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Insurance

How does pet insurance work?

Pet insurance can reimburse you for accidents, illnesses, and more depending on the type of policy.

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Inti St Clair | Tetra Images | Getty Images

Getting pet insurance can be a great way to ensure you'll always be able to give your animal companion the care they deserve without breaking your budget.

But pet insurance doesn't always work the same way your health insurance does. Here are a few things to consider about pet insurance coverage before picking the policy that's right for you (and your animal).

What does pet insurance cover?

Pet insurance generally covers new accidents or illnesses that appear with your pet. If you're shopping for pet insurance, CNBC Select has done some of the comparison shopping for you. Some of our top picks include Spot Pet Insurance for its wellness availability, coverage of vet exam fees, and no upper age limit. We picked Healthy Paws for its strong accident and illness coverage featuring unlimited annual and per-accident coverage.

Spot Pet Insurance

  • Policy highlights

    Spot Pet Insurance offers accident-only and accident and illness plans, plus two tiers of wellness add-ons

  • Age limits

    No upper age limit

  • Coverage limit

    $2,500 to unlimited

  • Annual deductible

    $100, $250, $500, $750 or $1,000

  • Reimbursement rate

    70%, 80% or 90%

  • Waiting period

    14 days for accidents and injuries

  • Discounts

    10% multi-pet discount

  • Direct vet pay

    No

Healthy Paws Pet Insurance

  • Policy highlights

    Healthy Paws offers accident and illness policies with no annual or lifetime coverage limits

  • Age limit

    8 weeks to 14 years

  • Coverage limit

    Unlimited

  • Annual deductible

    $100, $250, $500, $750 or $1,000

  • Reimbursement rate

    50%, 60%, 70%, 80% or 90%

  • Waiting periods

    15 days for accidents and illnesses

  • Discounts

    None

  • Direct vet pay

    Yes

When your pet needs treatment, the right pet insurance policy can be a huge help. But pet insurance doesn't cover every instance of your pet needing care. Here are several circumstances when pet insurance won't be able to come to the rescue.

It doesn't cover your pet immediately

Pet insurance will cover your pet after a set waiting period. A two-week waiting period after purchasing a policy is fairly standard for policies that cover illnesses, while accident coverage can sometimes have a shorter waiting period of a day or two.

Anything that happens to your pet before your policy's waiting period will not be covered by your policy.

For this reason, getting your pet insured while they're young and healthy can not only save you money in premiums, but it can also help make sure future illnesses and accidents are covered by the policy.

It doesn't generally cover pre-existing conditions

It's important to note that no pet insurance companies cover pre-existing conditions, including injuries or illnesses that your pet had before enrolling them in coverage and finishing the waiting period.

There are some distinctions, however. Some — but certainly not all — pet insurance companies will treat curable pre-existing conditions differently from conditions that are incurable. Embrace, for example, can reinstate coverage for conditions after a period of 12 months from the date of the last episode. However, the company does state on its website that it does this "at our discretion," so it's never a guarantee.

Embrace Pet Insurance

  • Policy highlights

    Embrace offers accident-only, accident and illness and wellness policies

  • Age limits

    6 weeks to 14 years

  • Coverage limit

    $5,000, $10,000 or unlimited

  • Annual deductible

    $100, $250 or $500

  • Reimbursement rate

    70%, 80% or 90%

  • Waiting period

    2 days for accidents, 14 days for illnesses

  • Discount

    10% multiple pet discount, 5% military discount

  • Direct vet pay

    Yes

As an example, Embrace considers several conditions as curable pre-existing conditions in pets:

  • Respiratory infections
  • Bladder infections
  • Gastrointestinal disorders

Incurable pre-existing conditions generally include things like:

  • Allergies
  • Cancer
  • Diabetes
  • Skin lumps or lipomas
  • Thyroid issues
  • Other chronic conditions

If your pet has an incurable pre-existing condition, your pet insurance likely won't cover any treatments related to these conditions. Saving a "pet care" emergency fund in a high-yield savings account dedicated could help you cover the expenses pet insurance can't.

The type of pet insurance you buy determines what is covered

There are three main types of pet insurance coverage you'll see while shopping, including:

  • Accident-only coverage: This coverage usually covers unexpected injuries to your pet, such as cuts and lacerations, ingesting a foreign object, or even poisoning.
  • Accident and illness coverage: This coverage can help pay for accidents plus new illnesses your pet experiences.
  • Wellness coverage: This coverage can help pay for more routine treatments, such as an annual wellness check, vaccinations, and sometimes even prescription medication or diets.

