Pet health insurance is a smart investment for many owners. It can help relieve the burden of expensive health care. It can make the difference between leaving an injured or ill pet untreated and giving them life-saving care. However, this doesn’t mean it’s appropriate or feasible for every pet. When determining if health insurance is right for your pet or which one is best, there is much information to consider.
In recent years, interest in health insurance for pets has increased significantly, as has the number of insured pets. Insurance can save owners considerable money, provide peace of mind, and prevent owners from having to make tough calls if care becomes too costly.
Some statistics to consider:
As interest in pet insurance rises, various groups continue to conduct more and larger studies on the subject.
According to a recent Market Watch survey of pet owners:
- Respondents without insurance who said they’re unsure about it and its worth—36%
- Those with insurance who do not regret getting it—99.5%
- Those with insurance who think it’s worth it—85%
- Those who said they’d lost a pet because they couldn’t afford veterinary care—16%
- Those who said they’ve avoided taking their pet(s) to a veterinarian to prevent a high bill—33%
According to a recent Forbes Advisor survey of pet owners:
- Dog owners who said they’re very or somewhat concerned about having means to pay an unexpected veterinary bill—50%
- Pet owners who said they’d have difficulty paying a surprise veterinary bill amid inflation—63%
- Those who said they can’t cover a surprise veterinary bill of $999 or less without going into debt—42%
Results of these and other surveys show pet health insurance in a favorable light. These surveys and statistics can help provide a snapshot of peoples’ experiences and concerns with and without pet insurance. However, there are many other factors to consider before deciding if insurance makes sense.
How to know if pet insurance is right for you
To determine if health insurance is right for you and your pet, do plenty of research and weigh several important factors:
- How old is your pet?
- Is your pet healthy?
- Is your pet’s breed prone to certain health issues?
- Does your pet have pre-existing conditions?
- Are you able to pay an unexpected veterinarian bill if your pet is injured?
- Are you able to pay in full for diagnosis and ongoing care for an illness?
Some answers will influence whether a company will insure your pet, how much you’ll pay for pet health insurance, and how much and what types of coverage you can get.
Some insurance companies have age restrictions on the pets they accept as insured. Others that insure older pets may be expensive. Most will not cover preexisting conditions.
Likelihood of disease is one major consideration. There are several common diseases and conditions that arise or become exacerbated later in life. For example, some canine breeds are predisposed to hip dysplasia. Kidney or urinary tract disease, diabetes, and joint disease are common ailments in aging pets. Purchasing insurance early can help with expensive bills later for diagnosis and treatment (including medication, therapy, or surgery) for a pet. That said, some companies will not insure certain breeds or cover certain conditions, so it’s essential to read fine print and make inquiries.
Pet health insurance may make sense for you if:
- Your pet is young, healthy, and/or predisposed to disease
- You cannot afford a large medical bill
- Having insurance comforts you in knowing you’re better able to cover emergencies
Pet health insurance may not be right for you if:
- Your pet is elderly and/or already suffering from health issues or a disease that insurers likely won’t cover
- You’re able to afford large veterinary bills if they arise
What to consider when shopping for pet health insurance
Two major considerations when shopping for insurance are budget and coverage.
If you’re shopping for health insurance for pets, find the one that’s right for you by comparing these specifics:
- Annual deductible amounts
- Premium amounts
- Percentage of reimbursement (typically between 70% and 90% of covered expenses)
- Price increases or coverage changes with age
- Price increases or coverage changes with residence change (out of state)
- Annual cap on payout amount
- Packages offered—including add-ons such as preventive care coverage and routine care/wellness plans
- Covered conditions including preexisting
- Breed or age restrictions (some companies won’t insure certain breeds or may have age limits)
- Waiting period before coverage begins
- Policy requirements regarding clients’ duty of care
There are many pet health insurance companies and a few typical coverage options. These include accident and illness (A&I), accident only (AO), and routine care or wellness add-on plans. Some companies also offer coverage for diagnosis and treatment of behavioral issues.
Each year, The North American Pet Health Insurance Association (NAPHIA) releases its State of the Industry Report (SOI Report). The average costs for premiums in the US according to the 2024 report were:
- Accident and illness policies for dogs—$675.61 annually and $56.30 monthly
- Accident only policies for dogs—$204.16 annually and $17.01 monthly
- Accident and illness policies for cats—$383.30 annually and $31.94 monthly
- Accident only policies for cats—$116.11 annually and $9.68 monthly
This gives a rough look at insurance premiums for pets; however, this is average and there are many insurance companies. These numbers will vary based on many factors including individual companies, the health and age of individual pets, and location. These numbers are likely to change over time.
Once settled on an acceptable amount you’ll pay in premiums, deductibles, and reimbursement percentage, it’s vital to understand if and how those numbers may change in the future. As pets age, prices of premiums may rise. If you move to a different state, prices may also increase (or decrease), or you may have to cancel a current policy and begin a new one.
