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What Does Pet Insurance Cover? An Essential Guide

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Updated October 4, 2023

Many pet owners consider their pets to be family. But data from the American Veterinary Medical Association (AVMA) shows that pet medical care can be expensive. The average household spends $410 per year on veterinary care for dogs and $182 per year for cats. 

To manage the cost of veterinary care for dogs and cats, some pet owners choose to purchase pet insurance. While pet coverage has many benefits, it’s not right for everyone. If you’re thinking about getting pet insurance for your dog or cat, it can be helpful to understand what it covers, what it doesn’t cover, and how much it costs. 

Metlife

Metlife Pet Insurance

Metlife Pet Insurance

Max annual coverage
$2,000 to $10,000
Reimbursement rates
Up to 90%
Deductible choices
$50 to $500 per year
Pet age restrictions: No upper age limit

Money-back guarantee: 14 days

What does pet insurance cover?

Pet insurance provides coverage for many types of veterinary care for your dog or cat. Some insurance companies sell coverage for other types of animals, but it’s less common. Pet insurance usually covers:

  • Emergency care.
  • Diagnostic tests.
  • Surgeries.
  • Medications.
  • Accidents and injuries.
  • Illnesses.

Pet insurance policies are not one-size-fits-all. There are several different types of pet insurance which vary in terms of covered services, exclusions, and costs.

You can also get a pet insurance plan or add-on that covers routine care, like annual exams and flea or tick prevention. These are often called wellness plans. However, wellness plans don’t usually cover things like injuries, accidents, or serious illnesses.

Many pet insurance companies sell combined policies that provide the most complete protection. However, these plans may come with higher premiums. 

What isn’t covered by pet insurance

There are some things that are typically not covered in a standard pet insurance plan, including:

  • Injuries sustained in an organized race or fight.
  • Grooming.
  • Training.
  • Costs associated with breeding.
  • Cosmetic or elective procedures.
  • Pre-existing conditions.
  • Routine or preventative care.

You can purchase coverage for routine or preventative care by buying a wellness plan for your pet. You can also find pet insurance or pet insurance add-ons for breeding dogs and cats.

Types of pet insurance

There are several types of pet insurance that provide coverage for different expenses and conditions. Most insurance companies that sell pet insurance, like Lemonade and Metlife Pet Insurance, offer several types of plans or add-ons, depending on your needs.

Accident-only coverage

Accident-only pet insurance covers the cost of treatment after an accident. Under this plan, things like injuries stemming from a car accident, broken bones, lacerations, and x-rays are usually covered. It doesn’t cover costs that are not related to the accident, or accidents that were caused by a pre-existing condition.

Pros:

  • Accident-only coverage has lower premiums than accident and illness coverage.
  • Plans that cover illnesses typically don’t cover pre-existing conditions, and they cost more than accident-only coverage.

Cons:

  • These plans won’t help if your pet develops a health condition unrelated to an accident. 

Accident and illness coverage

Accident and illness plans provide the same coverage as accident-only plans, but they also cover treatment for a variety of illnesses. Examples of covered conditions may include cancer, hereditary conditions, arthritis, and hypothyroidism. It will also pay for the cost of a veterinary exam, medications, hospitalization, and surgery. 

Pros:

  • Accident and illness coverage provides complete protection for accidents and illnesses.
  • This coverage can be useful if your pet may be prone to certain conditions, but has not developed the condition yet. 

Cons:

  • These have more expensive premiums than accident coverage.
  • These plans do not cover routine care.
  • Some plans have a waiting period.
  • Pre-existing conditions are not usually covered.

Wellness plans

A wellness pet insurance plan provides coverage for basic care, such as routine veterinary exams, vaccines, medications, and dental care. This policy is sometimes sold as an add-on to an accident-only or accident and illness policy.

Pros:

  • Premiums for some wellness plans are less than $20 or $30 a month.
  • Since wellness plans cover  routine care services your pet will most likely need, you’ll actually use the coverage. 

Cons:

  • These plans do not generally cover accidents, injuries, or illnesses.

How does pet insurance work?

In many ways, pet insurance is like regular health insurance. After a visit to the vet, you’ll pay for your pet’s care. Make sure you get a receipt and any other documentation you might need. Then,submit a claim to your pet insurance provider. Once the claim is approved, you get reimbursed for the service.

Many pet insurance policies also have a deductible, annual coverage limit, and reimbursement rate for each service. 

The deductible is the amount you need to pay in covered pet care costs before the insurance company will start paying.

The annual coverage limit is the maximum amount of money your insurance provider will pay for all medical services for the year. Once you reach the annual coverage limit, your insurance company is not required to continue paying for your pet’s care. 

The reimbursement rate is the amount that your insurance company will pay for a covered service after the deductible is met. It usually covers 80% to 90% of the cost. 

Waiting periods

Some pet insurance plans have a waiting period before you can use the benefits. For example, Lemonade’s waiting period is two days for accidents, 14 days for illnesses, and six months for cruciate ligament issues.

How much is pet insurance?

The cost of pet insurance depends on a variety of factors. Some of the criteria that insurance companies use to calculate premiums include:

  • Type of plan
  • Pet breed
  • Pet age
  • Annual coverage limit
  • Deductible

Because the cost of pet insurance can vary, it’s a good idea to get several quotes and compare them. Comparing quotes can help you find the most affordable pet insurance for your situation and your coverage needs.

Is pet insurance right for you?

Pet insurance can be a great investment for some pet owners, but it’s not right for others.

For example, if your pet is young and healthy, and is not at risk of developing medical issues, pet insurance might not be worth the cost. You might want to consider accident or wellness coverage if regular pet insurance isn’t the right fit for you.

On the other hand, pet insurance can be very valuable if your pet is older, or their breed is likely to develop certain conditions. If you’re concerned about paying for unexpected medical expenses out-of-pocket, pet insurance can also provide some peace of mind.

Frequently asked questions (FAQs)

Does pet insurance cover all expenses?

The best pet insurance companies provide comprehensive coverage for various medical expenses, but not everything is covered. Depending on the type of pet insurance policy you purchase, it might cover routine care, vaccines, accidents, injuries, illnesses, and diagnostic testing. However, some things, like grooming, cosmetic procedures, and pre-existing conditions are usually not covered.

What is a typical deductible for pet insurance?

Most pet insurance policies have a deductible, which typically ranges from $100 to $1,000. Higher and lower deductibles may be available depending on the insurer.  In general, plans with a higher deductible will have a lower monthly premium. 

Does pet insurance cover hip dysplasia?

Some accident and illness pet insurance plans cover hip dysplasia, but not all plans do. It’s also common for pet insurance plans to have a waiting period before you can use the benefits for hip dysplasia. For instance, you might have to wait several weeks before your pet can get treated for this condition.

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