Understanding Key Insurance Terms:

We know pet insurance can get confusing but we’re here to help! There are few important Insurance terms that we’ll help you understand so you can make an informed decision about your coverage and expenses.

Deductible: This represents the portion of your veterinary bill that you must pay out of pocket before your insurance policy begins to reimburse you. Most pet insurance companies offer an annual deductible range. $100, $250, $500, $750 and $1,000.00 are the most common options you can choose from. However, some providers offer a per-incident deductible, which means that if the same injury or condition occurs more than once in your policy year, the deductible may no longer apply. Or you may reach your deductible multiple times if the incident is different each time in the same policy year.

We want to note that if you want to change your deductible you can do so at any time, but most carriers will cancel your current policy and issue you a new policy. What does this mean for you?  This generally means that any prior treatment or conditions will now be considered pre-existing and a new waiting period will begin. If you’re thinking about changing your deductible it’s important to ask your insurance carrier what their policy is so that you can make the best decision for your furry friend.

Co-Insurance: Coinsurance is like sharing the cost of a bill with your insurance company. It’s shown as a percentage. So, if you choose a 80% reimbursement rate you have a 20% coinsurance plan. To further explain, it means that when you get a medical bill, you have to pay 20% of it, and the insurance company pays the rest. Usually coinsurance payments (your insurance reimbursements) are issued after you meet your annual deductible.

We want to note that if you want to change your coinsurance you can do so at any time, but most carriers will cancel your current policy and issue you a new policy. This generally means that any prior treatment or conditions will now be considered pre-existing and a new waiting period will begin. If you’re thinking about changing your co-insurance it’s important to ask your insurance carrier what their policy is so you can understand how this change will affect your pets’ coverage.

Reimbursement Rate: This is the percentage of your total veterinary expenses that a pet insurance company will repay you after you have paid and once your annual deductible has been met. The most comprehensive pet health coverage typically reimburses between 80% and 100% of your vet bills, depending on the policy limits.

We want to note that if you want to change your reimbursement rate you can do so at any time, but most carriers will cancel your current policy and issue you a new policy. What does this mean for you? Generally, prior treatment or conditions will now be considered pre-existing and a new waiting period will begin. You’ll want to discuss how changing your reimbursement rate will affect your pets’ coverage.

Pre-Existing Condition: A pre-existing condition means a health issue that your pet already has before you sign up for a new pet insurance plan. Pre-existing conditions generally also include accidents and illnesses that began during the waiting period. Insurance companies decide what counts as a pre-existing condition.

Limits: When selecting a policy, it’s crucial to consider limits, especially as you anticipate your pets’ potential healthcare needs based on their age and conditions:

Per-Incident Limits: These caps limit the amount you can be reimbursed for a single illness or accident. For instance, if your expenses for an injury add up to $5,000.00, but your limit is $2,000.00, only $2000 is eligible for reimbursement and  you will be responsible for covering the remaining $3,000.00 balance.

NOTE: If you want to change your Per-Incident Limits you can do so at any time, but most carriers will cancel your current policy and issue you a new policy. You should discuss how changing your per-incident limits could affect your pets’ coverage with your insurance provider so you can make an informed decision.

Annual Limits: Annual limits determine the maximum reimbursement you can receive within a 12-month period. Once you reach your policy’s annual reimbursement limit, you will need to cover any additional expenses until your coverage renews for the year.

NOTE: If you want to change your Annual Limits you can do so at any time, but most carriers will cancel your current policy and issue you a new policy. What does this mean for you and your pet? Generally,  any prior treatment or conditions will now be considered pre-existing and a new waiting period will begin. 

Waiting Period: All insurance policies have a waiting period before your benefits are available to use. Some policies have separate waiting periods for illness, accidental injuries, and orthopedic coverage. It’s important to read your policy details to fully understand your policies waiting periods.

In addition to these terms, it’s essential to consider your premium, which is the regular fee you pay, either monthly or annually, to keep your insurance policy active. A higher monthly premium typically indicates more extensive coverage, but the lowest premium might be the right choice if you’re on a tight budget. Carefully assessing these insurance components will help you make the best decision for your pet’s well-being and your financial circumstances.

Bilateral Conditions: Bilateral means it can happen on both sides of the body. Imagine if your knees, eyes, hips, or elbows had a problem, and it could happen on both your left and right sides. Some of the problems are called luxating patellas, Cruciate Ligament Events, glaucoma, entropion, ectropion, hip dysplasia, elbow dysplasia, cataracts, cherry eye, and osteochondritis dissecans.

Cruciate Ligament Event: Any time your pet’s knee ligaments (those are like stretchy bands that hold their knee together) get hurt, it can be a strain, sprain, tear, or just wearing out.

Accident: Any unforeseen, unexpected event that results in physical injury to your Pet.

Illness: Disease, sickness, or any change to your pet’s normal healthy state not caused by an accident.

Injury: Physical harm or damage to your pet caused by an accident.

Chronic Condition: A condition that can be looked after and controlled, but it can’t be completely fixed. Some of these conditions include hip dysplasia, Cruciate Ligament Event, renal disease, osteoarthritis, diabetes, inflammatory bowel disease, heart disease, hyperthyroidism.

Effective Date: The effective date is the day when your insurance coverage for the year or a certain time period begins, like when your insurance starts working.

Renewal Date: The renewal date of an existing insurance contract is the date on which it must be renewed.

Periodontal Disease: Periodontal Disease is when the tissues around your pet’s teeth get infected and swollen because of bacteria in the plaque on their teeth. This includes two kinds: Gingivitis, which is when the gums get red and puffy because of the plaque, and Periodontitis, which is a more serious problem. In Periodontitis, the disease affects the tissues holding the teeth and the bone, which can lead to problems like the gums moving away from the teeth, and the bone getting weaker.