Does My Pet Need Health Insurance?

Our Santa Monica Pet Medical Center team understands the bond you share with your pet. They're part of your family, and their well-being is one of your top priorities. However, veterinary care can be expensive, especially for unexpected accidents or illnesses for which treatment might be cost-prohibitive. Pet insurance can provide peace of mind and financial security to ensure your pet receives the best possible care without straining your budget. To determine whether insurance is right for your pet’s health care needs and your financial security, learn about various plans’ ins and outs to make an informed decision.

How Does Pet Insurance Work?

Unlike health insurance plans for people, pet insurance does not cover upfront costs. If your furry pal receives care, your pet insurance provider reimburses you for a portion of covered veterinary expenses. You choose a plan with specific coverage levels and monthly premiums. When your pet needs care, you pay the vet upfront and then file a claim with your insurance company for reimbursement.

Here are a few key terms you should know:

  • Reimbursement rates — Plans typically offer reimbursement percentages ranging from 50% to 90% of covered expenses. Higher reimbursement percentages mean higher premiums or monthly payments.
  • Deductibles — Most pet insurance plans have deductibles. You pay this amount before reimbursement kicks in. Lower deductibles result in higher premiums or monthly payments.
  • Coverage limits — Some plans also have annual or per-incident coverage limits, capping the amount reimbursed for specific conditions or within a year. Be sure to choose limits that align with your pet's potential needs.
  • Exclusions — Pre-existing conditions, preventive care, and cosmetic procedures are often excluded from coverage. Read your policy carefully to understand what's covered and what's not.

Pet Insurance Types

While pet insurance may help to offset veterinary costs, not all plans are created equal. Some policies cover certain care types while other plans do not. Consider these primary pet insurance types and what they cover:

Accident-Only Plans

Ideal for young, healthy pets or if you have budgetary constraints. These plans act as an emergency safety net for unexpected accidents such as broken bones, swallowed objects, or lacerations. Reimbursement typically ranges from 50% to 90% with annual or per-incident limits, and deductibles apply.

Example: If your pup encounters a squirrel, takes a tumble, and fractures his leg, this type of plan will cover a percentage of the treatment. If your deductible has been met, you will be reimbursed for that percentage after you pay the bill upfront. This type of plan does not cover preventative care or chronic disease treatment.

Comprehensive Plans

Ideal for senior pets, those with breed predispositions for certain conditions, or those needing broader coverage, comprehensive pet insurance plans go beyond accidents and cover a range of medical conditions such as allergies, ear infections, cancer, and even behavioral issues. Reimbursement is similar to accident-only plans but potentially with higher percentages and limits because of their broader scope. Expect higher premiums to reflect this.

If your elderly cat develops diabetes, requiring ongoing medication and specialized food, a comprehensive plan would cover a significant portion of your cat’s long-term treatment and significantly offset the ongoing costs, offering long-term financial relief.

Wellness Plans

Ideal for proactive pet owners and those wanting to manage preventive care costs, these plans are an investment in your pet's long-term health. They cover routine checkups, vaccinations, spaying or neutering, and sometimes even dental cleanings. Rather than reimbursing for unexpected expenses, pet wellness insurance plans typically work on a fixed-benefit basis, offering specific allowances for covered services each year.

If you enroll your puppy in a plan that covers annual checkups, vaccinations, and spaying or neutering, your insurance provider will reimburse a set dollar amount per checkup, vaccination appointment, or procedure, potentially saving you hundreds of dollars compared with paying out of pocket.

Breed-Specific Plans

Ideal for breeds prone to specific health problems. Flat-faced (i.e., brachycephalic) breeds, such as pugs or English bulldogs, often have breathing issues. Some breeds, such as German shepherd dogs, are prone to hip dysplasia. These plans cater to specific breeds’ unique needs, offering targeted coverage for conditions commonly seen in those breeds. Reimbursement is similar to comprehensive plans but with a focus on breed-specific conditions and potentially higher premiums attributable to the specialized coverage.

If you own a pug, a breed prone to breathing difficulties, your breed-specific plan covers treatments for brachycephalic obstructive airway syndrome (BOAS). A breed-specific plan offers financial security for potential future issues.

Factors to Consider When Choosing Pet Insurance

You have many factors to consider when choosing a pet insurance plan. A breed-specific plan likely won’t be of much use to a mixed-breed dog with no condition predisposition, and an accident-only plan might not be suitable for an indoor-only cat. Understanding your pet’s health care needs and condition risks helps you choose a plan with which you’re comfortable, one that will benefit your pet and help you stay within your budget. Before enrolling in a pet insurance plan, consider the following:

  • Your pet's age and breed — Younger pets and breeds prone to health problems often benefit the most from insurance.
  • Your budget — Consider the monthly premiums and potential claims against your annual budget.
  • Your risk tolerance — Are you comfortable with potentially high vet bills, or do you prefer financial security?
  • Your preferred level of coverage — Does your pet need basic accident coverage or comprehensive protection?

Veterinary care can be costly. However, pet insurance can provide peace of mind and financial security to ensure your pet receives the care they need when they need it. If you are unsure which type of insurance plan your pet needs, call our Santa Monica Pet Medical Center team.