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Pet Insurance Simplified

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For millions of pet parents, pet insurance is as common in their household as home or auto insurance—they will have pet insurance for as long as they have a pet. In the case of many other pet parents, using pet insurance is still a distant idea that seems overwhelming to consider.

To better understand the benefits of pet insurance and why so many people remain loyal customers year after year, it can be helpful to dive deeper into the basics of pet insurance. By getting a better grasp of what insurance terms mean and the pros of different types of coverage plans, the vast world of pet insurance can easily be understood.

Pet Insurance Basics: Common Terms

When dealing with any insurance, there are many terms or phrases that you will no doubt repeatedly hear. By taking the time to research this standard insurance language, you can better understand the definitions of the terms and how they relate to your pet’s insurance plan.

  • Annual Coverage Limit

    As the name suggests, an annual coverage limit deals with your 12-month policy period. Your coverage limit is the total amount you can be reimbursed during that time. Most insurance companies will allow you to select your annual coverage limit, and this amount can be altered whenever a new policy period begins.

  • Chronic Conditions

    Certain health issues, such as cancer or diabetes, could be considered chronic, in which case they may require care across multiple plan periods. It’s essential to be aware of your insurance company’s and specific insurance plan’s policy for chronic conditions

  • Claim

    A pet insurance claim is what you submit after your pet has received treatment in order for you to be reimbursed. Though each insurance company has their preferred way for claims to be submitted, most offer multiple options such as email, fax, mail, or an app.

  • Deductible

    A deductible for pet insurance works the same way as it does for home or auto insurance. A deductible is the amount of money you need to meet before your insurance company begins reimbursing you.

  • Exclusions

    Exclusions are items that are not covered by your insurance plan. All pet insurance providers have exclusions, though the specifics may differ from one plan and company to another. Some exclusions may include cosmetic procedures, breeding costs, and pre-existing conditions.

  • Pre-existing Conditions

    This type of condition occurs or shows symptoms before the pet’s insurance coverage begins or during their waiting period. Most pet insurance providers do not cover pre-existing conditions, and companies have varying ways to define them.

  • Reimbursements

    After you submit your claim and it is processed, if it is approved, your reimbursement is the amount you will receive back. Some pet insurance companies allow you to choose how you would like to receive your reimbursement—via check in the mail or direct deposit.

  • Reimbursement Percentage

    When signing up for your pet’s insurance plan, you can (depending on the insurance provider) select your reimbursement percentage, in other words, the percentage of covered costs you will receive after meeting your deductible.

  • Waiting Period

    A waiting period is a pre-designated amount of time that needs to pass between signing up for a plan and the coverage beginning. Not all plans have a waiting period, and each insurance provider may have a different timeframe for their waiting periods.

By understanding this short list of insurance terms, you can have an easier time researching insurance companies and their plans. Plus, after you enroll your pet, you will already be a step ahead with the insurance lingo, so whenever these terms pop up in any communication you may have with your insurance provider, you’ll be good to go.

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How Pet Insurance Works

On your insurance provider’s side, there are many intricate moving parts that ensure that their business is working like a well-oiled machine. The process can be boiled down to three steps on the customer’s side.

  1. Visit your veterinarian and pay your bill as usual.
  2. Submit a claim to your insurance company via your preferred method.
  3. Get reimbursed for your covered services.

Occasionally, your insurance provider may ask for additional information about your pet’s condition or their veterinary visit. Otherwise, you can sit back, relax, and let the system work for you.

What Does Basic Pet Insurance Cover?

Each pet insurance company has plan options and exclusions, so it’s important to do your research ahead of time to determine which one best suits you and your pet’s needs.

One of the most common exclusions, even for a basic plan, includes pre-existing conditions. However, you may find that various coverage plans will have different waiting periods, or some may not have a waiting period at all.

Some insurance providers, like the ASPCA Pet Health Insurance program, offer an accident-only plan, which is typically a budget-friendly option. With accident only, items such as broken bones, cuts, swallowed objects, ingestion of toxins, bite wounds, or torn ligaments could be covered. This type of plan additionally covers the cost of X-rays, bloodwork, or similar methods used for diagnosing the issue. Plus, the cost for treatment, including medication, in order for your pet to get better would be covered.

Pet Insurance Prescription Coverage

When shopping around for different pet insurance plans, it’s essential to inquire whether medication is covered. Some plan options, which may be more comprehensive, include drugs, while others offer optional drug coverage, which may need to be purchased as a separate add-on item.