Before committing, investigate and understand what exactly an insurance policy and any add-ons will cover and under what circumstances. Carefully read all fine print and ask questions about anything unclear or unstated. Look for specific stipulation, exemptions, and insured responsibilities.
For example, insurers may or may not reimburse for medication, supplements, or prescription food, while others may cover them under specific circumstances. Say a veterinarian recommends supplements for overall health or disease prevention. The insurer may refuse coverage if they aren’t treating a specific diagnosed illness.
Additionally, insurers may deny claims for treatment of illness or emergencies if clients fail to meet duty of care. If a dog or cat has a dental emergency such as a broken or abscessed tooth (that would typically be covered under the policy), an insurer may deny the claim without proof of routine dental care.
Similar stipulations are often in place requiring routine wellness exams and vaccinations, which prevent illness. Most insurers request veterinarian records upon signing and with each claim submitted.
Another element to be aware of when shopping insurance companies is the waiting period between obtaining insurance and the start of coverage. Waiting times are typical for most insurance companies and can vary by condition. Accident coverage may have a small (or even no) waiting period, while illness may have a longer waiting time of several weeks. Some insurers have waiting periods up to several months for specific conditions.
The most common conditions claimed under pet health insurance
Not surprisingly, the conditions most claimed under insurance policies are consistently some of the most common and costly conditions veterinarians see. According to a recent database analysis of 1.2 million Nationwide insured pets, they are as follows:
Canines
- Dermatitis
- Gastroenteritis (diarrhea, vomiting, stomach upset)
- Otitis externa (ear infection)
- Degenerative arthritis
- Trauma
- Dental disease
- Urinary tract infection
- Heart disease
- Respiratory infection
- Liver disease
Felines
- Gastroenteritis (diarrhea, vomiting, stomach upset)
- Urinary tract infection
- Kidney failure
- Dental disease
- Degenerative arthritis
- Hyperthyroidism
- Respiratory infection
- Diabetes mellitus
- Inflammatory bowel disease
- Dermatitis
How pet health insurance works
Many who consider insurance for their pets wonder how the claims process works and what happens at the time of service. Typically, owners are responsible for all veterinary care at the time of service. They then submit a claim to their insurance provider for reimbursement. Most insurance companies require owners to pay an annual deductible amount before they begin paying a percentage of health care costs.
One example of how this would look:
Say an insurance company pays 80% of veterinary costs after an owner meets an annual $250 deductible. The owner has a veterinary bill of $1000 for a covered illness. The owner pays the full $1000 at the time of service and then submits a claim to insurance.
The insurance will subtract the annual deductible amount of $250, and pay 80% of the remainder of the bill, which is $600. For each veterinary bill that falls under coverage for the rest of the year, the insurance company will reimburse 80%.
Alternatives to pet health insurance
For those who cannot budget for insurance coverage or for whom it doesn’t make sense for any reason, there are other options for help affording healthcare for pets:
- Many cities and states have local resources and programs for low-income households
- Local animal charities and rescue groups may be able to help with veterinary care
- The Humane Society has a generous compilation of resources for those needing assistance with pet care including medical funding, food, and other supplies
- Apply for a credit card designed specifically for medical care
- Set up a savings account reserved for pet healthcare expenses with automatic monthly deposits
To conclude, pet insurance can relieve much of the burden of expensive care. If you’re considering purchasing pet health insurance, read all the fine print and question everything. To avoid any surprises down the line, if you can’t find all important information in a quote or a contract, call and speak with someone who can clarify. Make sure you understand the contents of a contract before signing. This is vital to understanding which insurance is right for you and your pet and to making sure your expectations are set correctly.
References
Are you having trouble affording your pet? The Humane Society of the United States. https://www.humanesociety.org/resources/are-you-having-trouble-affording-your-pet
Insurance NM. Dermatitis, gastroenteritis among most common conditions that prompt veterinary visits. Dermatitis, Gastroenteritis Among Most Common Conditions That Prompt Veterinary Visits. Published September 12, 2024.
Megna M. Pet Ownership Statistics 2024. Forbes Advisor. Published January 25, 2024. https://www.forbes.com/advisor/pet-insurance/pet-ownership-statistics/
North American Pet Health Insurance Association (NAPHIA), Towers Watson W. 2024 NAPHIA State of the Industry Report.; 2024. https://naphia.org/wp-content/uploads/2024/04/NAPHIA-SOI2024-Report-Highlights_Public-May16.pdf.
Zagame K. 2024 Pet insurance Survey: Fearing costs, 30% of pet owners have avoided the vet. Published June 27, 2024. https://www.marketwatch.com/guides/pet-insurance/pet-insurance-survey/