What Does Pet Insurance Cover and Not Cover?

What Does Pet Insurance Cover and Not Cover: If you share your home with a furry companion, you probably enjoy pampering them with delightful treats, cozy beds, and an abundance of toys. Alongside the joyous aspects of pet ownership, ensuring your pet’s well-being is paramount.

This includes regular visits to the veterinarian and necessary medical interventions in case of health issues. To alleviate the financial burden of pet healthcare, pet insurance serves as a valuable option. Let’s explore What Does Pet Insurance Cover and Not Cover, providing you with a natural blend of information that is easy to comprehend.

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Pet Insurance Plan Types Comparison -Understanding Pet Insurance Coverage: What’s Included and Excluded

When it comes to pet insurance, it’s important to know What Does Pet Insurance Cover and Not Cover. Let’s take a closer look at different types of pet insurance plans and compare their coverage options according to Forbes Advisor analysis of pet insurance policies.

Accident & Illness Pet Insurance Plans:

Covered expenses: These plans typically cover accidents and injuries such as poisonings, sprains, and ACL ruptures. They also provide coverage for common illnesses like ear infections, vomiting, and diarrhea.

In addition, serious illnesses such as cancer, diabetes, and heart disease are generally covered, although specific conditions may vary depending on the plan. Hereditary conditions like blood disorders, eye disorders, and hip dysplasia are usually included as well.

Testing and diagnostics: Most accident & illness plans cover various tests and diagnostics like blood tests, ultrasounds, and CT scans, as long as they are related to accidents or illnesses.

Procedures: If your pet requires procedures such as chemotherapy, endoscopies, or surgeries due to accidents or illnesses, these plans typically offer coverage for them.

Prescription medications: Medications for pain and inflammation related to accidents or illnesses are usually covered by accident & illness pet insurance plans.

Holistic and alternative treatments: Options like acupuncture and chiropractic care are commonly covered by these plans.

Excluded expenses: Routine wellness exams, flea and heartworm prevention, and vaccinations are typically not covered under accident & illness pet insurance plans.

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Accident-Only Pet Insurance Plans:

Covered expenses: Similar to accident & illness plans, accident-only pet insurance covers accidents and injuries. This includes poisonings, sprains, and ACL ruptures. Common illnesses like ear infections, vomiting, and diarrhea are also covered.

Testing and diagnostics: These plans cover tests and diagnostics specifically related to accidents.

Procedures: Accident-related procedures such as surgeries are covered under accident-only pet insurance plans.

Prescription medications: Medications for pain and inflammation resulting from accidents are included in the coverage.

Holistic and alternative treatments: Like accident & illness plans, accident-only plans generally cover holistic and alternative treatments.

Excluded expenses: Routine wellness exams, preventive care, and vaccinations are not covered by accident-only pet insurance plans.

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Routine Wellness Plans (Usually an Add-On):

Covered expenses: Routine wellness plans are designed to cover preventive care and regular checkups for your pet. This includes routine checkups, flea and heartworm prevention, as well as vaccinations.

Excluded expenses: Illnesses, accidents, and related treatments are typically not covered by routine wellness plans.

It’s important to note that the exact coverage offered will depend on the specific pet insurance plan you choose. This information is based on an analysis of pet insurance policies by Forbes Advisor. Ensure you carefully review the terms and conditions of any plan before making a decision to ensure it aligns with your pet’s needs.

What’s Included In Pet Insurance Plans?

Pet insurance provides financial support for your pet’s medical expenses, including accidents, illnesses, and wellness visits. It’s important to know what is covered under the best pet insurance plans. Let’s explore the common coverage options:

Accidents and Injuries

  • Coverage for medical expenses related to accidents, including:
  • ACL ruptures
  • Bite wounds
  • Broken bones
  • Cuts
  • Swallowed objects
  • Toxic ingestions

Behavioral Therapy

  • Coverage for behavioral therapy costs addressing problems such as:
  • Aggression
  • Destructive chewing
  • Excessive barking

Chronic Illnesses

  • Coverage for medical expenses related to chronic illnesses, such as:
  • Allergies
  • Arthritis
  • Digestive problems (e.g., inflammatory bowel disease)
  • Seizures
  • Skin conditions

Common Illnesses

  • Coverage for medical expenses related to common illnesses, including:
  • Diarrhea
  • Ear infections
  • Urinary tract infections
  • Vomiting

Hereditary Conditions

  • Coverage for medical expenses related to hereditary conditions, such as:
  • Blood disorders
  • Eye disorders
  • Hip dysplasia

Holistic and Alternative Procedures

  • Coverage for expenses like:
  • Acupuncture
  • Chiropractic
  • Laser therapy

Microchip Implantation

  • Coverage for the cost of microchip implantation to help locate your pet if it goes missing.

