cleanings, and sterilization procedures.
While routine vet appointments aren’t covered in accident-only or accident and illness plans, unexpected testing and treatments for conditions discovered during a routine exam will be. In the case of accident and illness coverage, you can file a claim for reimbursement on radiographs, diagnostic panels, and prescriptions.
Emergency vet visits
In general, pet insurance doesn’t distinguish between emergency vets and regular vets, but rather the treatment your pet is receiving from the vet. In the case of emergency animal hospitals and clinics, you are likely there to treat an accidental injury, poisoning, or sudden illness, which would be covered by insurance. Your deductible and reimbursement rate will stay the same as it would for a regular vet visit, but per-incident limits may apply to certain injuries or illnesses.
Pre-existing conditions
Much like with health insurance, pre-existing conditions are typically excluded from pet insurance policies. This includes any illnesses or injuries included in the pet insurance plan that were diagnosed or occurred before enrolling in pet insurance.
When you register for pet insurance, your provider will take a look at vet records to determine any health conditions your pet has experienced or is currently experiencing, so sign up early to have more coverage.
In the event your pet has a pre-existing condition that the insurer considers curable, like a urinary tract infection (UTI) or vomiting, you may be eligible for coverage.
Surgery
Perhaps one of the biggest benefits of pet insurance is absorbing the high costs of surgery in the event your little one needs it. That said, not all surgery is covered by pet insurance, so you’ll want to familiarize yourself with your insurance plan before enrolling.
Surgeries eligible for reimbursement include those caused by accidents and — in the case of an accident and illness plan — illnesses. These include ACL surgery, tumor removal, and surgeries to extract a foreign object causing an obstruction.
In some cases, the same type of surgery may be eligible for reimbursement for some pets but not for others. For example, pets that require cataract surgery because of an injury to the eye will be eligible, since that is an accident, while pets that require cataract surgery because of genetic factors they were born with won’t be eligible, since that is a pre-existing condition.
X-rays
X-rays are commonly covered by accident and illness plans, but not accident-only plans or wellness plans. Of course, this is only the case when the X-ray is used to look into a new injury or ailment, not a pre-existing condition.
These screenings can be costly, particularly for larger breeds. Location is also important to consider, as having X-rays performed at emergency hospitals and clinics tends to be more expensive than your regular veterinarian’s office, which can in turn drain more from your annual limit.
Infections
If you enroll in accident and illness coverage, you can expect to be reimbursed for the treatment of any infections that aren’t the result of a pre-existing condition. This includes ear infections, eye infections, yeast infections, canine influenza , staph infections, parvovirus, and more.
Euthanasia and cremation
No one wants to think of their pet passing away, but it can also be a consideration in your enrollment for pet insurance. The coverage you get for end-of-life services varies greatly among insurance providers.
For some, they offer euthanasia coverage, typically under accident and illness plans, but not cremation. Others may offer cremation but not euthanasia and others may not offer either.
Does my pet really need insurance?
Looking at all the different complex terms and numbers on a health insurance enrollment form, you may be wondering if it’s even worth the headache.
- You’ll have to consider your finances and whether you’ll be able to afford the monthly premiums (which have gotten more and more expensive) on the off chance you never use your plan. Or, if you have the means to pay for a large emergency vet bill should it arise, are monthly payments or filing claims worth the hassle?
- Lifestyle plays a role as well. Does your pet go on hikes or camping trips a lot, or do they mostly stay at home where there’s less risk? The former may prefer having a policy for peace of mind while the latter may not.
- Think also of your pet’s existing conditions that won’t be covered, or if they’re an older pet that will cost more to insure.
All in all, pet insurance can be extremely beneficial when it comes to offsetting expensive vet bills, especially when it comes to emergency care and surgeries. Some folks prefer having a policy as a backup plan to avoid impossible decisions should they not be able to afford a vet bill in the future. Even if your pet is generally healthy, accidents happen, and getting sick is as natural for our furry friends as it is for us.
Hopefully, with this information, you can make the best decision for you and your pet.
Frequently asked questions
How does pet insurance differ from health insurance?
While both health insurance and pet insurance involve paying a monthly premium in exchange for reimbursements on medical services, health insurance will cover your cost of care at the time of your appointment so you only have to pay a copay, while pet insurance requires you to pay your vet bill upfront and file a claim for reimbursement afterwards.
What types of pet insurance plans are there?
The three main types of pet insurance are accident-only plans, which cover unexpected injuries or poisoning, accident and illness plans, which include non-injury related conditions like ear infections or arthritis, and wellness plans, which cover routine vet care and preventatives.
What are the pros and cons of pet insurance?
The benefits of pet insurance includes reducing expensive veterinary bills in the event of an emergency or when surgery is required. Cons can include high monthly premiums, having to pay upfront, deductibles, and no coverage for pre-existing conditions.
How soon after getting pet insurance can you use it?
The waiting period is typically 14 days for pet insurance coverage to kick in, but plans vary with some taking as long as six months. Luckily, any injuries or illnesses that occur during your waiting period will not be considered a pre-existing condition.
Does pet insurance cover medication?
Pet insurance covers prescriptions for medications unrelated to pre-existing conditions. For example, if a pet gets an ear infection and requires an antibiotic, your insurance will reimburse you for the antibiotic.
