How Does Pet Insurance Work?

As responsible pet owners, it is important to prioritize the health and well-being of our beloved animal companions. Just like humans, pets can unexpectedly fall ill or get injured, resulting in unforeseen veterinary expenses. This is where pet insurance can help. Pet insurance can offer financial protection, helping to ensure that your pet receives necessary medical care without compromising your budget. By investing in pet insurance, responsible pet owners can navigate unexpected veterinary costs while providing their pets with care and a lifetime of love and companionship.

What Is Pet Insurance?

Pet insurance is a type of insurance policy designed to help protect the health and well-being of pets. It functions similarly to health insurance for humans and, depending upon the type of coverage selected, can provide coverage for veterinary expenses incurred due to accidents, injuries, illnesses, and sometimes preventive care. Pet insurance can help alleviate the financial burden associated with unexpected veterinary costs, so pets can receive necessary medical treatments without owners having to make difficult decisions based solely on financial constraints. By offering coverage for a variety of veterinary services, including consultations, diagnostic tests, surgeries, medications, and even alternative therapies, pet insurance helps responsible pet owners provide their furry companions with care.

Pet insurance can also help promote proactive care through add-on wellness policy coverage for vaccinations, wellness exams, and check-ups, facilitating early detection of health issues. Moreover, it can offer more peace of mind, helping ensure pets are protected and promoting the well-being of your beloved companion.

Pet Insurance Coverage and Benefits

Pet insurance policies typically offer a range of coverage options so pet owners can select the policy that fits their particular needs.

Accident-Only Coverage

This type of coverage focuses solely on claims resulting from accidents and their associated expenses. It typically includes coverage for injuries resulting from accidents, such as broken bones, lacerations, or swallowed foreign objects. Accident-only coverage does not cover illnesses or preventive care.

Accident and Illness Coverage

This is a more comprehensive option that includes coverage for claims resulting from accidents as well as a range of illnesses. It typically covers veterinary expenses for conditions like infections, digestive issues, allergies, cancer, and more. Accident and illness coverage helps provide financial protection for both unexpected accidents and common health issues.

Routine Wellness or Preventive Care Coverage

This option provides coverage for preventive care and routine wellness services. It typically includes coverage for vaccinations, annual exams, flea and tick prevention, spaying/neutering, and dental cleanings. Routine wellness coverage encourages regular veterinary visits and can promote proactive healthcare for pets.

Full Coverage

Full coverage, also known as comprehensive coverage or lifetime coverage, combines accident, illness, and routine care coverage into a single policy. It offers the most extensive protection, encompassing a broad range of veterinary expenses throughout a pet's lifetime. Full coverage plans generally have higher premiums but is the most comprehensive option which can offer enhanced peace of mind for pet owners.

How Does Pet Insurance Work?

Here's a brief explanation of how pet insurance works and the process involved:

Eligibility and Enrollment

Eligibility criteria may vary depending upon the insurance company issuing the policy, but, generally, pets must satisfy certain eligibility requirements. During the enrollment process, pet owners usually complete an application that includes basic information about their pet's age, breed, and medical history. Most policies have age restrictions, often requiring pets to be at least a few months old, while other policies may have upper age limits for enrollment. Pre-existing conditions, which are health issues diagnosed or showing symptoms before the policy's start date, are typically excluded from coverage.

Making Claims and Seeking Reimbursements

When a pet requires veterinary care, the pet owner typically pays the veterinary bill to the provider upfront. To file a claim for reimbursement, the pet owner should submit the invoice and any necessary supporting documents to the insurance company. Some insurance companies may require that claims be submitted within a specific timeframe after the veterinary visit. Once the claim is received, the insurance company will evaluate it based on the policy's terms and conditions to determine if the claim is covered.

The method for reimbursement may include either:

• Actual veterinary bill reimbursement - Under this method, the pet owner is reimbursed for the eligible expenses based on the actual veterinary bill. After deductibles and any applicable copayments, the insurance company reimburses the pet owner for the remaining covered costs.
• Percentage-based reimbursement - In this approach, the insurance company reimburses a predetermined percentage of the eligible expenses. For example, if the policy offers 80% reimbursement, the pet owner would receive 80% of the covered costs after deductibles and copayments.

Pre-Authorization for Specific Procedures

Some insurance companies may require pre-authorization for certain procedures or treatments. This involves obtaining approval from the insurance company before the procedure is performed. The pet owner typically submits the relevant information for the procedure or treatment and the insurance company reviews it to determine coverage and potential reimbursement.

What Does Pet Insurance Cover?

While the terms and conditions of each policy may vary and, depending upon the specific coverage selected, pet insurance typically can cover:

• Veterinary expenses for accidents, injuries, and illnesses.
• Emergency veterinary care and hospitalization.
• Surgeries, including specialized procedures.
• Prescription medications and diagnostic tests.
• Chronic and ongoing conditions, including management.

What Does Pet Insurance Not Cover?

While the terms and conditions of each policy may vary and, depending upon the specific coverage selected, pet insurance typically does not cover:

• Pre-existing conditions.
• Certain hereditary or congenital conditions.
• Elective procedures or cosmetic treatments.
• Breeding-related expenses.
• Behavioral issues or training.
• Experimental or investigational treatments.
• Parasite prevention and routine vaccinations (typically available instead with an add-on wellness policy).
• Intentional acts or negligence of the pet owner.
• Non-veterinary related costs.
• Breed-specific exclusions or limitations.

What Factors Affect the Cost of My Pet Insurance Premium?

Several factors may influence pet insurance premiums, including the pet's age, breed, and species. Generally, older pets and certain breeds prone to hereditary or chronic health conditions may have higher premiums due to increased risks. Geographic location can also play a role, as veterinary costs may vary regionally. Coverage options and deductibles chosen by the pet owner also impact premiums, with more comprehensive coverage and lower deductibles typically resulting in higher premiums.

It's important to compare the cost of pet insurance options against potential veterinary expenses without coverage. For example, weighing the costs of a major surgery or long-term treatment for a pet against what pet insurance may cost over a period of time. 

Tips for Choosing Pet Insurance

When choosing pet insurance, here are several tips to keep in mind:

Assess your pet's specific needs and health risks. Consider your pet's breed, age, and any pre-existing conditions to determine the coverage which would be most appropriate for your pet’s specific needs. Some breeds are more prone to certain health issues, so understanding your pet's potential risks can help you choose the right policy.

Compare different insurance companies and policy options. Research and compare multiple pet insurance companies to find the one that offers the coverage and pricing that align with your needs. Pay attention to policy details, such as reimbursement rates, deductibles, and claim procedures. Some insurance companies may offer potential discounts or savings.

Consider customer reviews and ratings. Read reviews and ratings from other pet owners to gain insight into the experiences with different insurance carriers. Positive feedback and high ratings may be an indicator of reliable customer service and prompt claims processing.

Evaluate coverage limits and exclusions. Carefully review the coverage limits, exclusions, waiting periods, and any other terms and conditions of the policy. Ensure that the policy covers the specific treatments, medications, and procedures your pet may require.

Finding the Right Policy

Pet insurance helps offer enhanced peace of mind and financial protection for pet owners. With a range of coverage options available for accidents, illnesses, emergency care, prescription medications, and diagnostic tests, pet insurance can help pets receive necessary veterinary care without owners having to sacrifice their budget.

With Acrisure's pet insurance solutions, pet owners can explore options that suit their pets' specific needs and receive support and guidance throughout the process. To help protect your furry companion and enjoy the benefits of pet insurance, contact us today for more details about our pet insurance solutions.