Most insurance plans also have guidelines for medications that are covered. For instance, they typically need to have been prescribed by a certified veterinarian—though it’s recommended that you only give your pet medications recommended by your veterinarian anyways.

It's additionally key that you keep in mind that with pet insurance, the cost of medication covered still falls under the same rules of deductibles needing to be met while staying within your annual limit. Though you cannot use your health insurance to pay for your pet’s medication, even if it is filled at your pharmacy, you can help keep the costs lower. Try shopping around at local and online pharmacies and checking with your veterinarian if a generic version of the drug is available.

Types of Pet Insurance Coverage

Most pet insurance companies have multiple coverage plans customers can choose from, plus add-on options for more unique scenarios. Some of these can include:

  • Alternative Therapy Coverage

    Alternative therapy can include acupuncture, chiropractic care, hydrotherapy, rehabilitative therapy, and laser therapy. Your veterinarian may recommend some alternative methods as an option to help your pet with their recovery.

  • Behavioral Coverage

    This coverage can help cover the costs of diagnosing and treating behavioral-related issues and is only used for behavioral-related problems, which are different from a pet who is just untrained. Typical problems could include destructive chewing or scratching, fur pulling, excessive licking, pacing, or going outside the litter box. Treatment for these issues can vary.

  • Illness Coverage

    Illness coverage can include a wide range of health issues—anything from ear infections to cancer. This coverage can help with the costs of diagnostic tests and treatment methods.

  • Prescription Food & Supplements Coverage

    Some veterinarians may recommend prescription food or supplements to help your pet stay healthy, particularly if they have certain health issues. This type of coverage can help with the costs related to these products if it’s to help treat a covered condition.

  • Preventive Care Coverage

    Preventive care helps cover the costs related to services that can assist in keeping your pet healthy. Some of these can include wellness exams, vaccines, and dental cleanings.

When shopping around for pet insurance, these are some of the coverage options you can consider. Depending on what you would like your plan to include, knowing what type of coverage you want can help you narrow down your choices for providers.

Common Pet Insurance Questions

As you research pet insurance, you are bound to have a question or two—chances are, most other pet parents are thinking of the same concerns. Before signing up for a plan, some of the more frequent questions to pop up include:

  • Where can I use pet insurance?

    One of the many wonderful aspects of pet insurance is that you don’t have to search for a veterinarian that’s “in-network,” like you would for your own doctor. Pet insurance can be used at any licensed veterinarian’s office, so you don’t have to worry about switching offices just because you signed up for insurance. This also means that if your pet has a medical issue while traveling with you or something happens while your regular veterinarian is away, you can easily visit any other office.

    When it comes to pet insurance claims, one of the more important items to keep in mind is what you are having done, not where you are having it done. Since all licensed veterinarians are considered “in-network,” it doesn’t matter quite as much where you visit to receive the diagnoses and treatment. However, since the health conditions and procedures covered can vary drastically from one plan to another, you should be aware of what may and may not be under your insurance.

  • What is considered a pre-existing condition for pet insurance?

    Each pet insurance provider may have their own definitions of what they consider to be a pre-existing condition, so it’s vital that you thoroughly research their terms and conditions before enrolling. For most companies, when a pet has an injury or illness that shows symptoms before their insurance plan goes into effect or during the waiting period, then this is considered a pre-existing condition.

  • How does a deductible work for pet insurance?

    Your deductible for your pet insurance will work basically the same as it does for any other type of insurance. A deductible is an amount that must be reached before you can begin getting reimbursed. There are a few different types of deductibles (annual and per incident), and most insurance companies allow you to choose from a few options when selecting your deductible rate.

  • Is pet insurance affordable?

    Many different factors can affect the price of pet insurance. These can include the company and plan you choose, plus if you choose any add-ons, your geographic location, the number of pets you have, their species, breed, and age. However, even when considering all this information, most pet insurance plans are still at an affordable rate. For some, the cost to cover their pet for a month may be equivalent to going out for dinner just a few nights a month.

By better understanding common insurance terms, coverage options, and the basics of how your pet insurance plan works, you can ensure that you are getting the most out of your coverage and your pet is receiving the best care possible.

The information presented in this article is for educational and informational purposes only and does not constitute or substitute for the advice of your veterinarian.


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