Pet Health Insurance 101: Your Policy Shopping Checklist

3. Other exclusions. Plenty of pets will someday suffer from conditions that are pointedly excluded from many policies. Cancers, chronic diseases and congenital diseases (those they may have been born with) are examples.

Moreover, if you have a purebred pet, you’ll be interested to know that genetic conditions (suffered most often by purebreds) aren’t covered by all pet health insurance plans. That includes diseases with known hereditary origins, whether in a purebred or mix.

The flip side is that policies with lots of exclusions may be less expensive.

4. Reimbursement policies. It’s important to know how your insurance carrier calculates how much you deserve to be reimbursed. Does it reimburse you a set amount whether your veterinarian charges more for one visit than another? Whether you see a specialist or a generalist?

Some will reimburse only what they deem a “usual and customary” fee, while others reimburse a flat percentage of whatever your veterinarian charges. The issue is especially important for those whose veterinarians tend toward the higher end of the market and those who frequent specialists. But take note: You may pay more for that privilege.

5. Maximum coverage amounts. Almost all policies have caps on how much they’ll pay out. Those maximum coverage amounts may include caps on coverage per incident, per year, per lifetime and/or per body system (such as gastrointestinal coverage, skin disease coverage, etc.). Those that reimburse using a “usual and customary” fee schedule may also cap their payouts at a predetermined level based on their company’s fee structure.

6. Deductible options. Nearly every plan offers a deductible you must first satisfy before you can be reimbursed. It can be as much as $1,000. Be sure you know how big a deductible you can afford and how often you have to satisfy it. (Per year? Per lifetime? Per condition? Per body system?)


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