Pet insurance coverage ranges widely by provider and plan, and some of the omissions may surprise you — beginning with the fact that standard coverage typically doesn’t include checkups, vaccinations and other pet needs for routine care.
Buying the right coverage for your pet involves understanding the general types of policy and what they include. But it’s also wise to dig into the details of comparable policies at competing providers, since they differ in what is and isn’t covered and when.
This guide breaks down what is and isn’t covered by most pet insurance policies. If you want to know the companies that offer the best pet insurance coverage options, check out our picks for the best pet insurance companies.
Table of Contents
- What is Covered by Pet Insurance?
- Types of Pet Insurance Coverage
- How Does Pet Insurance Work?
- Pet Insurance Coverage FAQs
- Summary of Money's Guide to Pet Insurance Coverage
What is Covered by Pet Insurance?
In general, most pet insurance plans cover treatment for unexpected injuries and accidents, along with that for illness. The costs for surgery, medication, diagnostic tests and emergency care are typically included. But not every veterinary bill in those categories is customarily eligible for reimbursement.
In short, the details of what’s included in your policy for dog insurance or cat insurance will depend on the type of coverage and the provider you choose.
Types of Pet Insurance Coverage
Insurers typically offer three main coverage options: accident-only plans, accident and illness coverage and wellness insurance.
Specific benefits and restrictions for each option differ by company, which is why we cover pet insurance costs separately.
For instance, although all the companies we’ve researched cover hip dysplasia, some impose an age limit on treatment (of between 10 and 14 years of age). Others have no restrictions for the same condition.
1. Accident and illness coverage
- Covers injuries from accidents
- Covers vet-diagnosed sickness or disease
- Good fit for breeds that commonly experience health problems
- May include optional wellness rider for an extra fee
- Monthly premiums are higher than for accident-only coverage
- Often won't cover routine care, like check-ups and teeth cleanings
- Reimbursements are capped per accident and per illness
What is covered by accident and illness insurance
Although some insurers sell stand-alone illness coverage, it’s far more common to see this coverage bundled with accident coverage. Accident & illness policies (also typically known as “comprehensive 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.
The costs of veterinary examination and consultation fees, hospitalization, treatments, surgery costs and prescription medications are also usually within scope. Most of these insurance policies also cover hereditary and congenital conditions that are breed-specific, like a propensity to cruciate ligament injuries.
However, as with most other treatments, these hereditary problems are covered only so long as a 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 will not be covered.
Some policies also cover specific conditions only after a waiting period elapses. For example, an insurance company might pay for surgery to alleviate hip dysplasia, but only if treatment begins at least six months after the policy takes effect.
But this coverage is not universal across all policies. To cite just two examples, some omit certain types of prescriptions — such as those for behavioral problems — and put the pet owner on the hook for exam fees.
Other 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, again, not every insurer will cover every condition.
|• Hepatitis||• Polycystic Kidney Disease (PKD)|
|• Arthritis||• Skin allergies|
|• Inflammatory Bowel Disease||• Hip dysplasia|
|• Hyperthyroidism||• Elbow dysplasia|
|• Diabetes mellitus||• Hypothyroidism|
|• Type II diabetes (linked to obesity)|
Comprehensive plus wellness coverage
Some comprehensive (that is, accident and illness) plans are available bundled with wellness coverage. As we cover below, wellness coverage can include the cost of alternative therapies, and a host of additional non-traditional treatments, from behavioral therapy, acupuncture and chiropractic care to laser therapy and hydrotherapy. Some plans also cover specific dietary supplements and foods the vet prescribes to treat your pet’s health condition.
2. Accident-only coverage
- More affordable monthly premiums
- Best for young, healthy pets unlikely to develop a hereditary condition
- Covers only injuries from an accident
- Illness treatment and routine care are still out-of-pocket expenses
What is covered by accident-only insurance
Accident-only policies reimburse the cost of treating injuries or illnesses caused by mishaps, whether they’re self-inflicted by the animal or result from some other cause.
Claims for accidents stemming from such behaviors won’t increase your monthly premiums. But those fees may be determined in part by the propensity of your animal’s breed to accidents. For instance, premiums tend to be high for Labrador Retrievers in part because of the breed’s tendency to swallow foreign objects.
What isn’t covered by accident-only insurance
Medical treatment for incidents in which the pet owner is at fault — such as striking the pet or subjecting it to organized fighting or racing — will not be covered, and neither will any accident that results from a pre-existing condition.
Accidents: What is and isn’t reimbursed
|Covered||May not be covered|
|• Motor-vehicle accidents||• Poisoning|
|• Ingesting foreign bodies||• Intentional harm to the animal|
|• Sprains and lacerations||• Injuries in organized fights or races|
|• Broken Bones|
|• Accidental, unavoidable poisoning|
|• MRIs and x-rays for diagnostic|
When you buy pet insurance, read the fine print to verify what is and isn’t covered. For instance, not all policies cover poisoning and flea or tick bites, since those perils are often the result of owner negligence.
3. Wellness coverage
- Reimburses for preventative (routine) care
- Usually has a zero deductible
- Usually isn't a standalone policy, but an add-on or rider
What is covered by wellness insurance
Often referred to as “preventative 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.
Many routine veterinary care procedures are typically included. Other services like grooming and training can sometimes also be within scope.
