Pets have increasingly become more than just animals. They have taken on more central roles in our homes. Today, they’re more like family members than animals. That shift has brought several other changes, particularly in terms of how much money pet owners spend on their companions, and where those funds go in terms of pet products and services.
Surprisingly, or maybe not so much for those who’ve been pet owners for many years, medical procedures and pharmaceuticals now take a bigger bite from our annual budgets than ever before. In fact, a study entitled The Economic and Social Contributions of the Animal Health Industry found that the average family spent between $9,000 and $13,000 on medical treatments over the life of their pet. According to Statista, vet care alone in the US generates $18.98 billion per year in sales, with an overall market value of $50.1 billion.
That’s a significant amount of money -- more than many families can comfortably afford. Pet insurance plans can help to offset the financial burden while ensuring your pet has the quality care and drugs necessary for a happy, comfortable life. However, what does pet insurance cover?
It is easier to consider conditions and situations that pet insurance does not cover, rather than what a policy will include.
The Unexpected
Perhaps the most important consideration when considering insurance coverage for your pet is that these policies are designed to cover the unexpected, rather than the routine. Animal insurance does not work in the same way that health insurance for humans does. It’s more like car insurance in that it only kicks in when there’s an emergency or your pet needs unexpected care and treatment.
What falls under the heading of “unexpected”? What does pet insurance cover, really? With some caveats, a brief rundown would include:
- Bloat
- Poisoning
- Cuts
- Cancer (not preexisting)
- Pets hit by vehicles
- Ingesting foreign bodies
- Diseases spread by ticks
- Prescription medications for treating a covered condition, such as:
- Insulin and related supplies
- Antibiotics
- Eye drops
- Ear drops
- Allergy medications
- Alternative therapies for covered conditions, such as:
- Chiropractic care
- Acupuncture
- Hydrotherapy
Breeding/Whelping Related Conditions
When asking what does pet insurance cover, you will find that breeding, pregnancy, and whelping are often excluded. While this depends on the insurance provider in question, most companies exclude any and all related conditions. Pet insurance also typically does not cover the costs of spaying or neutering, but some wellness plans may.
Preexisting Conditions
When it comes to what does pet insurance cover, you’ll find preexisting conditions on the exclusions list. What counts as a preexisting condition, though? Pet insurance companies all have their own definition, but they tend to be similar in that they usually exclude injuries, illnesses, or conditions with signs or symptoms exhibited within 18 months prior to purchasing the pet insurance policy.
Additionally, some pet insurance providers also exclude specific health conditions that were diagnosed and recur within a year of the last treatment/diagnosis. These usually include bladder infections, urinary tract infections, respiratory infections, and GI tract disorders, among others. Diabetes, cancer, skin lumps, hyper and hypothyroidism and other incurable conditions are usually permanently excluded if a veterinarian has diagnosed your pet with them at any point.
Bilateral Conditions
A bilateral condition is one that is likely to occur on both sides of your pet – such as hip dysplasia. Most insurers will only cover bilateral conditions if there is no pre-existing condition component. For instance, if your pet was diagnosed with hip dysplasia and was treated, and you subsequently purchased pet insurance and your pet developed symptoms in the opposite hip, treatment would not be covered. However, most insurers will cover bilateral conditions that have not previously been diagnosed. Still, this varies from insurer to insurer, so be sure to refer to your policy’s specific list of exclusions.
Abuse-Related Injuries
According to the American Veterinary Medical Association (AVMA®), 70 million pet dogs and 74.1 million pet cats live in US homes. In homes where domestic abuse occurs, there is a significant chance that the abuser will also target the pet, according to the Humane Society. Pet insurance policies do not cover injuries sustained due to abuse by an owner, or anyone within the owner’s household.
Regular Care
If you’re looking to pet insurance to make regular care for your beloved pet more affordable, you may be in for a surprise. Most pet insurance companies do not cover regular treatments and preventative care. That means your annual vaccines are not covered, nor are regular checkups. As a rule of thumb, ask yourself: is this treatment, vaccine, or vet visit something that is predictable and that could be planned for? If so, chances are good it’s not covered by your pet insurance. Coverage for preventative care and routine check-ups are typically available through separate wellness plans.
Neglect and Cruelty
When it comes to determining what does pet insurance cover, you’ll find that injuries, illnesses, and other conditions related to any form of neglect or form of animal cruelty are excluded. This includes any form of animal fighting, such as cockfighting or dogfighting.
Racing
Animal racing is popular (and legal) in many areas of the country, despite evidence that it often leads to situations of neglect, cruelty, and abuse. Injuries, medical conditions, and illnesses that trace back to racing and similar activities are not covered.
DNA Testing
Yes, DNA tests are incredibly popular today, including those designed for pets. They seem like a great way to determine exactly what the genetic makeup of your pet might be. While that can provide you with useful information, you’ll find that your pet insurance policy doesn’t cover the test. You’ll need to pay out of pocket to find out what breeds went into your beloved dog or cat’s background.
Cosmetic Procedures
Those asking themselves what does pet insurance cover will find that many cosmetic procedures fall on the exclusions list. Unless deemed medically necessary, ear cropping, claw removal, tail docking, and similar procedures are not covered. Note that this also includes other “regular care” items, such as grooming and nail trimming.
Choosing the Right Pet Insurance
When seeking an answer to the question of what does pet insurance cover, you will need to make an informed comparison of your options. Many pet insurance providers exist, but their covered conditions and exclusions can vary significantly. You may also need to make several other considerations when shopping around for pet insurance.
For instance, if you have an older pet, it might be better to purchase an accident-only plan, particularly if your pet has a pre-existing condition that excludes it from other types of coverage. You might also consider purchasing specific prescription drug coverage plans, or a separate dental care plan. Other pets will benefit more from a standard pet insurance plan.
When shopping around, make certain to consider other factors beyond what’s covered by the insurer. Think about your premiums, as well as the amount of your deductible. Often, a higher deductible will help reduce monthly premiums, but could you realistically pay that deductible if something were to happen and your pet needed immediate care?
You should also determine whether the policy has per-incident limits in place, or if there are other limitations that might limit the plan’s protection for your pet or usability in the case that you need it.
Conclusion
Ultimately, pet insurance can help you save money on unexpected medical costs for your pet, but it pays to shop around and find the right plan for you and your pet.
