I have seen this question come up quite a bit in the last year…especially for those who are adopting new pets. The cost to care for pets has gone up exponentially, and sometimes a visit to the vet can cost hundreds or thousands of dollars (We’ve all been there, right?). So, the question is, in order to save money down the road, is pet insurance worth the cost?
We do need to remember there are many facets to pet insurance, so take the time to learn and choose wisely. Each policy and every pet insurance company is different. So…let’s start with the basics.
What Is Pet Insurance?
Pet insurance is very similar to medical insurance. You pay a premium each month (or year), and depending on the type of coverage you have, the insurance will cover certain medical conditions (minus a deductible or copay). There will also be exclusions on certain policies depending on the policy type or if your pet has a preexisting condition.
Depending on the insurance company, the pet owner will pay up front for the veterinary services and then submit the claim to the insurance company for reimbursement. There are only a handful of companies that will pay the veterinarian up front, so it is important to choose a plan that works for you and your budget.
What types of pet insurance policies are available? There are 3 categories you can choose from:
Accident Only: This plan only covers veterinarian bills due to accidents such as broken bones, or if your pet swallows a foreign object.
Accident and Illness (most common plan): This plan includes bills due to accidents, but it will also include if your pet gets sick. Illnesses can include: diabetes, cancer, arthritis, and allergies. This plan can also cover chronic illnesses or congenital conditions.
Routine Wellness or Preventative Care: Some insurance carriers offer this plan as an add-on (sometimes as a separate plan). This type of plan will cover your typical well visits, vaccinations, spay/neuter, and flea treatments.
What Pet Insurance Doesn’t Cover
When considering pet insurance, there are a few standard conditions / incidents that are not covered by the insurance companies. Here are a few that will help you decide if pet insurance is for you:
- Elective procedures such as ear cropping or tail docking
- Breeding and/or pregnancy
- DNA testing
- Accidents due to cruelty, racing, fighting, or neglect
- Food supplements
- Experimental treatments
- Preventative procedures
- Non-veterinary expenses (such as waste disposal)
- Some companies don’t provide coverage for preexisting conditions (some have a waiting period)
Who is Pet Insurance For?
Not everyone should jump to purchasing pet insurance for their pets. There are certain things to consider when deciding on whether to make the purchase.
- What type of pet do you have? Currently, most pet insurance companies cover dogs and cats; however, there are some that will cover birds, reptiles, etc… It is important to check with the company to see if your pet qualifies.
- Is your pet relatively young and healthy? The younger and healthier your pet is, the better price you will pay for insurance. This doesn’t mean your older, healthy pet doesn’t qualify; however, you will pay more in premium.
- Does your pet have a preexisting condition? If your pet has a preexisting condition, such as diabetes or hip dysplasia, these conditions may be excluded. Some companies may choose to put a waiting period in place for preexisting conditions instead of excluding coverage. For example, if you purchase a policy on January 1st, and the policy has a 14-day waiting period for preexisting conditions, coverage won’t be available for your pet’s preexisting condition until January 15th.
- What is your budget for pet costs? This needs to be considered on a few different levels. First, how much can you afford on a monthly basis for insurance premiums? Second, how much can you afford for insurance premiums and deductible/copay? Third, how much can you afford for emergencies.
- What type of policy are you looking for? For pets who generally only need well visits and vaccinations or spay/neuter, pet insurance may not be necessary. The cost of the insurance may be more expensive than paying out-of-pocket. On the contrary, if you have a pet known to need additional care throughout life (like Frenchies), an accident and illness plan may be less expensive than paying out-of-pocket per visit. If you know you can cover well-being visits, but may not be able to pay for more expensive bills such as ACL tears, an accidental policy may be right for you.
I know it is a lot to take in, but the major takeaway is: If you have a relatively healthy pet, and you can pay monthly premiums, but not expensive vet bills, pet insurance may be for you. Pet insurance will help reduce the stress of high emergency vet bills, surgeries, and even certain ongoing treatment for your pet. This can give you the peace of mind knowing you do not have to ‘break the bank” when getting care for your fur baby.
Pet Insurance Lingo
Before you decide which company to purchase pet insurance, let’s talk about what some basic terminology means:
Policy: This is the chosen plan for your pet. It will go over coverages, deductibles, copay, exclusions, and premiums.
Premiums: This is the amount you pay to keep the policy in force on a monthly basis. The premium will be based off of the following:
- Preexisting conditions
- Where you live
- Coverage types (accidental or accidental/illness, etc)
- Deductible / CoInsurance
Coverage: This is what the company will actually pay for or reimburse. Depending on the type of policy, coverage will be for labs, treatments, surgeries, medications, and certain vet fees.
Exclusions: This is a part of the policy that will explain what will not be covered under the policy. In most accident or accident/illness policies, well-visit fees and vaccinations are excluded under the policy. Some policies may exclude certain preexisting or hereditary conditions. It is important to read the fine print to understand what all would be excluded under the policy.
Waiting Period: A waiting period is an exclusion period where certain conditions will not be covered. For example, some companies may waiting periods from two to thirty days for certain accidents or illnesses. Other companies may have longer waiting periods for pets prone to hereditary or common conditions (like hip dysplasia). If your pet is being treated for these temporary exclusions within the waiting period, coverage will not apply. You will be out-of-pocket for that visit.
Benefits: This is the amount that the insurance company will pay.up to for a certain incident or time period. The best insurance companies will have the larger benefit amounts.
Deductible: This is your out-of-pocket expense before a claim will be paid. For example, if the visit costs $1,000, and you have a $250 deductible. The insurance company will pay the $750 after you pay $250. Depending on the plan, the deductible may be per incident or per year. In some incidents, the company may only require a single deductible if the pet is going through ongoing treatment (such as cancer).When considering deductibles, it is important to understand, the higher the deductible, the lower the premium…but in many cases that is not doable for most people. Choose a deductible that will easily be paid at any vet visit.
CoPay/CoInsurance: Outside of your deductible, the policy will most likely have a copay. Copay is a percentage of the bill you will be responsible for. For example, if you have a $1,000 bill and a $250 deductible, 10% copay, the company will pay up to 90% of the bill, minus the coinsurance. In this case, the company will pay up to $650. This is another important factor to consider. You will want to make sure the insurance you choose has a lower coinsurance such as 10 – 30%.
Our pets are family and we want to do everything we can to care for them. Unfortunately, sometimes the cost to care for them is more than we can bear; however, pet insurance can help alleviate that burden.
If you are thinking about purchasing pet insurance, there are a few things to consider before you make a decision. Not only do you need to consider your budget, but you need to research the insurance companies and what they cover….and how it pertains to your pet’s needs.
It seems like the number of pet insurance companies in the U.S. has increased exponentially…so it is even more critical to make sure you get the best policy for your pet and for your budget. I will be doing an insurance comparison in the coming week or so, but I at least wanted to get this blog out for those considering purchasing insurance.
Truly, pet insurance can be worth the cost….but it really depends on what your pet needs, how much you pay, and what the policy covers.
If you have pet insurance, is there a specific company you prefer? Tell me who you trust!