Prescription Food and Supplements

  • Coverage for prescription food and supplements required for specific health conditions covered by your policy.

Prescription Medications

  • Coverage for the cost of prescription medications to manage:
  • Chronic conditions
  • Infections
  • Pain and inflammation


  • Coverage for the cost of medical procedures, including:
  • Chemotherapy
  • Endoscopies
  • Hospitalizations
  • Nursing care
  • Surgeries

Serious Illnesses

  • Coverage for medical expenses related to serious illnesses like:
  • Cancer
  • Diabetes
  • Heart disease

Testing and Diagnostics

  • Coverage for the cost of testing and diagnostic procedures, such as:
  • Blood tests
  • CT scans
  • MRIs
  • Ultrasounds
  • X-rays

Wellness Procedures

  • Coverage for expenses like:
  • Flea and heartworm prevention
  • Neutering
  • Routine wellness exams
  • Spaying
  • Vaccinations

It’s important to review the specifics of each pet insurance plan to determine the exact coverage they offer. Consider selecting a plan that aligns with your pet’s needs and consult with the insurance provider for any clarifications.

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Types of Pet Insurance Plans

Pet insurance plans come in various types, each offering different coverage options tailored to your needs. Understanding these types will help you make an informed decision when purchasing a policy.

Accident and Illness Coverage

Accident and illness coverage is the most common type of pet insurance plan. It provides extensive coverage for a wide range of problems, including accidents (such as torn ACL or swallowing foreign objects) and illnesses (such as allergies, cancer, and ear infections).


– Covers both accident and illness-related issues.

– Includes chronic illnesses and hereditary conditions.

– Assists with payment for diagnostic tests, procedures, hospitalizations, and medical prescriptions related to accidents and illnesses.


– Relatively more expensive compared to other coverage types.

– Does not cover wellness exams.

Accident-Only Coverage

As the name suggests, accident-only coverage focuses solely on accident-related medical expenses. It covers injuries resulting from accidents, such as torn cruciate ligaments or lacerations from dog bites, but does not cover illnesses like ear infections or cancer.


– Lower cost compared to accident and illness coverage.

– Provides payment for accident-related diagnostic tests, procedures, hospitalizations, and medical prescriptions.


– Excludes coverage for illnesses.

– Does not cover hereditary issues.

– Does not pay for wellness exams.

Wellness Coverage

Wellness coverage refers to optional add-ons offered by many pet insurers. These plans cover routine wellness-related expenses, including annual wellness exams, flea and tick prevention, and vaccinations. It’s important to note that a wellness plan can typically be added to an accident and illness policy but not to an accident-only policy.


– Covers wellness exams.

– Provides coverage for flea, tick, and heartworm prevention.

– Includes coverage for vaccinations.


– Cannot be purchased as a standalone policy.

– Cannot be added to an accident-only policy.

Extras To Pet Insurance

In addition to the main types of pet insurance plans, you may have the option to add extra coverage with riders. For example, Trupanion offers a Pet Owner Assistance Package that covers non-veterinary problems, such as advertising and rewards for lost pets, boarding fees if you are hospitalized, cremation or burial for accident-related deaths, and liability coverage for pet-induced property damage.

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What’s Not Covered by Pet Insurance?

While pet insurance covers a wide range of expenses, there are certain exclusions to be aware of

Pre-existing conditions: Pet insurance plans generally do not cover injuries or illnesses that existed before the coverage started. Some plans may consider coverage if the pet has been cured of a condition for at least six months, supported by medical records.

Experimental treatment: Procedures or treatments considered experimental, investigational, or not within the standard of care accepted by your state’s veterinary medical board are typically not covered.

Grooming: Services like baths, dips, shampoos, or nail trims are typically not covered by pet insurance.

