skip to main content

Do I Need Pet Insurance?

vet examining kitten - personal and pet insurance coverage provider newton massachusetts

Every pet owner should ask themselves, “Do I need pet insurance?”.

It seems like there are a million different companies and plans to choose from. What exactly is covered? How much does it cost? Is pet insurance even worth it?

The general answer is YES, pet insurance is generally worth it. In case of an accident you might be left with thousands of dollars of bills to pay, or worse – having to choose between paying tens of thousands out of your pocket or keeping your treasured companion alive. You don’t want to have to make that kind of decision.

Having said that, you need to understand what you are getting and exactly what you are paying for so as to not be surprised and disappointed in the event that you need to file a claim. It is impossible to summarize everything about pet insurance in one post, but here are a couple of things you should understand and be familiar with when you purchase pet insurance. Please note, these are just examples of typical coverage and may vary from company to company.

What's Covered

  • New illnesses and accidents
  • Diagnostic tests related to illnesses/accidents
  • Prescription medications
  • Surgeries, prosthetics, chronic conditions, emergency services, advanced treatments, and much more

What’s not covered

  • Pre-existing conditions
  • Routine wellness or preventative care
  • Spaying or neutering
  • Dental cleanings or procedures not related to an accident
  • Prescription food

An important thing is to understand is the difference between chronic condition (covered) vs preexisting condition (not covered).

A pre-existing condition is any condition that was showing signs or symptoms prior to the purchase of the policy or during applicable waiting periods. A chronic condition can be considered either pre-existing or eligible for coverage depending on when the condition started showing signs or symptoms. For example, a heart murmur is both a chronic and congenital condition (meaning the animal was born with it) but sometimes it does not get noticed or become life threatening for the pet until much later in life. If there were no signs or symptoms of a heart murmur noted in the medical records or doctors notes prior to the purchase of the policy or during the 14 day illness waiting period, then insurance carriers could cover the heart murmur as a new, chronic condition.

Another example is allergies. Allergies are a chronic condition so if there were signs or symptoms of these noted (ear infections, hot spots etc.) prior to the purchase or during the 14 day illness waiting period then it will be considered a pre-existing condition and will never be eligible for coverage. If the allergies start after purchase and after the 14 day illness waiting period, then it is a chronic condition that could be covered.

Deductible and Reimbursement Percentage

  • Deductibles are usually relatively low.
    • You can typically choose between a $100, $250, $500, or $750 deductible. This is also an annual deductible – which means that once you have met your deductible in a policy period, you will not be assessed the deductible again. In general, deductibles work the same as with any other insurance, if you choose a lower deductible you will pay a higher premium
  • Your reimbursement percentage is how much of the treatment will be covered by the insurance company.
    • You can usually choose between 70%, 80%, 90% and 100%. Higher reimbursement percentages will result in a higher premium.
    • Some insurance companies list coinsurance instead of reimbursement percentage. Coinsurance is your share of the treatment and is essentially the opposite of reimbursement percentage. If you choose a higher coinsurance, you will have a higher out-of-pocket expense and a lower premium
  • The annual deductible will be applied and deducted from covered claims before benefits begin to apply.
  • Once the annual deductible has been met, you will be reimbursed at your selected reimbursement amount for the rest of your policy period.

Limit of Coverage

This varies greatly based on insurance carriers and plans; however you can typically choose a plan that covers anywhere from $5,000/year maximum to $20,000/year maximum. There can often also be lifetime maximum benefit limits.

How Does Payment Work?

Let’s say you incur a $10K hospital bill for emergency services. You have a $10,000 coverage limit, $500 deductible, and 80% reimbursement percentage.

  • First you will be assessed your deductible, let’s say $500. This leaves you will a potential reimbursement of $9500.
  • This will then be multiplied by your reimbursement percentage of 80%, leaving you with a potential reimbursement of $7600
  • Since you purchase $10,000 in coverage, the full $7600 cost would be reimbursed to you.

Waiting Period

The waiting period begins on your policy effective date. It can be as little as 3 days or up to a year. Please refer to your insurance policy for the details. Waiting periods are typically put in place to prevent insurance fraud.

Good to know:

  • Pet insurance reimburses you for covered services, you would first make the initial payment at the hospital or clinic yourself and then submit all invoices to your insurer for reimbursement.
  • Pay close attention to veterinary fees and if they are covered by your plan. Otherwise, you may need get an additional rider for an additional premium or pay more out-of-pocket.
  • Monthly premiums can range from as low as $10 to higher than $100 depending on the selected coverage, pet type, age and a breed. Most pet owners can expect to pay between $30 and $60 per month.

As always, we would love to answer any questions that you might have. Contact Kovalev Insurance today and request a complimentary consultation to ensure your beloved furry friends are properly protected.

Our Insurance Carriers