From Barking to Bullying, When Pet Insurance Covers Behavioral Therapy
Pet insurance can make it easier on your wallet the next time your furry friend gets physically sick. But what if your dog has anger issues or your cat persistently pees in the wrong places and you need the animal equivalent of mental-health care?
Depending on the insurer, insurance may cover therapy to treat such problems. Just don’t expect reimbursement for the cost of curing run-of-the-mill misbehaviors like failing to follow orders. And some insurers require you to pay an extra-fee rider or meet a special deductible when covering behavioral therapy under their policies.
Here’s what exasperated pet owners need to know about behavioral therapy and pet insurance.
What pet therapy is, and when insurance handles it
The most common problem that prompts pet therapy is aggression, including towards strangers and new pet “siblings” added to the household. Other frequent issues include excessive barking or meowing, along with long-term failure by cats to use the litter box.
If diagnosed as a behavioral condition -- rather than, say, a developmental issue -- such problems may require therapy and could be covered by insurance, says Beth Wymer, an animal health and insurance expert with Pumpkin Pet Insurance.
Your vet is the starting point for the diagnosis and possible treatments -- and some vets may even know if therapy costs are likely to be reimbursed by certain insurers. When therapy is being considered, Wymer says, the insurance company works with the pet’s professional "to determine if it's what they would consider an underlying condition that needs treatment," Wymer says.
The condition must be deemed serious in order for insurance to foot the bill, Wymer says. Challenges such as obedience and basic toilet training won't get covered, she says, nor will the likes of jumping up from exuberance and friendliness. As a rule, Wymer says, covered conditions are those that require a licensed animal behaviorist -- the pet equivalent of a psychologist -- rather than simply an animal trainer.
Some professionals offer both therapy and training, and might be good resources in cases where you and your vet are unsure of which service might be needed. Such versatile professionals, like Stacy Greer, owner of Sunshine Dog Training & Behavior in Dallas-Fort Worth, can assess the animal’s behavior and recommend the best treatment solution for both dog and client.
Which companies cover therapy
As with health insurance for humans, pet insurers cover behavioral issues to varying extents, from not at all to inclusion in all of their plans.
When we priced policies from several pet insurers — all on Money’s list of best pet insurance companies — late last year (see chart below), one didn't cover therapy at all. Most, though, included it in their accident and illness policies -- the type most pet owners buy.
A few additional insurers offered coverage, but only if you paid extra for a so-called wellness rider. That added coverage, which typically costs about $20 extra a month on top of accident and illness premiums, can add not only coverage for therapy but for routine checkups and preventive measures such as vaccinations.
Most pet insurance plans won't cover an animal's pre-existing conditions — as in any ailments the animal suffered prior to the policy going into effect. And that's a call a professional has to make, says Wymer.
"Whether an issue is considered pre-existing by an insurance company, depends on what the treating veterinarian considers as a behavioral condition, and if these issues were present prior to the insurance policy inception," says Wymer. "[And] whether a pet owner needs to disclose these types of issues as part of an insurance application depends on the pet insurance company’s stipulations for coverage."
|Yes = included in Accident & Illness coverage. |
$ = available if you buy wellness coverage at additional cost.
No = not available.
Based on information gathered online in late 2020 by Money staff from the websites of the pet insurance companies, supplemented by research of other types.
The cost to treat your dog or cat
The bills for pet therapy depend on a variety of factors, from the type of animal, your location, and the type of therapy. How long therapy will be required is unpredictable, says behaviorist Greer. “There's no way to reliably put a number to how many sessions it would take to help a dog with a major behavior challenge as there are far too many factors to consider,” she says. “It could be anywhere from 3-12 sessions. And the cost can also range quite widely, from $50 per session up to over $600 per session.”
In other words, total treatment costs could easily range from the low hundreds of dollars to the middle thousands. And the entire amount won't be paid by insurance, even with a policy that includes therapy coverage. “Pet Insurance plans that cover eligible behavioral treatment reimburse for the cost of treatment in the same way they do any other claim for accident or illness covered by the plan,” says Wymer.
That reimbursement rate varies by the policy, but typically ranges from 70% to 90% of the total bills -- leaving the pet owner responsible for a co-pay of between 10% and 30% of the total bill. There is also a policy deductible to meet. While these typically range between $250 and $1,000, Wymer warns that some companies have a separate deductible for behavioral treatment alone.
There’s no maximum number of therapy sessions your pet can receive, but you do need to stay within the policy’s coverage limits in dollars. Pet insurance comes with caps on the amount of coverage provided in any given year, with $5,000 a common amount, and over a lifetime, a total that can run to $30,000. If your expenses go beyond those limits, you'll have to pay out of pocket.
Fortunately, the propensity of your dog’s breed to behavioral issues should not be a factor in the premium you pay, at least not in isolation. The cost of your insurance plan will depend on factors ranging from the species (dogs cost about 60% more on average than cats) to your location to the animal's age. But Wymer says "while your pet’s breed does factor into the premium you pay, you wouldn’t pay a higher premium if your breed were particularly prone to having behavioral issues [alone]. The premium is based on the overall risk of developing any health issues."
Insure or not for behavioral problems?
Use our chart as a starting point to what therapies if any might be covered by various insurers. But check the company websites, and call as needed, to confirm that policies haven't changed, and to determine the therapies covered and what behavioral issues or incidents might constitute a pre-existing condition.
"If behavioral issues and therapy is an area an owner is particularly concerned about when they are looking for pet insurance, I recommend diving deeper into the different policies available and researching the pet insurance disclaimers and exclusions around behavior issues/treatment," Wymer says.
Be aware that vets sometimes prescribe medication for certain behavioral issues. Policies vary in their coverage of cover prescription drugs, too, so you might also want to check those details with insurers.
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