Pet insurance not only provides a financial safety net, it gives us peace of mind that we can protect our pets when they need us most.
That said, figuring out what your policy does and does not cover can be difficult. Although pet insurance carriers offer similar types of plans, they’re all different. Some might cover your dog’s bad-breath dental cleaning under a wellness package, others under their accident and illness plan, or simply not at all.
To understand your pet insurance coverage, we’ve created a general guide to walk you through the three types of plans available, what they cover, and what they don’t cover.
Want to get specific? Submit your existing pet insurance declaration page and or the entire policy for review, and we’ll let you know what gaps in coverage we find, so you can know exactly how far your pet’s protection goes.
Pet insurance typically is available at three different tiers: accident-only, accident and illness, and wellness care. Higher tiers offer more benefits, which means the pet insurance company will help pay for a broader variety of veterinary bills, but also means those plans cost more.
Although your pet insurance carrier might have a special brand name for them (like how ASPCA calls their accident and illness policy a “Complete Care” package), they’ll usually offer a version of each of these plans:
Want a policy just in case there’s an emergency or accident? That’s accident-only coverage.
These are the lowest-tier plans because they’re only meant to kick in if a true accident happens to your pet. Did your dog eat a grape or get into some chocolate? Did your cat get too excited and eat a bunch of hair ties? That emergency trip to the vet won’t be quite the hit to the wallet with accident-only coverage.
Accident-only plans also provide coverage for injuries caused by car accidents, dog bites, and other emergencies, but they won’t provide coverage for diseases your pet may pick up, or illnesses they may develop. For that, you’ll need the next tier up:
Need coverage for emergencies, but you also want coverage for diseases, cancers, and illnesses? You’ll want an accident and illness policy.
Accident and illness coverage is where pet insurance really shines as peace of mind. A one-time emergency vet clinic is expensive, but it happens one time. If our pet develops cancer, diabetes, hypothyroidism–or any number of other illnesses–those require ongoing care, treatment, and monitoring, and the vet bills add up quickly.
Accident and illness policies help cover the costs of those ongoing treatments, as well as protecting your pet in an emergency.
Coverage examples*
*These examples are commonly covered by these policies, but every plan and pet insurance carrier is different; check the specifics of any policy before signing up.
Looking for a plan that helps cover preventive and routine care? Make sure to add a wellness package onto your policy.
One of the most common misconceptions about pet insurance is that it covers the annual exam, vaccinations, and basic preventative care for your pet. Unless you have a wellness plan attached to your accident-only or accident-and-illness policy, you’ll have to pay for those by yourself.
Unlike accident and illness plans, wellness packages take care of expected veterinary bills.
Paying for a wellness plan upgrade can sometimes cost more than the benefits you’ll get out of it. Ask your veterinarian for the expected annual costs of routine care for your pet (annual exam, dental cleaning, vaccines, etc.), and compare that to how much it would cost with pet insurance to see if a wellness plan makes sense for your pet.
Most pet parents see the most benefit from wellness plans with new puppies and kittens; when their pets receive the preventative treatment to set them up for healthy adult lives.
There are three critical things to know about pet insurance coverage:
Pet insurance plans rarely offer coverage for pre-existing conditions
Coverage doesn’t start until after a waiting period
Most pet insurers don’t pay 100% of the bill–for anything
So when we say something like, “this pet insurance plan offers coverage for hyperthyroidism,” we mean that the pet insurance carrier will pay some percent of the bill if it’s not considered a pre-existing condition and you’re out of the waiting period.
Inadequate coverage could cost you tens of thousands of dollars.
Pet insurance carriers don’t pay for pre-existing conditions, i.e., any illness or injury your pet has prior to you buying pet insurance.
The reason is simple: if people could sign up for pet insurance when they arrived at the emergency vet clinic, and then ditch the policy once their pet was healthy, the pet insurance industry would go bankrupt paying for everyone’s emergency visits.
Only AKC offers coverage for incurable pre-existing conditions. For curable pre-existing conditions, your pet will still need to be “cured” of that condition for a certain length of time (usually six months to one year) before your pet insurance carrier would consider covering it.
Signing up for pet insurance at the emergency vet clinic doesn’t sound like that bad an idea….except that every pet insurance company has waiting periods before their policies kick in.
It’s for the same principle that they don’t cover pre-existing conditions; they can’t force people to keep paying for a plan once the emergency is over, and if they paid for every emergency, the pet insurance company would quickly be out of money.
What if I “don’t know” that my pet has a pre-existing condition? In addition to the waiting period, your pet insurance carrier might require a clean bill of health from the veterinarian before coverage starts.
Like most human health insurance plans, you’re not totally off the hook when it’s time to pay the vet, even with pet insurance. We dive into more detail in our “How Does Pet Insurance Work” article, but here’s the essentials.
Pet insurance plans do cover a lot of injuries and illnesses that may happen to your pet, but there are some exceptions to what your pet insurance company will help pay for.
These conditions or treatments often aren’t covered by pet insurance companies, but make sure to check your specific policy.
If it feels like deciding the right policy is a lot, here are five questions to help out:
2. Do you want to add a wellness package to cover routine and preventive care?
3. Do you want routine dental care to be covered?
4. Is your pet prone to any hereditary or breed-related conditions?
5. Are there any treatments that are “sometimes/usually not covered” that you want to have available to your pet?
Knowing the answers to these questions will help you avoid policies that don’t give your pet adequate protection, ensuring you get the coverage you need.
Want us to review a policy for missing coverage gaps? Submit it to our review tool (it’s free!) and we’ll identify any weak points in your plan.
Inadequate coverage could cost you tens of thousands of dollars.
