The Ultimate Guide to Pet Medical Insurance

Ultimate Guide to Pet Insurance

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Ultimate Guide to Pet Insurance

Being a pet owner is a serious responsibility that comes with its own expenses. Market research shows that spending on animal purchases, pet food, supplies, medication, and veterinary care keeps growing every year. The American Pet Products Association (APPA) estimates that the pet industry will have cost a whopping $75.38 billion in 2019.  Of this total, $18.98 billion would have been spent on veterinary care.

Thankfully, saving the life of a pet with a serious condition is now made possible with pharmaceutical advancements and sophisticated methods of treatment. Veterinarians can now easily perform hip replacements, cancer treatments, and more. However, veterinary care can set you back hundreds of dollars. This is where having pet medical insurance helps.

What is Pet Medical Insurance?

Pet medical insurance is a healthcare policy that helps you cover veterinary expenses if your pet gets sick or injured. Terms and conditions would vary according to your plan and insurance provider but generally, a good policy reimburses a percentage of your veterinary bill. Pet insurance makes it easier for you to afford costly medical care expenses should your pet need urgent treatment.

Pet insurance works in almost the same way as your own medical health insurance in that you’ll also pay monthly premiums. However, it’s different from human health insurance in that, pet medical insurance reimburses you for veterinary expenses when you file a claim. Some pet insurance providers will reimburse directly to the veterinary hospital so you’d only have to be responsible for your co-payment upon receiving service, after your deductible.

Different Types of Pet Insurance

Pet insurance plans may differ according to the extent of coverage you are paying for. Depending on your budget and risk tolerance, you have the choice to avail of a limited and emergency-only plan or a comprehensive plant that covers a wide range of illnesses and injuries. Some insurance providers allow more flexibility in that you can choose what you want to include in your pet insurance policy.

Lifetime Insurance. This is the most expensive type of insurance, but that’s because it gives the most comprehensive coverage that includes care and treatment for chronic and recurring conditions throughout your pet’s lifetime. Lifetime insurance policies may include annual, lifetime, or conditional reimbursement limits per condition.

Annual Insurance. Annual insurance offers coverage for a year once you’ve paid your deductibles. You can file a claim for standard injuries and short-term illnesses. Annual insurance typically becomes more expensive the older your pet grows and isn’t usually offered if you have older pets.

Accident-Only Insurance. Insurance to cover you for emergency treatments only is the most affordable type of insurance. An accident-only insurance reimburses veterinary care bills if your pet sustains injuries in an accident.

Per-Condition Insurance. Some dog breeds have higher chances of suffering some very specific or rare conditions. If you’d like to be insured for treatment of a condition that’s common to your dog’s breed, you can go for a per-condition insurance policy, which allocates fixed payouts for different illnesses and injuries. You’ll have to pay any amount exceeding the fixed sum.

Insurance plans may also come with a time limit or no time limit. You may opt for a plan that allows you to get reimbursement up to the maximum payment regardless of how long the treatment takes. Time-limited pet insurance, on the other hand, stops reimbursements when the covered period is over or the maximum payout is reached. Time-limited plans are cheaper compared to policies with no time limit.

How Pet Insurance Works

The main difference between pet insurance and your own health insurance is the method by which the insurer pays for the medical treatment or services.

With pet insurance, you’d have to pay the veterinary bill out of pocket first, and then file an insurance claim. Once your claim has been approved, the insurer will then reimburse up to 90% of the total bill, depending on the terms of your policy. The reimbursement rates would apply after the deductible has been met.

Most pet insurance plans will cover care and treatment for various injuries and illnesses. Coverage for vaccinations, laboratory work, dental care, pregnancies, and other types of preventive care, as well as therapy and behavior modification, aren’t standard inclusions. However, these may be covered by some providers at a higher premium.

Coverage for pre-existing conditions aren’t included in most pet insurance policies. Insurance providers often require pets to get a full health checkup to determine if there are any pre-existing conditions. A health condition is considered “pre-existing” if signs of the illness or injury have been observed before the insurance policy has been activated.

