What Does Pet Insurance Cover?

Decide if a Policy Is Right for You and Your Pet

Domestic cat lies in a basket
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If you’re a pet owner, you love your furry friend and probably consider it family. So it makes sense you want to take good care of your pet by taking it in for regular vet checkups and getting whatever medicines or medical procedures it needs.

But veterinary costs can be unpredictable and expensive. To avoid breaking the bank with sudden expenses, many pet owners consider buying pet health insurance. Learn more about the coverage pet insurance offers and see if it provides the right value for your pet and your budget.

What Pet Insurance Covers

There are three main types of coverage offered: accident and illness, accident-only, and wellness. Nearly all pet insurance policies written are for accident and illness, and wellness benefits are typically provided as an add-on. (Very few owners buy accident-only policies.)

Depending on the plan you choose, here are some possible coverage categories:

Accidents

This coverage helps pay costs when pets are hurt because of unexpected events (accidents). Broken bones, cuts, torn ligaments, bite wounds, ingested objects, or toxic substances are a few incidents that are typically covered. Services and treatments to help your pet recover may also be covered, such as surgery, sutures, and hospitalizations.

Illnesses

The types of illnesses covered vary by insurer, but your policy may include common, chronic, or hereditary conditions. This means you could be reimbursed for expenses related to conditions such as ear infections, allergies, diabetes, cancer, and hip dysplasia.

A few insurers may also cover congenital issues like heart disease, or offer coverage as an optional add-on.

Keep in mind that some policy coverages (such as hereditary conditions) may exclude certain breeds or pets older than a certain age.

Testing and Diagnostics

Diagnostic services to help find what’s wrong with your pet, the extent of injuries, or the best treatment protocols may be covered. This typically includes X-rays, bloodwork, surgery, and hospitalization.

Prescription Drugs, Food, and Supplements

This covers prescribed medication to treat your pet for acute illnesses or to manage chronic conditions like thyroid issues or to address recovery from an accident. Coverage may also include prescription foods and supplements given by your pet’s vet to treat certain conditions.

Alternative Therapies

Some plans provide coverage for the cost of alternative therapies to treat your pet’s condition. Acupuncture, chiropractic care, low-level laser therapy, physiotherapy, and hydrotherapy are some examples of these services.

Medical Procedures

This may cover emergency surgeries, tooth extractions, endoscopies, cancer care, and other procedures needed because of accidents or illnesses.

Behavioral Issues

If your pet shows signs of behavioral problems, like compulsive licking, pacing, marking, digging, or other distressing behaviors, your insurance may reimburse you for behavioral therapy.

Preventive Care/Wellness

More comprehensive plans may include preventive care, also called "wellness coverage," or offer it as an add-on or stand-alone coverage. You may see expenses such as routine exams, vaccines, and screenings covered, as well as flea, tick, and preventive heartworm medications. Teeth and ear cleanings and microchipping may also be included.

Annual, Lifetime, and Per-Incident Limits

It’s important to note that even though you may have these coverages under your plan, most plans have coverage limits.

Some companies have per-incident limits, meaning they’ll only reimburse you up to a specified amount for certain conditions or procedures. Many insurers also have annual and lifetime limits so that once you reach a certain threshold, the pet insurance company no longer reimburses you for the remainder of the policy term or the life of your pet.

An annual benefit, annual reimbursement, or an annual coverage limit all relate to how much the insurer will pay you back per year for your covered claims.

What Pet Insurance Doesn’t Cover

You’ll find that most pet insurance companies don’t cover preexisting conditions (meaning symptoms were present before enrollment). Policies typically also have a waiting period of about two weeks. Issues arising during that time are often seen as preexisting conditions and aren’t eligible for coverage.

If your pet develops the same condition on both sides of the body (known as a bilateral condition), such as hip dysplasia, some insurers only cover treatment for one side. Or if a pet has already developed the condition on one side before coverage began, some insurers won’t cover the other side.

Your insurer might exclude hereditary conditions for specific breeds only. Be sure to thoroughly read the policy to know exactly what coverage is provided.

How Much Does Pet Insurance Cost?

Average annual premiums for accident and illness policies are about $585 for dogs and $350 for cats. Accident-only policies are significantly cheaper, about $194 for dogs and $126 for cats.

Your premiums may be higher or lower depending on your pet’s age, breed, sex, species, and location, as well as the coverages, deductibles, and limits you choose. Upping your deductible or lowering reimbursement levels (the percentage you get back for each covered claim) often reduces your rates, but may also increase out-of-pocket expenses for covered issues.

Getting various online quotes shows how much a policy might cost for your specific pet and helps find the best pet health insurance companies. From there, you can decide if it’s right for you by weighing premiums against your budget and considering if important coverages as they relate to your pet are included, such as hereditary and bilateral illnesses.

Depending on how much you’d spend on premiums every year for the life of your pet, you may decide that options like setting up a pet savings fund are a better alternative. For others, pet insurance may provide peace of mind that they won’t be faced with a large, unexpected vet bill that they can’t afford.