The world of health insurance can be confusing, but, in general, pet health insurance is more straightforward than human health insurance. In fact, pet insurance operates similarly to car or home insurance, rather than to human health insurance. Our Gentle Touch Animal Hospital team answers common questions about pet health insurance, to clear up any confusion.

Question: How do I know which veterinarians accept pet health insurance?

Answer: Pet health insurance differs from human health insurance in that it is universally accepted by any licensed veterinarian. You do not need to search for veterinarians in your network, or worry about out-of-network fees. Once you have signed up your pet for an insurance policy, you can continue seeing your favorite veterinarian at Gentle Touch Animal Hospital.

Q: What is the difference between deductible types for pet insurance?

A: In general, pet insurance companies provide two types of deductibles—a per-incident deductible and an annual deductible. Annual deductibles work best if you foresee your pet undergoing several incidents that require veterinary care. A puppy with a penchant for eating things they shouldn’t is a great example of a pet who should have a policy with an annual deductible. Keep in mind that the tradeoff with a low deductible—whether per-incident or annual—is a high premium. Determine whether you’re more comfortable with a lower fixed monthly rate, or want to pay less out of pocket.

Q: What does a pet insurance company mean when benefits are not capped?

A: Some pet insurance policies have limits on the amount paid in claims for your pet. Some policies have no limits, but these come at a higher premium. If you choose a policy that caps your pet’s benefits, the payout will be limited. Payout limits are typically divided into five categories:

  • Maximum payout per incident — Each separate illness or injury will reach a maximum payout amount. Once you hit that limit, the insurance company will not reimburse any additional expenses.
  • Maximum payout per year — Once you reach the limit your insurance company has set for a 12-month period, they will not provide reimbursement until the next year.
  • Maximum lifetime payout — If your pet experiences a multitude of health issues, they may reach their maximum lifetime payout, and the insurance company will not provide reimbursement above that cap.
  • Maximum payout per body system — After hitting the limit for a particular body system (e.g., digestive system, musculoskeletal system), the insurance company will not provide reimbursement for additional expenses for illnesses or injuries associated with that body system.
  • Maximum payout based on a schedule of benefits —This is the maximum amount the insurance company will reimburse, based on a listing of allowances for health conditions.

Depending on your needs, you may choose a policy with no maximum payout limit.

Q: What are congenital and hereditary conditions in pets?

A: Congenital conditions begin while your pet is developing in utero. Examples include heart defects, a cleft palate, or organ or limb abnormalities. These issues are typically present at birth, and will likely need immediate care to help your pet have a healthy life. An hereditary condition is one that is linked to genetics, meaning the problem was passed down by your pet’s parents. Examples include allergies, cherry eye, and hip dysplasia. These conditions can take years to appear in an otherwise healthy pet, so you should purchase an insurance policy that covers congenital and hereditary conditions, whether or not your pet’s breed is prone to health issues.

Q: Why aren’t pre-existing conditions covered by pet health insurance?

A: Pre-existing conditions, which are health conditions that occurred before your insurance policy’s start date, are not covered by insurance, because this would allow owners to purchase a policy after their pet was sick or injured, and then cancel the policy once they received reimbursement. Insurance companies could not exist in this case, so policies never cover pre-existing conditions. To ensure your pet will be covered for as many health conditions as possible, purchase a policy the day you bring your four-legged companion home.

Q: What veterinary services do pet health insurance policies cover?

A: Pet insurance policies are typically divided into three major categories:

  • Accident coverage — These plans cover emergency situations that require immediate care. Broken bones, bite wounds, lacerations, and toxin and foreign body ingestion are common issues covered by accident-only plans. Since these plans cover the minimum of pet health issues, they’re typically the most affordable, and can provide peace of mind in an emergency.
  • Accident and illness coverage — Accident and illness plans provide coverage for emergencies and sudden illnesses, such as allergies, urinary tract infections, gastroenteritis, and cancer. Diagnostic testing and treatments for illnesses and injuries are covered under this plan.
  • Wellness coverage — A wellness policy covers typical preventive care services, such as annual physical exams, spay and neuter procedures, screening tests, vaccinations, dental cleanings, and parasite prevention.

Before you purchase a pet insurance policy, your pet will likely need a physical exam, to ensure they do not have any pre-existing conditions. Contact our Gentle Touch Animal Hospital team to schedule an appointment, or for more information on pet health insurance.