However, the exact things that any pet insurance policy will cover will vary based on the specific insurance company and policy. Make sure to read your pet insurance policy thoroughly or look at a sample policy on the brand's website before buying to get an idea of what's covered and what's not.

Pet insurance doesn't often cover elective procedures or pregnancy

Pet insurance doesn't often cover elective procedures you choose to have your pet undergo, like declawing for cats or tail docking or ear cropping for dogs.

Policies also generally exclude costs related to pregnancy or birth. Some pet insurance companies will cover spaying or neutering under wellness policies, however.

How does pet insurance work?

In general, pet insurance works by reimbursing you for a percentage of your treatment costs minus any deductible you're responsible for.

Here's what you need to know about how to use pet insurance to get your pet the care they need.

1. Use any vet you'd like

Unlike human health insurance, you don't need to worry about which vets are and aren't in a network of providers. Most pet insurance companies allow you to use any licensed veterinarian in your area.

2. Pay your bill in full

Most pet insurance companies require pet owners to pay for the vet bills in full on their own. That can mean that you'll need to have the cash or credit on hand to be able to pay for a vet bill up front, even if it's a large one. Make sure to save a copy of your receipt and bill to get reimbursed.

Some pet insurance companies can directly pay the vet to simplify the process. CarePlus by Chewy, for example, offers direct-to-vet payments with insurance through partner company Trupanion.

CarePlus® by Chewy Pet Insurance

  • Policy highlights

    CarePlus offers accident-only, accident and illness and wellness plans through Lemonade and Trupanion.

  • Age limits

    Pets from 8 weeks old to 14 years old can be enrolled

  • Coverage limit

    $20,000 or unlimited

  • Annual deductible

     $250, $500 or $1,000

  • Reimbursement rate

    70%-100% 

  • Direct vet pay

    Yes, with Trupanion

3. Submit your bill to your pet insurance company

Many pet insurance companies have an app or website where you can upload your receipts and veterinary bills after they're paid. You'll file a claim on the pet insurance company's website. Many insurance companies approve claims within a week, though some can take longer.

4. Get reimbursed up to a percent of your expenses, minus your deductible

When you receive your reimbursement from your pet insurance company, you might notice that it's less than what you paid. There are two reasons for that: the policy's reimbursement rate and your policy's deductible. Both are chosen when you purchase the policy.

Pet insurance companies can reimburse you for any qualifying expenses that exceed your deductible. A deductible is a set dollar amount you pay before your insurance policy contributes to cover its share of the costs. That amount can be anywhere between $100 to $1,000. Generally, the higher the deductible, the lower the premium, or the periodic cost you pay for coverage. Deductibles can come in one of two forms:

  • An annual deductible. A policy with this type of deductible would reset each year, similar to a health insurance policy.
  • A per-incident deductible. A deductible is required each time you file a claim.

After you meet your policy's deductible, you receive reimbursement from pet insurance companies as a percentage of the total balance. Generally, this reimbursement will be between 70% and 90% of the cost. Again, this reimbursement rate is chosen when you sign up for the policy.

As an example, if a pet owner with an 80% reimbursement rate, a $250 deductible, and a $5,000 annual limit faces a $1,000 vet bill for their dog, the pet insurance policy would pay out 80% of the remaining $750 of the expense, totaling a $600 reimbursement.

How much is pet insurance?

The cost of pet insurance depends on your policy's coverage, deductible and reimbursement limits, and annual maximum. It also varies based on your pet's age, breed, weight, and the type of pet you're insuring — dogs (for example) are generally cheaper to insure than cats.

According to the North American Pet Health Insurance Association (NAPHIA), the average pet insurance cost for dogs in 2023 was $56.30 per month for accident and illness policies, and $17.01 per month for accident-only policies.

For cats, the average accident and illness policy cost $31.94 per month, and the average accident-only policy cost $9.68 per month.

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Editorial Note: Opinions, analyses, reviews or recommendations expressed in this article are those of the Select editorial staff’s alone, and have not been reviewed, approved or otherwise endorsed by any third party.

How Does Pet Insurance Work?

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