What Does Pet Insurance Not Cover?
Key takeaways:
Insurance companies offer two types of pet insurance: accident-only and comprehensive plans. These cover a wide range of accidents and illnesses.
Preexisting conditions and expenses unrelated to injuries and illness are typically not covered by standard pet insurance.
If you want to supplement your pet insurance, you can buy an add-on wellness plan. This rider can help cover the cost of routine preventive care, such as vaccinations.
Table of contents
We love our pets. That’s why we want to do everything we can to keep them healthy. Pet insurance helps many people do that. In 2023, there were 5.6 million insured cats and dogs in the U.S., according to the North American Pet Health Insurance Association (NAPHIA).
A standard pet insurance plan can help cover the expense of injuries and illnesses. But it doesn’t typically cover the routine, preventive costs of keeping your pet healthy.
What is pet insurance?
Pet insurance is a type of health plan that can help cover the cost of veterinary bills. Most pet insurance plans cover dogs and cats. Depending on the plan and add-ons, pet insurance may cover accidents, illnesses, and wellness care.
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What are the different kinds of pet insurance?
Most pet insurance companies offer these types of insurance plans:
Accident and illness: These plans are also known as comprehensive policies. They cover accidents and illnesses, including chronic conditions and infections.
Accident only: Covers the cost of emergency care and treatment after an unexpected injury.
Wellness: This option is for routine checkups, vaccines, and other preventive care. It is sold as a stand-alone plan or as an add-on to comprehensive and accident-only plans.
How do the different types of pet insurance work?
Accident-only coverage
Accident-only pet insurance can help cover the costs of unexpected events, such as broken bones or swallowed objects. This type of plan doesn’t cover treatment for most illnesses.
Accident-only policies are typically the most affordable option. The average annual cost of premiums for these plans in 2023 was $204 for dogs and $116 for cats, according to NAPHIA.
Accident and illness coverage
Accident and illness coverage is also known as comprehensive pet insurance. These plans usually provide the same benefits as accident-only plans. But they also cover treatment for a range of illnesses, from minor infections to serious conditions such as arthritis and cancer.
In 2023, the average yearly cost for comprehensive coverage was $676 for dogs and $383 for cats, according to NAPHIA. Most pet insurance companies exclude coverage for preexisting or genetic conditions.
Pet insurance has two main types. Pet insurance can cover a wide range of accidents and illnesses, which is known as comprehensive coverage, or can be purchased as accident-only plans.
Help with veterinary costs: Pet insurance, charitable organizations, and care at veterinary schools are ways to reduce your vet bills.
Your pet policy and vaccinations: Pet insurance plans typically don’t cover vaccinations, but you can add a wellness or preventive rider to add those benefits.
Wellness coverage
A wellness pet insurance plan, also known as a preventive plan or rider, can help cover routine veterinary care. This can include vaccinations, flea and tick prevention, and annual exams. This type of policy is typically an add-on to an accident-only or accident and illness plan. But it is also sold as a stand-alone plan.
Pet insurance is considered property insurance. But these policies function the way human health plans do. They have premiums, deductibles, and varied benefits, and they may have coverage tiers.
What does pet insurance not cover?
Before purchasing pet insurance, learn about the policy’s benefits and limitations. Here are some of the most common exclusions for standard pet insurance plans:
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Preexisting conditions
If your pet has an illness or injury before the policy start date, that preexisting condition is typically excluded. But some insurance companies will extend coverage after your pet’s condition has been cured for a period of time. Check with your plan provider for more information about coverage for preexisting conditions.
Routine and preventive care
Routine checkups, vaccinations, and dental cleanings are typically not covered. You would need to buy an add-on wellness plan.
Grooming
Pet insurance does not cover grooming services such as haircuts, baths, and nail trimming.
Breeding costs
Costs associated with breeding and pregnancy services, such as fertility treatments, are typically not covered by standard pet insurance.
Cosmetic and elective procedures
Procedures that aren’t medically necessary will not be covered by most pet insurance policies. Examples include anal gland expression and declawing.
Food and nutritional supplements
Special diets are not typically a health plan benefit unless your pet has a covered health condition that requires prescribed food or supplements.
End-of-life costs
Cremation and burial expenses are not covered by most pet insurance plans. But some policies offer these benefits. You might consider a pet life insurance policy, known as animal mortality coverage, to get these benefits.
