Answering the question “what does pet insurance cover?” isn’t as straightforward as you’d think. Just like no other cat or dog is quite like the one we own and love, pet insurance coverage ranges widely by provider. As more Americans have become pet parents over the past year or so, interest in pet insurance, its coverage, and costs, has grown as well.
Some companies may offer comprehensive policies at competitive prices, while others might only have basic plans, with any extra coverage available as an add-on. To help you sort all of this out, we’ve created a guide that breaks down what is and isn’t covered by most pet insurance policies.
If you’re already on your way and would like to go straight to comparing companies, you can check Money’s top pet insurance picks for 2021.
|Pet Insurance Type||What it covers||What it doesn’t cover|
|Accident-Only||-Physical accidents, including poisoning, foreign-body ingestion, cuts and lacerations, fractures, bloat, and surgery.||-Preexisting conditions |
-Routine veterinary care
-May exclude older pets
– May not cover poisoning in certain circumstances
|Accident & Illness||-Mild to severe illnesses, including allergies, cancer, asthma, and digestive issues. |
-Hospitalization, treatment, surgery costs, and prescription medication.
-Can cover alternative therapies
|-Preexisting conditions |
-Routine veterinary care, including vaccinations, dental cleaning, among others.
-May exclude pets over a certain age limit.
-Can exclude certain prescription medications.
|Wellness||-Exam fees, vaccinations, routine lab work, spay/neuter operations, among others.||-Any pet-related illnesses or accidents|
How does pet insurance work?
Pet health insurance works a bit differently than traditional insurance. Whenever you visit your licensed veterinarian, if the medical expenses are covered by your pet’s insurance plan, the provider will reimburse you for a percentage agreed via your insurance plan. As with human health insurance, there is a deductible, typically between $200-$1,000, that you choose, and that you have to pay before the insurance kicks in.
Types of pet insurance
For the most part, insurers mix and match their policies into three main coverage areas — illness, accidents, and wellness. Specific benefits and restrictions within each area do differ by company.
For instance, although all the companies we’ve researched cover hip dysplasia, some impose an age limit on treatment and will deny coverage to older dogs. Others have no restrictions for the same condition. By understanding these differences, and planning a budget, you can navigate the industry calmly and can find the best pet insurance policy for you and your furball.
|More affordable monthly premiums||Less coverage|
|Only covers injuries from an accident||Illnesses and routine care are still out-of-pocket expenses|
|Best for young, healthy pets unlikely to develop a hereditary condition||Lowest reimbursement level for procedures|
What is Covered by Accident-Only Insurance
As a rule, accident-only policies reimburse the cost of treating injuries or illnesses caused by mishaps, whether they’re the animal or its owner’s fault.
You’re also covered for certain breed tendencies that can lead to accidents. Steve Weinrauch, Trupanion’s chief veterinary officer and chief product officer, states that Labradors tend to eat “silly things,” from rocks to socks, and then require expensive surgery to remove them.
While the cost to remedy such behaviors won’t subsequently boost your monthly premiums, the track records of certain breeds for self-harm, like their medical pre-dispositions, may affect how much you’ll pay to insure them.
What Isn’t Covered by Accident-Only Insurance
Any accident that can be traced back to the pet owner, such as intentional injuries, or any that result from organized sports will not be covered. Likewise, any accident resulting from a pre-existing condition won’t be covered either.
Not all policies cover poisoning and flea or tick bites either, since that is often the result of owner negligence. Additionally, accident-only policies don’t cover routine care, such as vaccinations, spaying, or neutering.
As with any type of coverage, consult company policies to check what is and isn’t covered.
Accident & Illness Coverage
|Covers the accidents previously mentioned||Monthly premiums are higher than for accident-only coverage|
|Covers vet-diagnosed sickness or disease||Often won’t cover routine care, such as check-ups and teeth cleanings|
|Good fit for breeds that commonly experience health care problems||Reimbursements are capped per accident and per illness|
|May include optional wellness rider for an extra fee|
What is Covered by Accident & Illness Insurance
Although some insurers have illness as its own category, it’s far more common to bundle it with accidents. Accident & Illness policies cover a gamut of illnesses, from the minor — such as vomiting and diarrhea, even if due to unidentified causes — to the serious, like cancer.
Accident and iIllness policies can also cover all veterinary examination and consultation fees, hospitalization, treatments, surgery costs, and prescription medications. Unfortunately, some policies omit certain types of prescriptions — such as those for behavioral problems — and put the pet owner on the hook for exam fees.
Most of these insurance policies also cover hereditary and congenital conditions that are breed-specific — such as torn ligaments. However, this is only true so long as your vet identifies the problem after the policy is in place. If your dog suffered any of these conditions before enrollment, they will be considered “pre-existing” and won’t be covered.
Some policies cover specific conditions, but only after a waiting period elapses. For example, 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.
Comprehensive Coverage – What is and what isn’t included
A variant of regular accident & illness coverage, comprehensive plans tack on wellness coverage, sometimes as a separate plan or as an add-on. This can include alternative therapies, and a whole host of additional covered treatments, from behavioral therapy, acupuncture, and chiropractic care, to laser therapy and hydrotherapy.
Some plans also cover specific dietary supplements and foods needed to treat your pet’s health condition.
The one caveat — comprehensive coverage usually won’t include routine checkups, vaccinations, or flea and heartworm treatment.
Serious Illnesses that are Usually Covered
Virtually every pet accident & 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 coverage for, although not every insurer may include every single one.