Insurance companies would also impose a waiting period after you buy a policy before the coverage period begins. The waiting period for accident coverage is usually much shorter. However, it would be best to get insurance as early as possible and to not wait until you need it before you get it.

Filing an Insurance Claim

In the event that your pet falls ill or meets an accident, you can get reimbursed for the expenses by your insurer if the claim falls within your insurance coverage. Filing a claim would require forms, as well as your veterinary receipts or invoice. Many pet insurance providers have made filing insurance claims much easier. Healthy Paws for instance allows you to file a claim online through their website. Other providers even have mobile apps.

It would be a good idea to contact the insurance company right before you visit the vet for treatment. If needed, you can confirm the details of your coverage and ask about any requirements for filing an insurance claim.

Getting Reimbursed

Insurance providers would take 2-3 business days or up to longer than a week to evaluate your insurance claim. When your claim has been approved, the insurer would reimburse the funds through a direct deposit or a check through email. Some pet insurance providers who will deal directly with vet hospitals, given that you seek treatment from a licensed vet that’s part of the insurer’s network.

Reimbursement amounts would depend on the terms of your policy. In validating an insurance claim, the insurer would look at the following factors:

Deductible. This refers to the amount you have to cover out of pocket before the insurer pays, either per incident or per policy year.

Reimbursement level. The reimbursement level determines how much of the total bill will be reimbursed by the insurer. Depending your policy, this percentage could be somewhere between 50% and 90%, after deductibles.

Annual max. The terms of your policy would state the maximum amount the insurance company will pay on veterinary bills per year. If your veterinary bills exceed this amount, the additional charges will be paid out of pocket.

Pet Insurance Costs

The monthly payments, or premiums, you have to make on your insurance vary with every provider and policy holder. Your plan will be customized according to specific factors relating to your own finances and your pet.

Type of coverage. The more comprehensive your insurance coverage and the higher the annual caps, the more costly your insurance premium will be. You’d have to decide if you want to pay more monthly so you’d have to pay much less out of pocket when you need to file a claim.

Your coverage would also include the types of medical procedures you want covered. The more risk on the insurer, the higher the premiums will be. With some plans, you can opt for add-ons to your policy, for pet expenses that standard plans don’t cover.

Pet’s breed. Insurance for larger pet breeds are normally a little more expensive, because these are more likely to develop health problems and live shorter lives. Some providers would refuse coverage for certain breeds, so this is among the things you need to check for when you go shopping for an insurance plan.

Pet’s age. Insurance for younger pets cost less than for older pets. This is why it would be a good idea to get an insurance policy while your pets are still young.

Species. Insurance for dogs typically comes with higher premiums than cats. Premiums would also vary according to gender.  

Location. Some locations are regarded as coming with higher risks than others. Your insurance premium might be a little higher, for instance, if you live in a densely populated area.

Generally speaking, plans could cost you as low as $15 a month for an emergency-only plan to up to $150 up a month for a more comprehensive pet insurance plan. When comparing pet insurance plans from different providers, also make sure to look at reimbursement rates, and of course, whether or not a plan matches your anticipated needs.

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Choosing a pet insurance provider

Find a Pet Insurance Provider

Pet insurance can be considered a good investment if you want to look out for your pet’s well-being no matter the cost. There are many trusted pet insurance providers you can choose from. You’d need to carefully study what benefits are being offered and which one meets your needs. You can check out our own list of Top 5 Pet Insurance Providers. (Spoiler alert: our first choice is Healthy Paws!)

In deciding what type of coverage to get, you can start with an assessment of your pet’s medical history. Is your pet prone to injuries or highly susceptible to serious health conditions? Your veterinarian can provide you with useful information in this regard.

Surgeries and treatment procedures for animals can cost you thousands of dollars. A good pet insurance plan can help protect you financially but more importantly, it can prolong the life of your pet when the unexpected happens.  

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