Food, dietary, and nutritional supplements: Regular dietary expenses for your pet are generally not covered, but some plans may cover prescription food and supplements.

Non-veterinary expenses: Expenses related to waste disposal services, record access or copying, licensing or certification, and compliance with government rules or regulations (such as dog licensing) are usually not covered.

Does Pet Insurance Cover Pet Liability?

Pet insurance companies may offer liability coverage in case your dog causes injury to someone or damages someone else’s property. However, incidents of this nature are typically covered by your homeowners insurance policy.

For example, if your dog bites someone and you face a lawsuit, the liability coverage in your home insurance will generally pay for medical expenses and legal defense.

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How Does Pet Insurance Work?

Pet insurance plans typically operate on a reimbursement basis. This means that you pay for your pet’s vet bills upfront and then submit a claim for reimbursement. You have the freedom to choose any licensed veterinarian for your pet’s treatment.

Here’s an example of how a pet insurance claim process works:

1. Take your pet to the veterinarian for an ear infection.

2. Pay the veterinarian bill at the time of the visit.

3. Submit a claim to your pet insurance company, including the vet’s invoice and medical records.

4. The insurance company will review your claim based on the policy’s coverage. If the problem is covered, they will reimburse you accordingly.

How Much Does Pet Insurance Cost?

The cost of pet insurance varies depending on several factors:

1. Type, gender, and breed of your pet: Certain breeds may be more prone to specific illnesses, resulting in higher insurance rates. Additionally, larger dog breeds often have higher medication costs due to potential heart and hip issues.

2. Pet’s age: As pets age, their likelihood of needing veterinary care increases, leading to higher insurance rates during policy renewal.

3. Pre-existing conditions: Medical conditions that existed before purchasing pet insurance are typically not covered. However, some plans may cover conditions that were previously cured and later resurface.

4. Location: Average veterinary costs in your area can impact the price of your pet insurance plan.

5. Coverage types: Comprehensive plans that cover accidents, illnesses, and routine wellness will generally cost more than plans focusing solely on accidental injuries.

6. Deductible and reimbursement level: Lower deductibles and higher reimbursement levels result in higher premiums. For instance, a plan with 90% reimbursement will be more expensive than the same plan with 70% reimbursement.

Overall, insuring a dog tends to be more expensive than insuring a cat.

By understanding the different types of pet insurance plans and what they cover, you can make an informed decision that suits your pet’s needs and your budget. Remember to review policy details carefully and consider factors like cost, coverage limitations, and exclusions before selecting a plan.

Average Pet Insurance Costs by Company

When considering pet insurance, it’s important to understand the average costs associated with different companies. Here are the average monthly pet insurance costs for various providers:

  1. ManyPets: $36
  2. Pets Best: $50
  3. Metlife: $51
  4. Lemonade: $55
  5. Figo: $55
  6. ASPCA: $56
  7. Healthy Paws: $56
  8. Embrace: $58
  9. Spot: $59
  10. Pumpkin: $60
  11. Trupanion: $60
  12. Fetch By The Dodo: $66

On average, pet insurance costs around $55 per month. These figures are based on an analysis by Forbes Advisor using data from Petinsurer.com. The analysis considered plans with unlimited annual coverage, a $100 deductible, and an 80% reimbursement level, or the closest options available.

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Is Pet Insurance Worth It?

Determining whether pet insurance is worth it involves weighing the potential impact of unexpected veterinary bills against the annual cost of insurance. To illustrate this, consider the following scenario:

Let’s say your active dog injures their hind ACL while chasing a ball, requiring surgery that could cost thousands of dollars. If you have pet insurance with a $100 deductible and a 90% reimbursement level, your out-of-pocket expense for a $3,000 surgery would be only $400 ($100 deductible + 10% of the surgery cost).

While pet insurance can save you a significant amount of money in case of a serious accident or injury, it’s essential to consider it as an expense. Over a 10-year period, paying an average of $500 per year for accident and illness coverage would amount to $5,000 in premiums. Some pet owners may prefer setting aside funds in a savings account for their pet’s medical needs.

If setting aside a large sum of money in savings isn’t feasible for you, pet insurance can be a valuable way to avoid the burden of a major veterinary bill by providing financial coverage.

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