How Pet Insurance Works

How Pet Insurance Works

As is the case with a person’s insurance policy, things can quickly get complicated and hard to understand.  Here we try to answer some common questions so that you can better make sense of the many pet insurance policies available.

  1. What is the procedure for a claim?
    Pet insurance is different to conventional insurance in that you will have to pay up front and then make a claim to be reimbursed.
  2. How is reimbursement calculated?
    Usually the insurance company will pay between 80% and 90% of a claim, but this is once you, as the pet’s owner, have met the coinsurance payment.  The details will vary between each provider.
    There are also cases where the insurance company has a set table of fees, which are used to calculate what are called reasonable costs in your area.
  3. Do the monthly premiums ever go up?
    As with most insurance policies, yes they do.  Sometimes the premium goes up as you make more claims, but on the whole costs of veterinary care are always on the rise and this is what drives up policy prices.
  4. How are limits on payouts implemented?
    Limits vary widely according to your particular policy as well as the insurance company itself.  There can be limits for each illness, or annually, or even on the lifetime of the animal.
  5. What is covered?
    Health insurance for pets normally covers the cost of veterinary care as a result of emergencies and illnesses.  This includes surgery, tests and medicine.  Occasionally, the insurance company also covers the charge of an initial exam by the vet.
  6. What is not included in a policy?
    Almost every insurance provider in the United States and Canada excludes any condition which was deemed to be in existence before taking out the policy.  Inherited or genetic conditions are usually not covered either.  As with most insurance, an act of god such as a hurricane is not covered.

How are chronic conditions dealt with?

If a chronic condition arises in your pet, it will usually be covered until the end of your policy’s period.  When it comes to renewing your policy, it may then be taken as pre existing and not covered any more.  Policies which do cover these serious and ongoing conditions are often a lot more costly.