Petriage Clinical Insights

IMPORTANT: This article, which is provided for educational purposes only, is based on published veterinary data and decades of work with pets and pet parents. The information provided here is not designed to be comprehensive but to help you avoid the pitfalls of online misinformation and most importantly, to frame the conversation you should have with your veterinarian. Your veterinarian’s perspective may differ from what is expressed here. Always consult with your veterinarian.

Choosing Pet Insurance

 

When your pet is facing unexpected medical issues, having a pet insurance can help pay for the cost of treatment, which can be very expensive. Having insurance for your pet can provide you with peace of mind, and most importantly it can help you take better care of your pet when it needs unexpected medical intervention. It can literally save your pet's life.

In human medical insurance, medical staff are responsible for filing a claim, but in pet medical insurance things are very different. The insurance is really a direct contract between you and the insurance provider, and you will be directly involved in all aspects of this relationship. Most importantly, it is most likely that you will have to pay your veterinarian first, and then deal with the claim reimbursement process. This is why it is so important that you choose the right insurance provider and policy for you and your pet from the beginning. Changing providers and/or plans later can be complicated, especially if your pet is older and has already had some medical issues.

Highlights

There are key concepts in three areas that you need to look at when you are comparing different policies.

#1 General Rules and Restrictions

  • What is the waiting period once you enroll, and are there any exceptions?
  • Are there penalties for making changes to your policy?
  • How is the deductible determined? (Per time frame, condition or body part?)
  • If the deductible is flexible, how can it be adjusted?
  • Will the cost of the premium increase as your pet ages?
  • Will previously covered conditions become “pre-existing” upon renewing the policy or changing the coverage amount?
  • Is there a minimum or maximum age for coverage?
  • Can the insurer cancel the policy for any reason other than lack of payment?

#2 Coverage Details

  • What are the coverage limits for the plan? Are the limits per year, per condition, or for the life of the pet?
  • Are there breed-based coverage restrictions which might be relevant for your pet?
  • If you are enrolling an adult or senior pet, is the coverage any different?
  • Are hereditary and congenital conditions covered?
  • Does the plan cover routine wellness care such as exams and vaccines? If so, is the additional cost of wellness coverage actually worth it?
  • Are there any coverage restrictions at speciality or emergency hospitals?
  • Does the policy cover telemedicine appointments?
  • Are prescription drugs and diets covered?
  • Is dental care included and if so, does it cover cleaning and extraction or just accidents?

#3 The Claim Process

  • What kind of documentation is needed to send in a claim?
  • How long does it usually take to receive reimbursements?
  • Does the provider offer pre-approval to ensure coverage?
  • What type of customer service is available, and can it be reached 24/7 in case of a life threatening situation?
  • If your veterinarian supports it, does the provider have the ability to directly make payments to the hospital at checkout?

Tips

  • The time to get insurance is when your pet is young and healthy, preferably as soon as you get your new puppy or kitten. Do not wait for the first vet visit or for your pet to have a problem, even if it is a very minor one.
  • It is very important that you do your homework before choosing a provider and plan. If possible, ask other pet parents for their experience. A good place to do that might be an online group, the local dog park, or the lobby of your veterinarian.
  • Keep in mind that cost is not everything. Basing your decision primarily on cost is often a big mistake, because there are significant differences between pet insurance providers and how they structure their policies.
  • Make sure you understand what is required to get reimbursed. Call customer support and ask them to walk you through it.
  • Carefully read all the fine print in the terms and conditions of the insurance plan, and do not hesitate to call customer support for help in understanding the terms.
  • Unfortunately, most veterinarians and their staff are not knowledgeable enough to advise you on choosing a provider and plan.
  • If you want to go deep, a good resource is the book Pet Health Insurance: A Veterinarian's Perspective by Dr. Doug Kenny, DVM. You can purchase an inexpensive ebook copy from the author’s web site, PetInsuranceGuideUS.com. The web site contains many more articles, and even a podcast on the topic.