Wellness: What is and isn’t reimbursed
|Covered||May not be covered|
|• Vaccination||• Pregnancy or other breeding/whelping expenses|
|• Flea/tick and heartworm preventatives||• Routine anal-gland expression|
|• Microchipping||• Grooming or training|
|• Spay/neutering surgery|
The following table provides a summary comparison of the different types of pet insurance and what each generally covers:
|Pet insurance type||What it covers||What it doesn't cover|
|Accident-only||• Physical accidents, including foreign-body ingestion, cuts and lacerations, fractures, bloating and surgery.||• Pre-existing conditions |
• Intentional injuries
• Routine veterinary care
• Very old pets, for some policies
• Poisoning, if deemed negligent
|Accident & illness||• A range of illnesses, including allergies, cancer, asthma and digestive issues |
• Hospitalization, treatment, surgery costs and most prescription medications
• May cover alternative therapies
|• Pre-existing conditions |
• Routine veterinary care, including vaccinations, dental cleaning, among others.
• Very old pets, for some policies
• Certain prescription medications
|Wellness||• Exam fees, vaccinations, routine lab work, spay/neuter operations, among others||• Any illnesses or accidents|
How Does Pet Insurance Work?
Reimbursement under pet insurance differs from the norm for human health insurance. Unlike your own insurance coverage, it’s unlikely you’ll be able to pay just a copay at the time of treatment for your pet. Instead, you’ll probably be required to pay the bill in full. You then make a pet insurance claim and wait to be reimbursed for the agreed-upon percentage stipulated in your insurance plan.
As with human health insurance, pet insurance policies have deductibles you must meet before coverage kicks in. Policyholders can choose the deductible amount they are comfortable paying, typically ranging between $200 and $1,000. (The lower the deductible, though, the higher the premium, as a rule.)
As a rule, insurers don’t cover pre-existing conditions. That’s to say, if your animal has a medical problem that predates you enrolling them for insurance, you can’t claim the cost of treating it, as a rule.
However, some such conditions may eventually be covered, provided your pet is symptom-free and deemed to be cured for a certain length of time — often 180 days. Every insurer has a different definition of what constitutes a curable pre-existing condition, so it pays to dig into these details before you buy a policy.
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, except for hip dysplasia and some other serious conditions that have their own specific periods.
Most policies require you to choose certain coverage limits. The list typically includes an annual limit on reimbursed expenses, often within a range of $5,000 to $30,000 — with higher limits usually triggering higher premiums. Lifetime limits are also sometimes imposed, as are limits on the treatment costs for any one condition.
Also, many insurers set age limits on coverage. This means that after your pet reaches a certain age, you’ll be unable to renew its policy. Likewise, some pet insurance companies won’t issue new policies for pets that are over a certain age — such as 10 years.
It’s rare for a policy to pay the entire expense for any type of care. The best cheap pet insurance will usually cover a fairly high set percentage of veterinary bills — typically 70%, 80% or 90%.
As with many other types of insurance, you must also select an annual deductible to be paid upfront before reimbursement kicks in. Typical choices are $250, $500 and $1,000, although a few insurers also offer (at high premiums) policies that have no deductible).
Pet Insurance Coverage FAQ
Is pet insurance worth getting?
Our analysis of the costs and benefits of pet insurance concluded that coverage is unlikely to pay off if your pet has a typical medical life, as in occasional non-catastrophic illnesses or accidents.
Instead, a pet insurance policy will likely pay off financially only if your animal develops a serious — and probably long-term — medical condition, such as cancer, or suffers a catastrophic accident that requires major surgery. That said, insurance may be less suitable if you're the type of pet owner who might be less comfortable with putting a very ill animal through the travails of chemotherapy, say, or serious surgery, especially if they're old.
Conversely, if you're a pet owner who's likely to take any step to save your animal, regardless of its age or the seriousness of the treatment, pet insurance may provide an emotional payoff that justifies getting it, despite the low odds that you'll recoup its cost in premiums, deductibles and copays.
How much will I pay for pet insurance?
The cost of pet insurance will depend on the pet type, age, breed and gender, in addition to the type of policy, co-pay, deductible and reimbursement level you choose.
Premiums will also vary depending on where you live. The cost of pet insurance is also higher in cities with high costs of living, such as New York and California. Most companies offer online insurance quotes.
What is the best affordable choice in pet insurance?
Accident-only and wellness policies are the most affordable pet insurance plans, mainly because they are less comprehensive.
Purchasing one of these policies will only cover specific aspects of your pet's health, like fractures and cuts under accident-only plans and routine labs under wellness-only plans.
Because of those limitations, you may want to consider another option if you're committed to insuring your pet but have a limited budget to do so. That's to opt for a customary accident & illness policy but opt for a low reimbursement rate and a high deductible. That way, you'll still be covered in the (unlikely) event that your pet has a major accident requiring lengthy surgery or develops a serious condition such as cancer that requires an extended and expensive treatment plan. And these calamities are when coverage is most likely to pay off financially, our cost/benefit analysis of pet insurance suggests.
Does pet insurance cover hip dysplasia?
Does pet insurance cover vaccines?
Does pet insurance pay out if my dog dies?
Few if any pet insurance policies include a death benefit if your pet dies. Life insurance policies for pets are available, though, and they typically cover burial expenses and the pet's replacement cost.Our analysis of the costs and benefits of pet life insurance found it isn't a good buy for most pet owners. The key reason: Unlike humans, pets do not after their deaths leave behind debts or families who have been financially dependent on them.
Summary of Money's Guide to Pet Insurance Coverage
- Most pet insurance plans cover unexpected injuries, accidents and illnesses as well as surgery, medication, tests and emergency care and exam fees.
- The details of your pet insurance policy will depend on the type of coverage and the provider you choose.
- There are three main pet insurance coverage options: accident and illness, accident-only and wellness.
- Accident and illness coverage will cover accidents and vet-diagnosed sickness or disease.
- Accident-only coverage will cover only injuries from an accident.
- Wellness coverage will reimburse pet owners for routine or preventative care.
- Is pet insurance worth it? The answer depends in part on whether you are unlucky enough to be among the relative few pet owners whose animal develops a serious condition that requires vet bills in the floor or even five figures to treat.