What does pet insurance cover?

Most comprehensive accident-and-illness pet insurance policies are designed to cover eligible veterinary expenses resulting from unexpected accidents and illnesses.

Depending on your policy, coverage may include:

• Accidents and injuries
• New illnesses
• Emergency veterinary care
• Surgery
• Hospitalization
• Diagnostic tests
• X-rays, MRIs and CT scans
• Cancer diagnosis and treatment
• Prescription medications
• Specialist veterinary care
• Hereditary and congenital conditions
• Chronic conditions

Coverage varies between insurers, and exclusions, waiting periods, deductibles and limits can apply.

Accident coverage is a core part of most pet insurance plans.

For example, your policy may help cover eligible veterinary expenses if your pet:

• Breaks a bone
• Is injured in an accident
• Swallows a foreign object
• Is bitten or attacked by another animal
• Suffers a cut or wound
• Accidentally ingests something toxic
• Tears a ligament

Treatment could involve an emergency exam, diagnostic tests, surgery, hospitalization and medication—all of which can quickly add up.

Accident-and-illness plans can also cover many new illnesses that develop after your policy takes effect and applicable waiting periods have passed.

These may include:

Cancer

Eligible diagnostics, surgery, chemotherapy and other treatments may be covered.

Infections

Treatment for new ear, urinary, respiratory and other infections may qualify.

Digestive problems

Diagnostic tests, medication and treatment for eligible gastrointestinal illnesses may be covered.

Chronic conditions

Conditions such as diabetes or arthritis may be covered if they aren't considered pre-existing and otherwise meet the policy's terms.

Coverage can continue to be particularly valuable when a condition requires treatment over months or years.

Many medically necessary surgeries for covered accidents and illnesses can be eligible for reimbursement.

This might include surgery for:

• ACL/CCL injuries
• Broken bones
• Foreign-object removal
• Cancer
• Bloat/GDV
• Certain orthopedic conditions
• Other covered illnesses and injuries

Whether a particular procedure is covered will depend on why it's required and the terms of your policy.

For example, surgery relating to a condition that existed before your coverage began may be excluded as pre-existing.

Many accident-and-illness policies can cover eligible treatment at emergency veterinary hospitals.

Imagine your dog suddenly becomes seriously ill on a Sunday evening and needs an emergency exam, diagnostic imaging, surgery and overnight hospitalization.

The resulting bill could run into thousands of dollars.

Pet insurance can help reimburse eligible expenses, subject to your policy's deductible, reimbursement rate, exclusions and coverage limits.

Diagnostic testing can be a significant part of a veterinary bill.

Depending on your plan, eligible tests used to diagnose a covered condition may include:

• Blood tests
• Urinalysis
• X-rays
• Ultrasounds
• CT scans
• MRI scans
• Biopsies
• Laboratory testing

It's worth checking whether your policy also covers the veterinary exam or consultation fee associated with diagnosing the condition, as this can vary.

Many accident-and-illness policies cover prescription medications used to treat an eligible condition.

That can be particularly important for pets that develop conditions requiring ongoing medication.

Coverage for prescription diets, supplements and other therapies can vary considerably, so check the individual policy if these benefits are important to you.

Pet insurance doesn't cover every veterinary expense.

Common exclusions can include:

• Pre-existing conditions
• Routine checkups and preventive care
• Vaccinations
• Spaying and neutering
• Routine dental cleaning
• Grooming
• Non-medically necessary or elective procedures
• Treatment excluded under the specific policy

Routine and preventive care may be available through an optional wellness plan or add-on from some providers.

Generally, pet insurance is designed to cover new and unexpected conditions, rather than medical problems that existed before coverage began.

A condition may potentially be considered pre-existing if your pet showed signs or symptoms before enrollment or during an applicable waiting period—even if the condition hadn't yet received a formal diagnosis.

Definitions vary between insurers. Some policies may treat certain curable pre-existing conditions differently after a specified symptom- and treatment-free period.

That's why it's important to understand an insurer's definition of a pre-existing condition before buying.

Many comprehensive policies can cover eligible hereditary and congenital conditions, provided they're not pre-existing and aren't otherwise excluded.

This can be particularly relevant for breeds predisposed to conditions such as hip dysplasia, heart problems or certain orthopedic disorders.

However, coverage varies considerably between plans, so breed-specific risks are worth considering when comparing policies.

Standard accident-and-illness pet insurance generally isn't designed to cover predictable routine expenses.

These can include things like:

Vaccinations • Annual wellness exams • Flea and tick prevention • Routine dental cleaning • Spaying and neutering

Some insurers offer optional wellness or preventive-care plans that can help with these expenses.

It's therefore important to distinguish between insurance for unexpected medical expenses and wellness coverage for routine care.

Being “covered” doesn't necessarily mean the insurer pays the entire bill.

Imagine you have $5,000 in eligible veterinary expenses.

Depending on the policy, you may need to account for:

Your deductible

The amount you're responsible for under your policy before reimbursement applies.

Your reimbursement percentage

For example, 70%, 80% or 90%.

Your coverage limit

The maximum the policy will reimburse, if applicable.

Non-covered expenses

Parts of the bill that aren't eligible under your policy.

Understanding all four is important when comparing coverage.

Don't compare pet insurance based on monthly price alone.

Consider what would happen if your pet developed a serious illness or needed expensive emergency treatment.

Look at:

• What's covered
• What's excluded
• Annual coverage limits
• Deductible options
• Reimbursement percentages
• Waiting periods
• Coverage for hereditary conditions
• Prescription medication coverage
• Exam-fee coverage
• Emergency and specialist care

The best policy for you is one that provides the protection you want at a price you're comfortable paying.

Pet insurance policies can look similar at first glance, but there can be important differences in what's covered—and what's not.

Comparing plans side by side can help you understand which policies provide the coverage that matters most for your pet.

Coverage varies by insurer and policy. Exclusions, waiting periods, deductibles, reimbursement rates and coverage limits may apply. Always review the policy terms before purchasing.