Pet owners all know how expensive our beloved companions’ health care can be. We’ve given some thought to buying insurance for them, but we wonder, what does pet insurance cover? Is it worth the hefty premiums?
Inevitably, just as we decide we can get by with paying out of pocket, we hear of some pet health emergency that cost the owner thousands of dollars? What if we don’t have that kind of money? What if we have more than one pet?
We feel your pain! In this article, we’ll try to help by explaining what pet insurance entails.
What Are Pet Insurance Premiums?
Determining the actual costs of pet insurance can be tricky. The following are the itemized premium costs for typical pet insurance policies.
Base Monthly Premium
This is exactly what it sounds like: the monthly premium before anything has been added.
Premiums for Riders
A rider is an insurance policy provision that adds benefits to or amends the terms of a basic insurance policy. Some examples of riders in pet insurance policies are a wellness rider, an exam rider, and a rider for inherited conditions.
Processing Fees
We aren’t sure why these fees are assessed over and above the base premium, though they do make the base premium appear lower.
So, the total monthly premium is the base premium minus any rider premiums or fees.
Factors in Coverage Cost
The overall cost of coverage depends on factors such as the following:
- The pet’s breed (purebreds are more prone to certain hereditary conditions)
- The pet’s age
- The rising cost of veterinary care in general
- The coverage options chosen–deductible amount, for example
Don’t forget that deductibles and co-pays are also insurance costs, as we’ll discuss below. In the meantime, it is helpful to know the things pet insurance policies cover.
What Does Pet Insurance Cover?
Proceed inquisitively and with caution here as pet insurance plans can have a lot of loopholes and exclusions. Be sure to ask for details on everything that is presented.
Representative Items Covered
Very comprehensive pet policies cover things like the following (adapted from an actual policy):
- Accidents
- Treatments for illness and disease
- Cancer and chemotherapy
- Surgery, hospitalization and nursing care
- Lab work and diagnostic tests, including X-rays and MRIs
- Medications
- Genetic conditions*
- Alternative therapies like acupuncture, hydrotherapy, and holistic and homeopathic medicine
- Chronic and recurring conditions like
allergies, diabetes, and hyperthyroidism
*Genetic and breed-specific conditions are covered, provided the pet does not show signs or symptoms of them prior to enrollment.
Some insurers offer packaged coverage–with plans for accidents only, accidents and illness, and routine wellness–to give some examples.
If a sales rep is trying to sell you a package, be sure to ask for a list of everything that is covered and any exclusions.
Typical Exclusions
Pet insurance policies have a lot of exclusions. The most common are:
- Dental disease
- Preexisting or hereditary conditions
- Behavior issues
- Routine check-ups, preventative care
- Hip dysplasia
- Grooming
Some of these seem like obvious exclusions, while others are precisely the reason(s) we even want pet insurance at all.
Try to find pet insurance that will cover pre-existing conditions, and find out to what extent, since these easily could be your biggest cost.
When investigating different pet insurance policies, be sure to ask how the companies determine what are pre-existing conditions.
How Does Pet Insurance Work?
Pet insurance is a lot like the lower end of human health insurance: there seem to be more qualifiers and exclusions than actual coverage. There is coverage, though; whether it’s worth what you pay for it is another question.
You need to determine this based on questions to various insurers as well as your estimate of cost (premiums) versus value (reimbursements).
Consider asking companies to provide examples of past reimbursements and the conditions those covered. This can help you determine not only whether to get a policy at all, but how to set deductibles, the annual maximum, etc.
Here’s the Process for Reimbursement
The owner of the insured pet(s) pays monthly premiums, which can run from $75-200. The total monthly premium represents a combination of the base premium, additional rider premiums (e.g., routine exams), and any extra fees.
When a veterinary service has been performed, the owner must pay out of pocket and then file a claim. The insurer then evaluates the claim and, if approved, reimburses the owner the determined amount.
How a Claim is Evaluated
The amount of the reimbursement depends on how the plan is set up, with the main claim-related parts of most plans being:
- The deductible: This is the part of a bill the pet owner has to pay (either per year or per incident) before the insurer pays. These can range from $0 to $1,000.
- The level of reimbursement: Once the deductible is paid, a percentage of the bill will be reimbursed by the insurer. This is usually between 50-100%.
- The annual maximum: The highest amount your insurer will pay each year. Any charges incurred above the maximum will come out of pocket.
- There also might be a lifetime pet insurance maximum.
When shopping for pet insurance, be sure to ask about each of these important items as they differ among plans.
Pet Discount Plans
An alternative worth considering when doing pet insurance comparison is a pet discount plan. This is a program where one or more veterinarians agree with a networked business entity to offer discounts for vet visits and procedures.
Pet discount plans cover more routine veterinary expenses, such as check-ups and vaccinations, along with various procedures. Discount cards are widely sold, in drugstores, convenience stores, and other commercial outlets.
Pet discount plans can be used by themselves or in combination with pet insurance.
Adding It All Up
Like any form of insurance, pet insurance makes its money from people’s fear of the unknown. And few people fear the unknown more than pet owners. Our pets are with us for so little time!
The question, what does pet insurance cover, comes to mind often as we worry about how to ensure the longest possible lives for these furry family members. We worry that we won’t be able to pay for a level of care they might need someday.
Is pet insurance worth it, though? It can be if your pet suffers a major illness or injury that doesn’t involve a pre-existing condition and is within your policy’s coverage. But it’s always a gamble.
Less than one percent of North American pets are insured. Instead of pet insurance, many people maintain savings accounts dedicated only to pet emergencies. If not spent on one pet, it will be there for other needs, including future pets.
If you’re reading this article, you already know that our blog has some pretty interesting and informative articles for parents. Please keep reading it!
