PET INSURANCE BASICS
OPTIONS AND VOCABULARY: DECIDING WHAT YOU WANT
“Per Condition” versus “Annual”
Your insurance will kick in once you have paid a deductible (we'll cover that in more detail later). Your first decision will be whether you want your deductible to be annual or "per condition."
Insurance with an annual deductible lumps your pet's medical conditions for the year together and after you have paid a deductible towards your pet's assorted illnesses, the insurance kicks in for the rest of the year.
Example: In a given year, your pet has an upset stomach, a bite wound, and an ear infection. If the total expenses for these conditions adds up to meet or exceed your deductible, your insurance kicks in for the rest of the year. Next year you have a new deductible to meet before the insurance kicks in again.
With "per condition" insurance, each medical condition has its own deductible but once that deductible has been met, insurance kicks in for the life of the pet at least with respect to that condition.
Example: That same pet with the upset stomach, bite wound, and ear infection will have to meet the deductible on each of those conditions separately. If the conditions are simple, none of them may meet the deductible but, on the other hand, if one of those conditions end up recurrent, eventually the deductible will be met and insurance will pay on that condition for life.
Per condition tends to be better for older pets or dog breeds with genetic issues
The cap is the maximum paid by the insurance company. You either want no cap or a very high cap (at least $8000). Insurance with a low cap will not reliably cover a major illness in this city and the last thing you want is to max out your insurance payment when you need more. The cap can be annual or per condition as well.
The Deductible (you typically pick from $0 to $1000)
This is what you pay before the insurance kicks in. If you have an annual deductible, this is the amount you pay per year for covered conditions before insurance kicks in and next year you have to pay it again before insurance kicks in. If you have per condition insurance, this is the amount you pay for a given disease/condition before insurance kicks in.
If you pick a very high deductible to get a lower premium,
Percent Covered (How much your insurance will pay)
After you pay your deductible, insurance kicks in and pays a percentage of your expenses here on out (for life if you have a Per condition deductible or for the rest of the year if you have an annual deductible). How much of your bill will they pay? You get to pick generally between 70 and 100%. The higher the percentage they pay out, the higher your monthly premium (your monthly insurance bill) will be. It will likely be 100%, 90%, 80%, or 70%. Obviously, the higher the percent covered, the less you have to pay out of pocket. Some policies do not have options: they simply cover 90%. Others let you pick your percent covered so you have more control over your premium.
When you sign up for insurance, there is likely to be a waiting period before coverage begins. This period differs between insurance companies or may differ for orthopedic illnesses vs. other illnesses. Some plans do not have a waiting period.
Insurance is made for accident/illness situations but many companies offer “wellness coverage.” Wellness services include: vaccination, flea products, annual examination, teeth cleaning, microchipping, spay/neuter, routine lab testing and more. Since these are services that every pet needs, it is possible to budget for them on your own but it may be worthwhile to have them covered through your pet’s insurance.
If you choose to add Wellness coverage, be sure you are not restricted to
The Premium (How Much it Costs)
The “premium” is your monthly payment. The more you want the insurance company to cover, the higher your premium will be. You can control your premium by changing the cap, deductible, and percent covered.
WHAT IS NOT COVERED BY PET INSURANCE
SPECIAL SITUATIONS OTHER CONCERNS
There are special situations that you may want to check into before settling on coverage.
There are currently about a dozen pet insurance companies. Each one will have a premium calculator on its web site so you can determine premium for the options you want. If you are looking for more help making insurance comparisons please visit:
(an independent site put up by a veterinarian who sorted through it all and made an easy to follow format).
Page last updated: 1/10/2020