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Pet Insurance/How It Works

How Pet Insurance Works

Pet insurance is different from human health insurance. Unlike health insurance where you pay a copay at the office, pet insurance works on a reimbursement model.

The Reimbursement Model Explained

1

Pay Your Bill

You pay the full veterinary bill at the time of service

2

Submit Claim

Submit your claim online or via app with receipts

3

We Review

Insurance company reviews and approves your claim

4

Get Reimbursed

Money deposited to your account minus your deductible

Types of Pet Insurance Coverage

Accident-Only

$10-25/mo

Best for: Budget-conscious owners, breeds prone to accidents

Covers:
  • ✓ Broken bones
  • ✓ Hit by car
  • ✓ Foreign body ingestion
  • ✓ Poisoning
Doesn't Cover:
  • ✗ Illnesses
  • ✗ Cancer
  • ✗ Routine care

Accident & Illness

$30-60/mo

Best for: Most pet owners, comprehensive protection

Covers:
  • ✓ Accidents
  • ✓ Illnesses
  • ✓ Cancer
  • ✓ Infections
  • ✓ Surgery
Doesn't Cover:
  • ✗ Pre-existing conditions
  • ✗ Cosmetic procedures
  • ✗ Breeding costs

Comprehensive

$50-100/mo

Best for: Pet owners wanting full coverage including wellness

Covers:
  • ✓ Accident & illness
  • ✓ Routine care
  • ✓ Vaccinations
  • ✓ Dental cleaning
  • ✓ Preventive care
Doesn't Cover:
  • ✗ Pre-existing conditions
  • ✗ Grooming
  • ✗ Breeding costs

Key Pet Insurance Terms

Premium— The monthly amount you pay for coverage, regardless of whether you use it.
Deductible— The amount you pay out-of-pocket before insurance kicks in. Typical deductibles range from $100-$500 per year.
Reimbursement Rate— The percentage of covered costs the insurer pays back. Common rates are 70%, 80%, and 90%.
Annual Limit— The maximum amount your insurer will pay per year. Can range from $5,000 to unlimited.
Waiting Period— The time between enrollment and when coverage begins. Typically 2-14 days for accidents, 14-30 days for illnesses.
Pre-Existing Condition— Any health condition that existed or showed symptoms before your coverage start date.
Claim— A request for reimbursement submitted to your insurance company after paying for veterinary services.
Sub-limit— A cap on specific types of coverage. For example, a $500 sub-limit on dental disease.

Example Reimbursement Calculation

Your Policy Settings:

  • • Vet bill: $3,000
  • • Annual deductible: $250
  • • Reimbursement rate: 80%

How Reimbursement Works:

  • 1. Subtract deductible: $3,000 - $250 = $2,750
  • 2. Apply reimbursement: $2,750 × 80% = $2,200
  • 3. You receive: $2,200
  • 4. Your out-of-pocket: $800

Get Your Personalized Quote

Now that you understand how pet insurance works, get a quote tailored to your pet and budget.

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