How does pet insurance work?

There can be differences depending on the plan, but most pet insurance works in the same basic way:

  1. Visit your veterinarian and pay as usual.
  2. Submit a claim online, through an app on your phone, or by email, fax, or mail.
  3. Get reimbursed for covered services.

When you’re comparing plans, be sure to read up on what’s covered and what’s not so there are no surprises later. For instance, not all providers cover veterinary exam fees, which are part of nearly every veterinary bill. Some providers also have vaccine or other pet care requirements that you’ll need to follow or risk having your claims rejected.

Calculating Reimbursements

For accident and illness coverage, the amount of your payouts depends on factors including your deductible, reimbursement percentage, and annual coverage limit.

Deductible

You’ll need to meet a deductible before you can start getting reimbursed. Some providers have a per incident deductible, which means you’ll need to meet that amount for every incident. Other providers have an annual deductible that you only need to meet once a year no matter how many times your pet is hurt or sick.

With the ASPCA Pet Health Insurance program, you can choose from $100, $250, and $500 annual deductible options. You can select a higher deductible to pay a lower monthly premium or pick a lower deductible if you want the ability to get more money back.

Reimbursement Percentage

This is the percentage of covered costs you’ll get back after you meet your deductible. We let you pick from 70%, 80%, and 90% options. If you choose a lower amount, you can pay a lower monthly premium. If you go with a higher amount, you’ll get more cash back on your claims.

Here’s an Example:

So, let’s say you chose a $100 annual deductible and 90% reimbursement percentage:

  • If you submit a veterinary bill for $500 of covered costs, you would first need to meet your deductible.
  • $500 minus your $100 annual deductible equals $400.
  • You would then get back 90% of $400, which is $360.

Annual Coverage Limit

This is the maximum amount you can get reimbursed over a 12-month policy period. It resets when a new policy period begins. For example, if you selected an annual limit of $2,500 and had $2,700 in covered veterinary costs during your policy period, you would get reimbursed $2,500. You would be eligible for reimbursement on the $200 that was over your $2,500 limit. We offer a choice of annual coverage limits from $2,500 to unlimited so you can pick the amount that works best for you.

Preventive Care Reimbursements

With our preventive care coverage, there is no deductible or reimbursement percentage. You get reimbursed a set amount for a list of covered wellness services, such as annual visits, vaccines, and flea prevention. The amount depends on the preventive care coverage option you choose when you sign up.

Submitting Claims

When you’re shopping around for pet insurance, you should consider how easy it is to submit a claim. Providers may allow you submit claims online or by email, fax, or mail. We also offer the My Pet Insurance App so you can submit claims right from your phone even before you leave the veterinary clinic. This app also lets you:

  • Track the status of your claims and see when they were received, in progress, and completed.
  • Pay your bill and view your billing history.
  • Find a nearby veterinary clinic.
  • Sign up for direct deposit for your reimbursements so you don’t have to wait to receive a check in the mail.
  • Review your benefits in case you have any questions about your coverage.
  • Find answers to frequently asked questions.
  • Update your contact information if you’ve moved to a new address or changed your primary email address or phone number.
  • Get in touch with us.

Additionally, you can add veterinary clinics to your favorites for easier claim submission. Simply locate the veterinary clinic with the app and select Save to My Vets. The next time you need to submit a claim, you can simply upload the clinic’s information.

Tracking Claims

Another thing to look at when you’re comparing providers is whether or not and how they allow you to track the status of your claims. With the ASPCA Pet Health Insurance program, you can track your claims online after you sign into your account or by using the My Pet Insurance app. We’ll also notify you by email when we receive and complete your claims.

Receiving Payments

You should also find out how you will receive your reimbursements. Do you have to wait for a check in the mail? Or can you choose to have your money directly deposited into your bank account? Direct deposit can be a faster and more convenient way to get your reimbursements. You can select our direct deposit option when you first enroll in a plan or later on by signing into your account online or using the My Pet Insurance app.

Preventive Care Claims

If you’re interested in preventive care coverage to help manage the costs of routine wellness services, such as yearly check-ups, vaccines, and heartworm medication, you may be wondering how you would submit those claims. With the ASPCA Pet Health Insurance program, wellness claims are submitted the same way as claims for accidents and illnesses. Just check the box to indicate the claim is for preventive care and include your invoice for the wellness services your pet received.

Enrolling Your Pet

You can get started with a free quote, which will show you the coverage options available for your pet along with pricing. After you get your initial quote, you can customize your plan by choosing your deductible, reimbursement percentage, and annual limit. If you’re ready to enroll, you can sign your pet up online in minutes. Still not sure? We’ll save your quote so you can come back and review it any time.

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