Should I Consider Pet Insurance? ~ Trisha, Patient Care Advocate

What is Pet Insurance?

It is a policy that helps protect against the unexpected costs associated with owning a pet. It is available for cats & dogs, and even some exotic pets. It will sometimes cover some wellness or preventative care services, but that’s usually an additional component of the policy that generally costs extra.

What does it cover?

Pet insurance is there mostly for the unexpected costs. Most pet insurance plans view wellness services as an expected expense that pet owners can plan for. The sick visits which involve injuries or illnesses are where it’s really beneficial. Whether your pet gets an ear infection, is diagnosed with diabetes, or breaks a leg, those are all things you can be reimbursed for (plus obviously lots more!).

What doesn’t it cover?

All pet insurance policies have specific exclusions for pre-existing conditions. This means that anything the pet has experienced prior to signing up for the policy will not be paid out. So if your dog has allergies, and then you sign up for the policy, they will not pay out anything further for allergies but could pay for anything/everything else. If you signed up before any signs, symptoms, or diagnosis, then you could expect payout moving forward. [Note: Some policies can actually have pre-existing conditions “fall off”. This means if after a determined length of time, the pet doesn’t show any further signs of that condition, it may no longer be pre-existing. For example, if the pet had diarrhea 1 time, maybe due to something it ate, it could be removed as pre-existing. But if the pet kept having diarrhea due to IBD, then that would still be pre-existing since it continued to be a concern.]

Other things the policy will not cover are explicitly written into the policy and can vary pretty widely by policy. Some policies will not cover conditions that are considered congenital or hereditary, even if the pet isn’t showing signs for it at the time of the policy. Some policies will not cover a “mirror” injury, such as a Cranial Cruciate Ligament tear(similar to an ACL ligament in people) rupture to 1 leg if the other leg had the injury prior to policy sign-up. A few policies have specific exclusions for periodontal disease unless further trauma is noted (such as breaking a tooth). And as stated previously, wellness services are not typically covered unless the policy allows for an additional add-on for that service.

It’s also worth checking what the policy says about prescriptions, pet food, and supplements. Sometimes they specify that you need to get the products from a veterinarian, so the products from the local pharmacy or online-store may not be covered. Prescription pet food and supplements are pretty hit-or-miss; it is definitely worth it to read the fine print.

Are there any waiting periods?

Depends on the policy. For some of the policies, it could be from 5 to 30 days, and it may also depend on if the condition is for an illness or injury-related claim.

How does it work?

You enroll your pet for the policy of your choosing. For most programs, this can be done online at the company’s website. For Trupanion, we can actually send an Exam Day Offer where we can email you a link for a 30-day free trial; it actually waives the waiting period since the exam will identify any pre-existing conditions that the waiting period is normally trying to identify. You must sign up for the trial within 24 hours of the exam though! Most of the insurance policies will allow you to do a medical history review immediately after signing up. I HIGHLY recommend doing this, as it allows you to submit all medical records known for that pet, and the policy can immediately identify what conditions would be considered pre-existing. This is super helpful to know what to expect moving forward rather than being surprised that something isn’t covered down the road.

Each month you will pay a monthly premium which can vary from $25-75 per month. That’s a huge range, and it depends on the terms of your policy (such as if you can choose your deductible or your pay out percentage), your pet’s age, pet’s breed, your zip code, etc. My experience is that most people pay closer to $50 per month. Trupanion & Companion Protect will lock you into a price so that it won’t increase except for cost-of-living, but won’t increase based on the pet’s age, which is definitely an incentive to start the policy while they’re young.

Your deductible is the amount of money you’d be expected to pay before the insurance policy will help cover anything further. It is very important to pay attention if the deductible is per-visit, per-incident or annual. Per-incident is nice for pets with a chronic condition, versus annual is better for pets who may have a few isolated incidents. Example 1: A pet who gets diarrhea and is then diagnosed with IBD. Per-visit deductible: you would pay for each visit, so each recheck is it’s own visit. Per-incident deductible: you would only pay the deductible once, and then rechecks would fall under the first deductible. Annual deductible: you’d still pay the deductible each year, even if the pet didn’t have any other conditions, and regardless of how many rechecks you had in a single year. Example 2: A pet who gets diarrhea, an ear infection, a broken toe-nail in the same year. Per-visit: you would pay the deductible for each visit (and also if there were follow-ups for any of those visits). Per-incident: you would pay for 3 different deductibles in the per-incident model, but rechecks would fall under the prior visit’s deductible. Annual deductible: only pay the deductible once, as long as they all happened in the same year.

Once you’ve met the deductible, most plans today will pay out a percentage of all costs after that. This can vary from 70%-90% (Trupanion typically will also not cover exam fees, as they consider it as part of their co-pay). Most policies will also typically not cover administrative fees or taxes.

Lastly most plans have a limit, but not all. This means that there may be a maximum that you can expect to receive as a payout per year or per the lifetime of your pet. Hopefully you never bump into those numbers; but it’s possible, and worth looking at if you have “that” pet.

What veterinarians accept pet insurance?

All pet insurance plans will allow pet owners to choose the veterinarian they prefer within the United States. Because the model is typically that you (the pet owner) will pay your bill in full and then the pet insurance company will reimburse you after you submit the claim, any vet will work for that purpose. However, Shiloh Animal Hospital is partnered with both Trupanion Express and in the Companion Protect Vetwork partnership. We offer a system where we can submit the claim while you are still here, determine the amount due that day, and then the insurance company will reimburse us rather than you. It adds a few minutes to the checkout process, but can certainly be nice when you can skip the reimbursement step and get to the bottom line quicker. Even if you have another insurance policy and you leave a claim form for your pet’s policy on file with our hospital, we will submit any invoices from our hospital on your behalf. We typically submit claims about every other week, which takes the work out of it for you. You can of course submit it yourself if you prefer, but it’s a perk we offer to encourage pet owners to have coverage.

Parting thoughts:

We hear a lot of people who say “I wish I had pet insurance.” By the time you’re saying that, there’s likely already pre-existing conditions that may make it more difficult to justify. Getting pet insurance after that point may help cover the things that are still not identified, but won’t cover whatever prompted you to make that statement. So that’s why we try to plant the seed of at least thinking about it on your pet’s first puppy/ kitten visit to our hospital. However anyone can do it at any point. If you ever want the Trupanion exam-day offer, just let us know!

If your animal is just “a pet”, then this probably isn’t worth your while. If your pet is more like a “fur-baby”, then this is something to consider if it’s right for you. It doesn’t mean you have to get it, but at least think about it before the list of pre-existing conditions makes it too much to stomach.