The type of insurance coverage you have will determine what your pet insurance will and will not cover. In general, while some pet insurance plans will cover accidents and injuries caused by accidents, most insurance policies will not cover neutering, spaying, and dental care. Understanding the various pet insurance policies and how they work will help you with what to look for while purchasing a plan. We’ll give a general overview in this guide.
What Does Pet Insurance Cover?
Most pet insurance policies, in general, cover unexpected injuries or accidents, unexpected diseases, surgery, medication, tests, and diagnostics, as well as emergency care and exam fees. However, not all expenses in those areas are reimbursable.
In summary, the type of coverage and provider you select will determine the specifics of your pet insurance policy.
Pet Insurance Coverage Options
Insurance companies normally provide three types of coverage: accident-only coverage, accident and illness coverage, and wellness coverage.
Because the specific benefits and restrictions for each plan vary by business, we cover pet insurance pricing separately.
#1. Accident and illness insurance
This sort of insurance is ideal for breeds that are prone to health issues. It covers veterinary-diagnosed illnesses or conditions, as well as accidental injuries. It also avails you the option of adding an additional rider.
What Does Accident and Illness Pet Insurance Cover?
Although some insurers sell illness coverage separately, it is considerably more typical to find it bundled with accident coverage. Accident and illness insurance (sometimes known as “comprehensive policies”) covers a wide range of conditions, from the small (such as vomiting and diarrhea) to the serious (such as cancer). They can also pay for all veterinary examination and consultation fees, as well as hospitalization, treatments, surgery, and prescription medications.
Most of these policies also cover breed-specific hereditary and congenital disorders, such as damaged ligaments. However, this is only true if your veterinarian discovers the problem after the policy is implemented. If your dog has any of these ailments prior to enrollment, they will be considered “pre-existing”. And so, they will not receive coverage.
Some policies cover certain conditions as well, but only after a waiting time. For example, an insurance company may pay for hip dysplasia surgery if it is performed at least six months after the coverage takes effect.
Unfortunately, some policies exclude specific types of prescriptions, such as those for behavioral issues, and charge the pet owner for exam fees.
Comprehensive and Wellness Protection
Some comprehensive (accident and illness) plans are available in conjunction with wellness coverage. Wellness coverage can include alternative therapies as well as a slew of other covered treatments, such as behavioral therapy, acupuncture, chiropractic care, as well as laser therapy, and hydrotherapy. Some plans also include dietary supplements and meals that you need to treat your pet’s health condition.
#2. Accident-only insurance
Accident-only insurance is recommended for young, healthy pets who are unlikely to develop a hereditary condition. It only covers injuries sustained during an accident.
What Does Accident-only Insurance Cover?
Accident-only coverage covers the cost of treating injuries or illnesses caused by incidents. This is regardless of whether the animal caused them or the owner did.
While claims for accidents caused by such behaviors will not increase your monthly premiums, a breed’s proclivity for accidents may affect the cost of accident insurance – and comprehensive plans that contain the coverage. Premiums for Labrador Retrievers, for example, are expensive due to the breed’s proclivity to swallow foreign things.
What Does Accident-only Insurance Not Cover?
Accidents that can be linked back to the pet owner, such as intentional injuries or those caused by the pet’s participation in organized fighting or racing, will not be covered, nor will any accident caused by a pre-existing ailment.
A lot of things will influence how you purchase pet insurance. For example, not all policies cover poisoning and flea or tick bites because these hazards are frequently the consequence of owner negligence. Read the fine print, as with any sort of coverage, to ensure what is and isn’t covered.
#3. Wellness insurance
Wellness coverage, often known as “preventive care,” is provided as an add-on or “rider” to a broader policy or, with some carriers, as a distinct stand-alone insurance.
What does wellness insurance cover?
Typically, many regular veterinary care treatments are provided. Other services, including as grooming and training, are sometimes provided.
What Is The Process of Getting Pet Insurance?
Pet insurance reimbursement differs from that of human health insurance. Unlike your own insurance, it’s doubtful that you’ll be able to pay only a copay for your pet’s care. Instead, you must pay the cost in full and wait for reimbursement for the agreed-upon percentage specified in your insurance plan.
Pet insurance products, like human health insurance, have deductibles that must be met before coverage begins. Policyholders can set their own deductible amount, which commonly ranges between $200 and $1,000. (However, in general, the lower the deductible, the higher the premium.)
Existing Medical Conditions
Pre-existing conditions are typically not covered by insurers. That is, if your animal has a medical problem before you enroll them in insurance, you will not be able to claim the expense of treatment.
However, some disorders may eventually be covered if your pet is symptom-free and judged cured for a set period of time – often 180 days. Every insurer has a different definition of what defines a pre-existing condition, so do your homework before purchasing coverage.
Waiting periods exist to discourage pet owners from rushing to insure their animals after any diagnosis or symptom appears. Except for hip dysplasia and other diseases that have their own waiting periods, the standard waiting time for a pet insurance policy is 14 days.
Most policies require you to select specific coverage limitations. These often have an annual cap on reimbursed expenses ranging from $5,000 to $30,000 – the higher the cap, the higher the premium. Lifetime limits are often applied as well.
Furthermore, many insurers impose age restrictions on coverage. This means that coverage on existing policies will end after a certain age. Similarly, some pet insurance firms will not provide new plans to pets over a particular age.
It is uncommon for a pet insurance policy to cover the total cost of any sort of care. The finest low-cost pet insurance will normally cover a certain proportion, such as 70%, 80%, or 90%.
