Pet Insurance Information

Know what's covered by Your Policy

This free pet insurance information explains the basics and will help you to learn how to find the best pet health insurance for your pet.

Accidents and unexpected pet health issues strike us usually out of the blue and as pets get older, they will likely develop diseases or treatable chronic health problems that can easily cost a small fortune.

A well choosen pet health insurance plan will help to save you money and enable your vet to provide your pet with the best possible services.

How does Pet Health Insurance work?

Briefly, with buying a policy, you, the pet owner seals a contract with a pet insurance company and pays an agreed monthly premium.

Pet insurance policies are usually renewed annually.

If you get a vet bill, you pay first your veterinarian, then you fill out a claim form, send it together with your receipt(s) to the insurance company, which will send a reimbursement check back to you.

Depending on your individual policy, the amount of your reimbursement can vary: the company will deduct the agreed excess/ deductible, co-pay percentage and costs for procedures that were not covered by your policy.

As you can see, it is actually an easy, straight forward procedure.

Bad surprises and frustration usually come up when a pet owner reads the pet insurance information of his or her policy after a claim was rejected by the insurance company.

To avoid this scenario, it is crucial that you take that time to read through a pet policy before you buy it!

Pet Insurance Information - Basic Terms

You will read in every qoute and policy basic pet insurance information and terms, such as maximum benefit, deductible (US) or excess (UK), co-pay, per incident, pre existing condition, chronic or hereditary health problems and wellness procedures.

See what stands behind the following basic terms you can read in a company's pet insurance information:

• Maximum Benefit
• Deductible or Excess
• Co-pay
• Pre-existing health problems
• Chronic health problems and diseases
• Hereditary and withborn conditions
• Wellness and Prevention
• Other not covered procedures

Maximum Benefit of a Policy

This is the maximum amount an insurer will pay out.

There exist three kinds of maximum benefit:

• Lifetime : max. amount paid out over the whole lifetime of your pet
• Annual : max. amount paid out over the term of a policy with annual renewal
• Per Incident : max. amount paid out on each occasion a new health problem or injury occurs

Deductible or Excess

This is the agreed and fix part of the vet bill you will need to pay before your pet insurance company pays anything at all. It ranges normally between $50 and $1000, dependent on your choice. Again, deductibles/excess can be annual or per incident.

Annual deductible/excess means, you pay during the policy year this agreed amount, for example $200 towards your vet bills. Once this was spent, your insurance company pays for any other upcoming costs (that are covered) during the remaining policy year.

Per incident deductible/excess is better for the insurance company: you will need to pay for each occuring health problem or accident a separate deductible/ excess upfront!

Practically this means, if your pet suffers from kidney disease, a broken leg and a chest infection during the insurance year, you need to pay the deductible separately for each of the three problems.

On the other side, if your pet needs to be blood tested, examined and treated over several weeks or months for the kidney problem, you need to pay your deductible/excess for this specific health problem only once during the policy year.

Co-pay

This is an amount you need to pay on top of the deductible or excess. It is an agreed percentage (usually between 0 and 35%) of the total of the vet bill.

It is usually calculated as a percentage from the vet bill after the deductible/excess has been deducted.

This means, it is an unknown amount you will need to pay out of your pocket.

Pre existing Health problems or diseases

Health conditions and diseases that already have been diagnosed or your pet suffered from before the start date of your pet policy are called pre-existent conditions.

Pet insurance providers will want to know exactly if your pet ever suffered from a health problem in its life, so they will ask for the medical pet health record and gather details and information for a pet insurance policy tailored to your pet.

You need to provide your pet insurance with information that is true and valid as otherwise it is seen as fraud and a policy can be terminated without a refund.

You will find that there are providers that will cover a successfully cured, but not chronic problem provided that your pet was free of any signs and did not need any treatment for it over the last 180 days.

Chronic health problems and diseases

These are treatable and manageable conditions, but there is no cure for them. Pets will most likely develop in their later life chronic health problems.

Therefore it is highly recommended to buy a policy that covers diseases of the cardiac, renal, endocrine, musculoskeletal (joint) systems or cancerous diseases. These require all a life long and intensive diagnostic work up and monitoring and expensive medication.

Read a company's website thoroyghly about pet insurance information given for succeeding years, as most policies are due to an annual renewal and some companies will categorize a chronic disease as pre-existing problem and exclude it.

Be aware that policy premiums will cost more, if they do cover chronic problems.

Hereditary and congenital (withborn) conditions

Hereditary diseases are breed related, known health problems your pet may have inherited and carries a potential risk to develop them. These are diseases such as hip dysplasia, haemophilia, cruciate ligament rupture, progressive nephropathy, retinal atrohpy,... to name only a few.

Before you buy a policy, ask, if hereditary problems will be covered. Usually this kind of pet insurance information is not in a prominent place on a company's website, sometimes it is not displayed at all.

If a company does not offer coverage for these problems, ask what conditions and diseases are excluded. The list you get could be very long.

Withborn or congenital diseases and conditions, such as congenital heart disease or the congenital form of myasthenia gravis, a severe muscle weakness, are usually categorized as pre-existing problems and therefore excluded.

Some pet health insurers will cover these kinds of problems under the condition that your pet did not show any signs or was not diagnosed by a vet for such a health condition before you bought the policy, nor during the obligatory 2 -4 week qualifying period.

Generally, inclusion of hereditary problems into your policy is much more important than cover of congenital diseases: the risk that a pet will suffer from an inherited health condition at some stage of its life is a lot higher than it is to suffer from a withborn health condition.

Wellness and Prevention

What are wellness and preventative treatments?

Included are usually annual check ups and routine tests, dental scale and polish procedures, de worming, flea treatments, heart worm testing and prevention (US).

These procedures can usually be scheduled and planned ahead, so you can save for them upfront or manage to pay for them without claiming.

Premiums that cover wellness and prevention will cost you much more, so consider before you purchase a policy, if this is right for you.

Some pet insurance information given on companies' adverts will sound quite tempting: include cover for wellness treatments and prevention and get a higher maximum benefit for those procedures.

This may be a very good idea inthe first year of your pet's life, when a spay/neuter OP or the full range of immunisations needs to be done. In following years it is questionnable, if you needed it, but you would still pay the higher premium.

Other, not covered procedures

Conditions and diseases related to behaviour are usually not included in a policy.
Excluded are also problems during pregnancy and parturition as well as elective and cosmetic surgical treatments.

Reference: Dr. Kenney, Doug: "Your Guide to Understanding Pet Health Insurance", 2009 Philo Sophia Publishing, Memphis, TN

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What should be included into a Pet Health Plan?

Pet Health Plans and their exclusions.

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End of page pet insurance information