How carriers compare on Accident & Illness coverage
We compared what nine of Money’s top picks in pet insurance offer in accident & illness coverage. An $ indicates that the coverage is offered, but only through buying a wellness plan at an added cost.
The insurers are listed alphabetically, and the information is drawn directly from the companies, generally through their online sample policies. 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 more details.
|Reimburses for preventative (routine) care||Usually isn’t a standalone policy, but an add-on or rider|
|Usually zero deductible|
What is Covered by Wellness Insurance
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, as a separate stand-alone policy. A host of routine veterinary care procedures are typically included. So are some insurance services that go beyond wellness, at least physical wellness, such as grooming and training services.
Pre-Existing Conditions, Waiting Periods, and Policy Limits
There are some medical expenses that your pet insurance policy likely won’t pay for.
Pre-existing conditions – As a rule, insurers don’t cover pre-existing conditions. Your pet insurance company may offer you a policy even if your pet has a veterinary diagnosis, it just won’t cover you for anything related to a pre-existing or chronic condition. Be aware that every insurer may have different definitions of what constitutes a pre-existing condition.
Waiting periods – The reason for waiting periods is simple: they prevent pet owners from rushing to insure their animals after any diagnosis or symptom pops up. The traditional waiting period for pet insurance policies is 14 days, excepting hip dysplasia and other conditions that have their own specific periods.
Policy Limits – Most policies require that you choose certain coverage limits. These include an annual limit on reimbursed expenses, typically within a range of $5,000 to $30,000 — the higher the limit, the higher the premium.
It’s rare that a policy pays the entire expense for any care, since covered costs are usually a set percentage — typically between 70%, 80%, or 90%.
As with many other insurances, you must also select an annual deductible to be paid before reimbursement kicks in. These normally range around $250, $500, or $1,000.
Finally, many insurers have age limits to coverage, meaning after a certain age, coverage will stop on an existing policy. Likewise, some pet insurance companies won’t take out new policies on pets over a certain age limit.
Choosing the Right Kind of Pet Insurance
When you’re looking to insure your pet, the first thing to do is take a good look at your finances — and how much you’re able and willing to spend in case of an emergency. Now that you’re more familiar with the coverage limits on different types of plans, let’s break it down further.
- Accident-only policies – An accident-only plan may suit you best if your main concern is your cat or dog’s propensity for mishaps. They’re usually more affordable than plans with more coverage. For example, an accident and illness plan for a four-year-old mixed-breed, medium-sized dog would cost around $45.21 monthly through the American Society for Prevention of Cruelty to Animals (ASPCA). Meanwhile, their accident-only plan would cost $22.25 — a little more than half as much.
- Accident & Illness policies – These 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 add-on rather than an integrated part of the plan.
- Comprehensive policies – Some insurers offer truly comprehensive policies that cover everything, from accidents to illnesses to wellness to routine care. Naturally, these plans have the heftiest price tag, but may be worth it for the peace of mind.
Remember that, if you want to evaluate whether an insurer is right for you, it might be a good idea to download one of their online sample policies. Read all its inclusions, exclusions, and restrictions thoroughly, and if you’re comfortable with them, you can then move on to enroll your pet.
Does pet insurance cover all vet bills?
The amount of vet bills covered by your pet insurance depends highly on the policies and add-ons you’ve purchased. For example, Accident-only plans cover vet bills like toxin ingestion and physical injuries, while illness plans cover illnesses like cancer and hereditary conditions. Unfortunately, both don’t cover routine care and/or dental cleaning. If you want your pet insurance to include these, you will have to purchase a wellness plan or add-on with your policy, since it covers everything related to routine-care.
Is pet insurance expensive?
Pet Insurance isn’t necessarily expensive, although it all depends on the coverage, add-ons, and on the premium amount you choose. According to the 2020 state of the industry report by the North American Pet Health Association (NAPHIA), accident & illness plans for dogs cost $585 per year in 2019, while accident-only plans cost $194 annually, on average. For cats, it’s way cheaper. Accident & illness plans for cats averaged at $349.93, while accident-only plans averaged at $126.08. These costs can increase or decrease due to various factors that pet insurance providers take into account, including your pet’s breed, age, and gender.
What is the best affordable pet insurance?
Accident-only and wellness policies are the most affordable pet insurance plans, mainly because they are less comprehensive. However, purchasing one of these policies will only cover specific aspects of your pet’s health, like fractures and cuts for accident-only, and routine labs for wellness-only plans. If you want a more comprehensive policy, you will have to pay more.
Do all pet insurance providers offer the same?
Not all pet insurance agencies offer the same policies. Some companies are very thorough and offer various types of insurance and add-ons, while others focus on specific policies. Additionally, some companies might bundle policies at a cheaper price, or offer unique plans altogether. Embrace, a pet insurance agency, is a great example of a unique policy, since its Accident & Illness plan includes protection for pre-existing conditions they consider “curable.” The company determined specific curable pre-existing conditions if they don’t recur for at least one year.
Is it worth it to have pet insurance?
Whether pet insurance is worth it or not ultimately depends on your budget as a pet parent and your pet’s health needs. If your pet is young and healthy, pet insurance may not be as necessary — though the older they get, the more expensive to insure. If your pet is older and its breed has a history of illnesses, pet insurance could be a help in the long run. Before committing to a pet insurance policy, always consider its overall costs, and compare it to the potential veterinary bills you might incur. If the difference is considerable, chances are that your pet can benefit from pet insurance.