As with many other types of insurance, you must choose an annual deductible that must be paid before payment begins. These often cost $250, $500, or $1,000.
What Pet Insurance Does Not Cover
What pet insurance does not cover, often known as exclusions, may vary between insurers, so you should always read your policy’s Terms & Conditions or Insurance Product Information Document carefully before taking out a new policy or renewing a current one.
The following are some of the most common things that pet insurance does not cover:
#1. Pre-existing illness
In general, insurers will not cover illness or damage that your pet had or showed signs of having before the coverage began. This typically includes illnesses and injuries that may reoccur or manifest in other sections of your pet’s body. For example, if your pet had an ear infection before you purchased your current coverage, your insurance will most likely not cover the cost of treatment for any subsequent infections in either ear, regardless of whether you submitted a claim under a previous policy.
#2. Exclusion or waiting period
A period at the beginning of the insurance during which veterinary treatment is not covered, often the first 14 days (but can be 30 days in some instances). Insurance coverage begins for illnesses that appear or occur after this date. Some insurance includes a similar or shorter duration for injuries.
#3. Routine and preventative treatment
Vaccinations, spaying, castration, flea, worm, and tick treatments, grooming, claw clipping, and dental or teeth upkeep is examples of routine and preventative treatments. Any costs incurred as a result of these therapies, as well as any consequences that may arise, may not be reimbursed.
#4. Pregnancy and childbirth
Pregnancy, childbirth, and care of any offspring are typically not covered.
#5. Administrative costs
In general, insurance will not cover fees incurred by a veterinarian in providing a prescription, completing a claim form, or obtaining receipts, invoices, or reports required as part of the claim.
#6. Exclusions or limits that are specific to your insurance policy
Insurers may contain exclusions, limitations, or conditions that are specific to your insurance policy. These could include inner caps or conditions or treatment limitations. For example, $10,000 of coverage may contain a $2000 per condition restriction, which means that if the maximum is met, there is no more coverage for future treatment expenditures. These will differ between insurers and policies, so always check your policy’s terms and conditions and, if in doubt, contact your insurer.
Other possible exclusions include:
- Elective treatments or procedures (those that are not strictly necessary for your pet’s health);
- Dogs with restricted breeds, behavioral concerns that are not related to an illness or documented condition
- Animals employed in business (e.g., racing or protection/security) or kept on commercial facilities;
- Animals that are not permanently resident in the United States
Does Pet Insurance Cover Spaying And Neutering?
No, because spaying and neutering are considered elective procedures, many pet insurance plans do not cover them. There are, however, pet wellness plans, also known as preventative care plans or routine care plans, that may cover the cost of spaying and neutering.
Where Can I Find Pet Insurance Plans That Cover Spaying and Neutering?
Pet insurance plans that cover preventative and routine treatment are uncommon among pet insurers, so compare policies thoroughly before purchasing. If you locate a pet insurance plan that can cover elective or preventative operations, make sure it includes coverage for spaying and neutering. Finally, confirm the amount of coverage for a spay or neuter procedure and any issues that may arise.
Is Getting Pet Insurance to Cover Spaying Or Neutering Worth It?
Despite the fact that the treatment is extremely prevalent, problems can emerge following the surgery. Some of the most common problems are fluid buildup around the incision, as well as moderate bleeding and infection, which can cost hundreds or thousands of dollars more than the original surgery. On top of your spay/neuter reimbursement, pet insurance plans that cover illnesses may provide coverage if your pet develops difficulties after being spayed or neutered.
Does Pet Insurance Cover Dental Care?
It is unusual for pet insurance companies to cover dental care. However, comprehensive or preventative pet insurance may cover some dental operations.
How to Find Pet Insurance Plans That Cover Dental Care
While pet dental insurance isn’t common, check for pet insurance policies that include complete and routine/preventative dental care coverage:
Comprehensive plans normally include accidents and illnesses, thus dental-related accidents and illnesses should be covered unless there are dental exclusions in the plan’s coverage. Please keep in mind that in order for insurance to cover the dental care, your pet may need to meet specific conditions prior to enrollment and maintain regular tooth cleanings.
Routine/preventive care plans, while significantly less prevalent, may include dental cleaning and checkup coverage to help prevent disease and spot problems early.
Does pet Insurance Cover Vaccinations?
Pet insurance does not cover vaccinations. However, having all of your animal’s vaccines up to date may result in lower insurance prices.
Furthermore, if you do not vaccinate your pet and they become ill with an illness that could have been avoided with a vaccine, your insurer is unlikely to cover treatment costs.
Most pet insurance policies cover unexpected injuries, accidents, and diseases, as well as surgery, medicine, diagnostics, emergency care, and exam fees.
The specifics of your pet insurance policy will be determined by the type of coverage you select and the provider you choose.
As we already discussed, there are three types of pet insurance policies, and they include accident and illness, accident-only, and wellness.
Frequently Asked Questions
How do you use pet insurance?
After paying a vet bill, you can file a claim with your insurance company for reimbursement. Most pet insurance companies allow you to file claims online, over the phone, or by mail.
How much will I pay for pet insurance?
The cost of pet insurance is determined by the type of pet, age, breed, and gender, as well as the policy, co-pay, deductible, and reimbursement level selected.
Is pet insurance worth the cost?
Pet insurance coverage will pay up financially only if your pet gets a significant medical condition, such as cancer, or is involved in a tragic accident that necessitates major surgery.
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