What Pet Medical Insurance Covers

Australian Shepherd in Tall Grass - Credit: Lisa H/Adobe Stock
Australian Shepherd in Tall Grass - Credit: Lisa H/Adobe Stock

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When a pet gets sick or injured, getting the best medical care is a top priority. Since veterinary care is often costly, you may want to consider the financial assistance that a pet medical insurance plan offers. But while pet medical insurance covers a wide range of health-related issues, there are a few expenses some insurers simply won’t pay for.

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To ensure there are no surprises when you visit the vet and submit a claim, here’s a breakdown of what pet medical insurance does (and doesn’t) cover.

What Pet Insurance Covers

Pet insurance policies are medical plans of sorts that reimburse you for a portion of your pet’s veterinary expenses. The most comprehensive plans cover treatment for a pet’s accidents and illnesses.

Related: Compare Pet Insurance Quotes

Some expenses typically covered in by pet insurance include:

  • Injuries and accidents such as broken bones or the ingestions of toxins

  • Hereditary or breed-specific conditions such as intervertebral disc disease (IVDD) and blood disorders.

  • Chronic illnesses such as diabetes or seizures

  • Orthopedic conditions such as osteosarcoma or ligament lacerations

  • Behavioral and alternative therapies like acupuncture or treatment for behavior issues such as marking or aggression

  • Dental illnesses such as gingivitis and tooth extractions

  • Emergency care such as hospitalization at a vet clinic

  • Testing and diagnostics such as biopsies and X-rays

  • Procedures like surgeries or rehabilitation

Some pet insurance companies also offer add-ons for preventive and routine care. By adding a routine wellness plan, you can receive some reimbursement for the annual vet wellness visit and costs such as heartworm and flea protection and vaccinations.

You can reduce pet insurance costs by buying an accident-only plan, but the majority of pet plans sold cover accidents and illness.

Related: Compare Pet Insurance Quotes

What Pet Insurance Doesn’t Cover

Although pet insurance policies can cover a wide range of expenses related to accidents, illnesses and preventive care, there are some things that they generally don’t cover.

Pre-existing Conditions

All pet insurance providers exclude pre-existing conditions from coverage. A pre-existing condition is when your pet has an injury or illness before coverage begins. Insurers may even deny coverage if the pet wasn’t officially diagnosed with a condition but they showed signs or symptoms of the problem (like limping).

Some insurers will cover what they consider “curable” pre-existing conditions. For example, if your dog had a respiratory infection but hasn’t had any treatment related to that illness in the last year, your insurer may cover the costs for new infections.

Elective Procedures

Pet insurers typically don’t cover elective procedure costs like feline declawing, ear cropping, nail trimming and grooming.

Non-veterinarian Costs

Plans usually don’t cover anything that is not a vet cost. Some of these costs include transportation fees, disposal of waste, taxes and fees for pet records or copying.

Holistic Treatment or Experimental Therapy

Pet insurance usually doesn’t cover treatments or diagnostics that are deemed experimental. In other words, veterinary treatments that aren’t accepted by your state’s veterinary board likely don’t fall under coverage.

Dietary Costs

Expenses related to the dietary needs of the pet are typically not covered by insurance. Some plans will cover prescription pet food.

Behavioral Training

Training such as basic obedience training might not be covered under a pet insurance policy. It’s important to check your policy for exclusions so that you’re not taken by surprise if you have a claim denied.

Looking Under the Hood

The coverage in pet insurance plans will often vary by insurer. This can make comparison shopping challenging. You may see a great monthly price for a pet insurance plan, but under the hood it could lack valuable benefits. The best pet insurance plans combine solid benefits at a competitive price.

While these coverage types may be harder to find, keep an eye out for them in better pet insurance plans.

  • Coverage for the vet exam fee: While treatment may be covered, not all plans cover the actual vet fee for the visit

  • Behavioral therapy: This could include treatment for compulsive behaviors such a repetitive tail-chasing over over-grooming.

  • Alternative therapy: This could encompass acupuncture, hydrotherapy and chiropractic care.

  • Stem cell treatment: This might be used, for example, on a dog with arthritis or hip dysplasia who hasn’t been helped by conventional treatment.

  • End of life expenses: Such as euthanasia, burial or cremation.

Also, make sure your pet plan includes access to a 24/7 vet chat line. This will be invaluable for unexpected late-night problems.

Some pet insurance plans include perks like advertising costs for a lost pet and boarding fees if you must be hospitalized and your pet has nowhere to stay. While these types of coverage shouldn’t be your decision-makers when buying a plan, they can be useful when you need them.

Related: Compare Pet Insurance Quotes

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