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By Ingrid Case and Valeria Aguirre
Updated: September 28, 2020 11:26 AM ET | Originally published: September 8, 2020
Naomi Elliott for Money

No cat or dog is quite like the one we own and love, and the policies to protect their health are almost as varied. Pet-insurance coverage ranges widely, and understanding those differences will help you make the right choice for your animal.

The decisions begin with the type of policy to buy, which determines the general coverage you can expect from your coverage. According to the American Pet Health Insurance Association, almost all pet owners opt for plans that cover both illnesses and accidents. Consumers sometimes add wellness coverage, too, to take care of such routine procedures as vaccinations. But you can also narrow your coverage, to buy less expensive policies that cover only illness, accidents, or wellness.

For the most part, insurers mix and match those main coverage areas — illness, accidents, and wellness — in similar ways. But specific benefits and restrictions within each area can differ by company. For instance, while all the companies we’ve researched cover hip dysplasia, a genetic condition that typically affects large dogs, some impose an age limit on treatment and will deny coverage to older dogs. Others, by contrast, have no restrictions when it comes to the same condition.

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This guide explains what’s covered by pet insurance, and what isn’t, along with comparing what Money’s nine top picks in insurers include in their policies.

What isn’t covered

Let’s start with the medical expenses your policy likely will not pay for, no matter the insurer you choose. Those omissions begin with routine veterinary care, such as vaccinations, dental cleanings, or spay/neuter surgery. Those aren’t part of regular policies, as a rule, but some insurers offer that coverage through an extra-cost “wellness” add-on.

Pre-existing conditions are not covered. If a veterinarian diagnoses Fido or Fluffy with a medical condition before you buy a policy, the insurance company won’t pay to treat that problem. But exceptions are made for recurring curable illnesses. So you’re unlikely to be denied coverage for an ear infection, say, because your pet suffered some of them before they were insured.

Be aware that policies require that you choose certain limits to coverage. Those include a lifetime limit on reimbursed expenses, typically within a range of $5,000 to $30,000; the higher the limit, naturally, the higher the premium. The policy will not pay the entire expense for any care; you choose a percentage of costs that will be covered, typically either 70%, 80%, or 90%. And as with much other insurance, you also select a deductible that you must pay annually before reimbursement kicks in; the norms are $250, $500, or $1,000.

Illness coverage

Many policies, known as comprehensive plans, combine policies for both illness and accidents. (You can also buy plans that cover only illness or only accidents, though not from all providers.)

Pet policies cover a gamut of illnesses, from minor to catastrophic. Vomiting and diarrhea is covered, for example, even if it’s due to unidentified causes. On the more serious end of the list, cancer treatment is universally reimbursed.

With most conditions and most policies, conditions are covered that may be congenital, hereditary (or genetic), or chronic to certain breeds — such as torn ligaments. However, that’s true only as long as your vet identifies the problem after the policy is in place.

However, a breed’s susceptibility to these problems, based on medical data, will likely be reflected in the premiums you pay. So you might pay more to insure a Golden Retriever than an Airedale, since the former is more than 15 times as likely to develop cancer, according to years of data developed by a D.C animal hospital.

Some policies cover specific conditions, but only after a waiting period has elapsed. Hip dysplasia, a problem caused by an abnormally formed hip joint, is a common example. Its symptoms appear as a puppy grows. An insurance company might pay for surgery to alleviate hip dysplasia, but only if treatment happens at least six months after the policy takes effect. The reason is simple: insurance companies don’t want you to notice that your dog is limping, buy insurance, and then take the dog to a veterinary specialist for what may be a very expensive fix.

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To avoid pet owners rushing to insure their animals after any diagnosis, or even of symptoms consistent with one, illness coverage invariably has a waiting period for treatment of illness after a policy is taken out. The norm is 14 days, excepting hip dysplasia and other specific conditions that have their own periods, running to months.

Insurance also usually, but not invariably, covers all veterinary examination and consultation fees, hospitalization, treatments, surgery costs, and prescription medications. However, some policies omit certain types of prescription (such as those for behavioral problems) and put the pet owner on the hook for exam fees.

As with many human health plans, it’s common now for coverage to also include select alternative therapies. These may be part of illness coverage or require the purchase of an add-on wellness plan. The range of covered treatments varies by the insurer but may include behavioral therapy (for aggression, excessive barking, and destructive chewing, as examples), acupuncture, chiropractic care, laser therapy, and hydrotherapy. Some plans will also cover specific dietary supplements and foods used to treat your pet’s condition.

