Your pet insurance policy checklist

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Your pet insurance policy checklist

You have a cat or a dog. You dote on them, brush them, play with them. They’re happy and healthy.

For now.

What happens if they get hurt or sick? Do you have the funds to cover an expensive treatment or vet visit?

You need pet insurance, and you know that. But even though you have other insurance policies – health, auto, homeowners – you’re not quite sure where to start.

What should you look for in a pet insurance policy? What are the important things to note? What should absolutely make sure you get covered?

Use this checklist to make sure you’re covering all of your bases and getting the most out of your pet insurance policy.

What type of deductible does my policy have?

You probably know the term deductible from other types of insurance policies. It’s the amount of money that you’re liable for if you have to use your insurance, and it works the same with pet insurance. You’re pet insurance will have either a per-incident deductible or a annual deductible.

Per-incident deductible

Just like it sounds, you’ll pay this deductible every time you use your pet insurance. If your per-incident deductible is $100, you’ll pay that each time you bring Fido to the vet before your insurance kicks in.

Annual deductible

A deductible that’s paid once a year. If your annual deductible is $500, you won’t pay any more than that no matter how many accidents Fido has during the year.

What type of coverage does my policy provide?

It’s important to note how expansive your pet insurance policy is so you aren’t expecting coverage for something that isn’t eligible.

Comprehensive coverage

This covers accidents, illnesses, congenital and hereditary conditions, and chronic diseases like cancer.

Accident-only coverage

This is good if your pet gets into an accident – like getting hit by a car – but not for much else. Because it’s so limited, we don’t recommend it, and the policies you’ll find on PolicyGenius all offer comprehensive coverage.

What’s not covered?

Pre-existing conditions, routine care and wellness visits, and standard office visit or exam fees typically aren’t covered by a pet insurance policy.

What is the reimbursement rate with my policy?

Pet insurance works a little differently than other insurance types; rather than your insurance company covering the costs right away, you’ll pay the costs upfront and get reimbursed.

This is good because it means you don’t have to worry about a vet accepting your insurance (since they aren’t dealing with the insurer at all) but it also means you need to know how much the insurer will reimburse you. The reimbursement rate is how much of the cost will be reimbursed after you’ve paid the deductible. A higher reimbursement rate means higher monthly premiums.

An average reimbursement rate is 80%. So say the total cost of your bill is $3,000 and you pay a $500 deductible. That leaves $2,500 eligible for reimbursement. At an 80% reimbursement rate the insurer will pay $2,000, leaving you with $1,000 to pay (the $500 deductible and $500 that wasn’t reimbursed).

Some insurers reimburse based on "usual and customary costs," meaning average costs for procedures rather than your individual vet bill, so make sure you know how the reimbursement will be calculated.

What are the payout limits on my policy?

Your policy may have a limit on the amount paid in claims.

Maximum payout per body system

Body systems are things like digestive systems, nervous systems, and so on. Payouts may be limited based on individual body systems and will not pay out anymore once you reach that limit for a particular body system.

Maximum payout based on a schedule of benefits

If your pet has specific health conditions, such as asthma, there may be limits on treatments related to these individual conditions.

PolicyGenius doesn’t recommend policies with maximum payouts per body system or based on a schedule of benefits, as they usually don’t provide proper coverage

Maximum payout per incident

The maximum payout for each instance of an illness or injury. If a policy has a maximum payout per incident, make sure the payout is actually high enough to cover your costs.

Maximum payout per year

Your total allowable annual payout.

Maximum lifetime payout

The total allowable payout for the lifetime of your pet.

How will my pet’s age affect my policy?

Just like with health insurance for humans, a pet’s age will determine your coverage. Older dogs will cost more to insure (or may be uninsurable altogether), and dogs of different breeds and sizes age at different rates. Insurers may have limits on coverage for dogs over a certain age.

As with any insurance policy, it’s important to know that the coverage is meeting your needs. After all, the point of pet insurance is not having to decide between your pet and your bank account. By using this checklist when shopping for pet insurance policies, you’ll understand the coverage you’ll be getting so you can make sure it’s the right policy for you.

Note: We haven’t forgotten about our more exotic friends like reptiles and birds. Unfortunately only one company, VPI, offers insurance for exotic pets, which you can learn more about here. Those are very specialized plans, and this checklist covers general plans for common pets. Think more "cat and dog" and less "iguana."

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