Can you buy add-on coverage for a pet insurance policy?
Most pet insurance companies let you buy add-on coverage with your standard pet health plan. This is known as a rider. A pet wellness plan is the most common add-on. It provides coverage for routine preventive care. Depending on your insurance provider, you can choose from different tiers of wellness coverage.
Basic wellness plans
This tier typically covers the following services:
Routine checkups
Fecal tests
Heartworm screenings
Deworming
The monthly cost for a basic wellness plan can be less than $10 a month.
Comprehensive wellness plans
This tier provides more extensive benefits and typically covers what’s included in basic wellness plans as well as the following services:
Microchipping
Dental cleanings
Parasite prevention
Bloodwork and urine tests
Dietary supplements
Alternative therapies
The monthly cost for a comprehensive wellness add-on can exceed $46 for plans with the most benefits.
Is pet insurance worth it?
The value of pet insurance will depend on several factors, including:
Your pet’s health
Your pet’s breed
Your pet’s age
Your financial situation
In some situations, pet parents don’t get pet insurance if the costs of coverage exceed what you expect to pay for care. It’s also best to compare insurance policies based on their deductibles, benefits, coverage limits, and exclusions.
Pet insurance can be worth it if:
You want financial protection
Pet insurance was designed to help save you from significant out-of-pocket expenses, especially for accidents and chronic conditions. But most insurance companies increase premiums as your pet ages. This can make pet insurance unaffordable over time.
Your pet is prone to health issues
Some breeds are more susceptible to costly medical conditions. For these pets, insurance can be beneficial if you enroll while they are young and healthy.
You want peace of mind
You’ll be able to access medical care for your pet based on need, rather than cost. This can help reduce the financial and emotional toll that can come with caring for your pet.
How can you save on pet healthcare that your pet insurance doesn’t cover?
If your pet insurance plan doesn’t offer needed benefits — or you don’t have a pet health plan — there are ways to reduce the costs of your pet’s healthcare:
Preventive care: Maintaining a schedule of checkups and vaccinations can help keep your pet healthy. This can also help your veterinarian screen for illnesses before they become advanced conditions, which are more costly to treat.
Discount programs: Many insurance companies that offer home and auto policies will give you a multipolicy discount for bundling coverage with your pet insurance.
Nonprofit animal groups: Organizations like the Animal Health Foundation and The Humane Society can connect you with financial assistance programs that may be able to help you cover the costs of pet healthcare.
GoodRx savings: Using GoodRx can help you find the lowest prices on pet medications.
Can you appeal a pet insurance claim denial?
If your pet insurance claim is denied, you can appeal the decision. First, review your plan’s benefits and any information related to the denied claim. Next, gather all necessary documentation. This includes medical records, lab tests, and vet bills related to the claim. Then follow your insurance company’s appeals process.
An appeal doesn’t guarantee that your claim will be approved. But a denial can be reversed if you convince your pet insurance company that there was an error or oversight.
The bottom line
Standard pet insurance typically covers veterinary expenses associated with injuries and illnesses. Most standard pet health plans don’t include preventive benefits, such as coverage for vaccinations and checkups. You can add a wellness rider to your standard plan or buy a stand-alone wellness plan to help cover preventive care.
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References
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Bourne, M. (2024). Animal mortality insurance. U.S. News & World Report.
Consumers’ Checkbook. (n.d.). Pet insurance. Center for the Study of Services.
Delfino, D. (2024). What is pet life insurance? U.S. News & World Report.
Goodnight, D. (2020). Pet insurance. VCA Animal Hospitals.
Hawkins, A., et al. (2024). What does pet insurance cover? MarketWatch Guides.
Hiles, C. (2024). Pet wellness plans for 2024. Time.
The Humane Society of the United States. (n.d.). Are you having trouble affording your pet?
Kilroy, A. (2023). How to file a pet insurance claim: A step-by-step guide. Forbes.
Liberty Mutual Insurance. (n.d.). What does pet insurance cover?
Nationwide. (n.d.). What’s not covered.
North American Pet Health Insurance Association. (n.d.). Section #2: Total pets insured.
North American Pet Health Insurance Association. (n.d.). Section #3: Average premiums.
Rivelli, E. (2024). Pet insurance coverage: An essential guide. Time.