Meanwhile, while dental treatment and prosthetic devices are part of some companies’ plans, they are omitted from others. With dental coverage, illness that requires extractions and even root canals is usually included, although some plans are limited to dental disease (such a periodontal conditions) and at least one we surveyed covered only dental work that arose from accidents.

Serious illnesses that are (usually) covered

Virtually every pet illness policy covers cancer and specialty care of any kind. Here are other specific conditions, both chronic and inherited, for dogs and cats that you can typically expect illness insurance to cover, although not every insurer may cover every one of them, and some carriers may also cover other serious illnesses.

Based on information gathered online by Money staff from the websites of the pet insurance companies, supplemented by research of other types.

How carriers compare on illness coverage

Despite being nearly ubiquitous in covering the conditions noted above, plus virtually every other minor ailment, companies also universally cover regular prescriptions and hospitalization. But their coverage differs in other ways, as the chart below details. See the illness coverage section for more on what each of these areas may or may not include.

We compared what nine of Money’s top picks in pet insurance offer in illness coverage, within popular comprehensive plans that combine illness and accident coverage. An $ indicates that the coverage is offered, but only through buying a wellness plan at additional cost.

The specifics for each insurer differ somewhat, so if one or more of these aspects of this coverage is especially important to you, consult the companies’ online policies for details. The insurers are listed alphabetically, and the information is drawn directly from the companies, generally through their online sample policies.

Based on information gathered online by Money staff from the websites of the pet insurance companies, supplemented by research of other types.


Accidents coverage

As a rule, pet insurance will reimburse the cost of treating injuries or illnesses caused by mishaps, whether the fault of the animal or its owner. Exceptions, though, are usually specified for intentional injuries to the pet, or those that result from organized sports involving it. And not all policies cover poisoning, since that too is often the result of owner negligence.

As with medical conditions that occur more in certain breeds than others, you’re also covered for certain breed tendencies that can lead to accidents. An example is what Steve Weinrauch, Trupanion’s chief veterinary officer and chief product officer, identifies as the tendency of Labradors, to eat “silly things,” from rocks to socks, and then require expensive surgery to remove said items. While the cost to remedy such behaviors will not subsequently boost your premiums, the track records of certain breeds for self-destruction, like their medical pre-dispositions, may affect the premium you will pay to insure one of them.

As with illness coverage, consult the companies’ policies online to check on the listed items that may not be covered, if those especially matter to you.

Based on information gathered online by Money staff from the websites of the pet insurance companies, supplemented by research of other types.

Wellness coverage

Often referred to as “preventive care” coverage, wellness coverage is available as an add-on or “rider” to a broader policy or, with some carriers, also as a separate stand-alone policy. A host of routine or preventive care procedures are typically included. So are some treatments that go beyond wellness, at least physical wellness, such as grooming and training services.

Based on information gathered online by Money staff from the websites of the pet insurance companies, supplemented by research of other types.

Making your choice

Many pet owners who choose to insure their pets want it all when it comes to coverage. Comprehensive plans are the all-inclusive plans of pet insurance, covering both accident and illness coverage. They can be expanded to be truly comprehensive by adding wellness coverage, which is usually an extra-cost add-on rather than an integrated part of the plan.

You can also go à la carte with pet insurance, and cover only the perils that most concern you, or that you can afford to insure. For example, if you’re most worried about the possibility of a massive bill for a chronic condition such as cancer, you could opt for illness coverage alone, especially if your dog is fairly sedentary and goes outside only for walks.

Conversely, an accident-only plan may suit you if your main concern is mishaps for your outdoor cat or your dog’s propensity to escape the yard and engage with cars. Such a policy can also be much more affordable than a comprehensive plan. For example, an accident and illness plan for a four-year old mixed breed, medium sized dog would cost around $45.21 per month through the American Society for Prevention of Cruelty to Animals (ASPCA). Meanwhile, an accident-only plan costs $22.25 — a little more than half as much.

Sometimes the need to buy less coverage will be imposed upon you because your pet can’t be fully insured. A pre-existing condition may prevent buying illness coverage, for example, and some companies won’t insure older pets — say, those that are 11 to 14 years or older — at all.

Indeed, as the tables above show, important differences in coverage lie in the respective restrictions and omissions that insurers impose. Downloading companies’ sample policies, often readily available in their websites, can help guide you to what the different exclusions and restrictions are for each type of policy.