The basic idea
The NAIC describes pet health insurance as a policy that reimburses the pet owner for specified veterinary care. Like your own health insurance, policies typically itemize covered treatments, deductibles and lifetime or per-illness maximums, and the price can depend on the amount and type of coverage and on your pet's breed or species [1].
What policies may cover
According to the NAIC, some policies may reimburse covered expenses for accidents, illnesses, surgeries, X-rays, prescriptions, hospital stays, emergencies or cancer treatment; others cover accident and illness only after a waiting period [1].
- Pet health insurance: reimburses specified vet care [1].
- Pet life insurance: covers end-of-life costs such as burial or cremation [1].
- Pet injury coverage: sometimes part of an auto policy, for a pet hurt in a car accident, up to a set limit [1].
What is often not covered
Not every plan covers preventive care, dental care not linked to an accident or injury, behavior problems, breed-specific hereditary conditions or elective procedures, and congenital or hereditary conditions may have limited benefits [1]. Some vet offices sell their own wellness plans for vaccines and exams instead [1].
How you get paid back
A benefits schedule lists how much the insurer pays per treatment, as a percentage of the cost or a dollar amount. Some companies pay the vet directly, but often you pay the full bill at the visit and are reimbursed for covered expenses later [1]. Some policies require you to use a network of veterinarians [1].
Deductibles, copays and limits
You may owe a deductible and a copay on top of the insurer's share [1]. The NAIC's regulator guide notes that deductibles are usually applied per incident or per year, and that limits can be annual, lifetime, per procedure, per incident or a combination [2].
Waiting periods and pre-existing conditions
Many policies have a waiting period before coverage starts [1]. Hereditary and certain medical conditions are considered pre-existing; conditions considered incurable, such as diabetes or cancer, may be excluded or covered only on a limited basis, while curable ones may face a waiting period [1]. A vet exam may be needed to certify your pet's health [1].
Watch the renewal terms
The NAIC warns that if your pet is treated for a covered condition during the policy term, some companies may treat it as pre-existing and exclude it when the policy renews. Ask whether the policy has renewable benefits [1].
Who regulates pet insurance
Pet insurance is regulated by your state insurance department, which can confirm that an agent is licensed and answer questions [1].