The Guide to Understanding Pet Insurance

by | Jun 28, 2023 | Pet Insurance

Are you an animal lover who would do anything for your furry companion’s well-being? You aren’t alone – pets bring us immense joy and are often considered beloved members of our families. 

But what happens if our pal falls sick or is unexpectedly injured? Costly veterinary bills can quickly add up, forcing us to make tough choices and endure financial strain. Pet owners everywhere face this problem, so we compiled this comprehensive guide on understanding pet insurance. 

Within this guide, we’ll explore the intricacies and benefits of pet insurance that will empower you to make informed decisions regarding your pet’s healthcare. Whether you’re an experienced pet parent or looking to bring one into the household for the first time, we’re here to equip you with the knowledge you need to ensure your fur baby receives the best possible care without breaking the bank.

What Is Pet Insurance?

Pet insurance provides peace of mind in the event of an unexpected accident or illness.

Pet insurance helps you pay the veterinary costs when your cat or dog becomes ill or has an emergency. Numerous plans, including Odie’s Pet Insurance for Dogs and Cats, offer comprehensive coverage to ensure your pet has the best possible care. 

Pet insurance can be a valuable tool that offers peace of mind and helps relieve the financial strain caused by unexpected veterinary expenses. Just like human health insurance plans, pet insurance provides vital coverage of costs related to medical care for your pet. When an unexpected illness or emergency strikes your beloved cat or dog, having the appropriate plan in place could make all the difference in their care.

Pet insurance provides pet owners with an invaluable safety net, enabling them to prioritize the health and well-being of their companions without worrying about financial implications. By covering an array of medical services, pet insurance helps ensure friend receives care when it is needed most.

The Guide to Understanding Pet Insurance Plans

Pet insurance provides peace of mind in the event of an unexpected illness or injury.

You’ve probably been baffled as to which plan you should choose, especially if you have multiple pets. And you’ve probably also wondered whether you could afford pet health insurance and if the costs are worth it.

Some pet insurance companies, like Odie, provide a free look period. During this time, you can change your pet insurance policy if it doesn’t cover what you need. 

But first things first! Let’s look at the most important terms when eyeing your best friend’s new pet insurance policy: 

Pet Insurance Terms

  • Accident – Unintended or unexpected event that results in injury.
  • Chronic condition – Lifetime chronic condition that includes an illness or injury.
  • Claim – Reimbursement request.
  • Coinsurance – a small sum of money you must pay during a veterinary visit.
  • Deductible – The sum must be paid yearly before veterinary services are rendered.
  • Exclusions – Conditions or care that the policy does not cover.
  • Maximum lifetime payout – Maximum amount of money that the insurance company will reimburse you during your pup’s lifetime.
  • Maximum payout per incident – The amount paid out per injury or illness.
  • Maximum payout per year – Also known as the “Annual Limit,” this is the maximum amount that is paid out on an annual basis.
  • Medically necessary – Anything that’s needed relating to the illness or injury.
  • Premium – Annual or monthly insurance payment.
  • Pre-Existing conditions – One of the most important things to consider when choosing a pet insurance company.
  • Preventative care – Routine care such as vaccinations, flea and tick preventative medications, annual wellness exams,  and so forth.
  • Waiting period – Waiting time before insurance is activated. During this period, any issues that your pet has are not covered by your policy. Most waiting periods range from 3 days to 6 months, depending on the type of injury or illness.

What Is the “Reimbursement Rate” in Pet Insurance?

Reimbursement rates, also sometimes called “coinsurance” rates, refer to the percentage of eligible expenses covered by pet insurance providers. When filing claims for covered veterinary expenses, this percentage determines what portion of the total bill will be reimbursed by insurance.

Assuming your pet insurance plan offers an 80% reimbursement rate, and your pet needs treatment costing $1,000, then the insurer would reimburse 80% of eligible expenses, covering $800 of the final bill.  This could leave you with a final bill as low as $200. 

What Does “Deductible” Mean in Pet Insurance? 

A deductible represents the upfront payment you must make out-of-pocket before your coverage kicks in, acting like an initial threshold that must be crossed before your provider reimburses veterinary costs.

Let’s say you have a policy with a $250 deductible, and your plan reimburses you 80% of eligible expenses. You will have to cover all of your pet’s veterinary visits and other medical costs until you’ve paid the entire total of $250. Once this condition is met, your insurance plan will start paying 80% of included services, and you will only be responsible for the remaining 20% until your plan resets.  

When evaluating a pet insurance product, be sure to clarify whether the deductible is on an annual or per-visit basis. Some plans lower their costs by making the deductible apply for each visit to the vet instead of an annual cap. This would mean that a $250 deductible would apply every time you visit the vet, which could add up and become much more costly to you over the course of a year. Other plans, like Odie pet insurance, have annual deductibles, which means you will only be responsible for $250 out of pocket, regardless of how many times you visit.

This is an important consideration for pet owners, as you can get much more value out of an annual deductible. Alternative policy options from companies offering per-visit deductibles are only beneficial if a vet visit is very expensive. 

What Are “Limits” in Pet Insurance? 

Limits determine the maximum amount of care expenses you can be reimbursed for in a single policy year. Odie Pet Insurance, for example, offers two tiers of annual limits: $10,000 and $40,000. 

Let’s say you selected a plan with a $10,000 annual limit. That means Odie will cover up to $10k in eligible claims within one policy year and reset on the policy anniversary date.

It’s important to note that some policies have sneaky clauses that limit coverage per condition, regardless of your annual limit. For example, an insurance company may stop reimbursement for cancer-related expenses after $4,000, even if your annual limit is $10,000. Odie offers transparent insurance coverage for your pet without per-condition limits. 

Pet insurance helps decrease the financial burden of unexpected illnesses.

How Does Pet Insurance Work?

Pet insurance is similar to car or health insurance and should cover some or all of your veterinary costs. If you currently have a cat or dog living at home with you, you’ve undoubtedly discovered that veterinary costs can be expensive. 

Having a comprehensive pet insurance plan can help soften the financial challenges of unexpected injuries or illnesses. These costs can be a financial strain and may lead to difficult decisions that a pet owner may regret later.

A comprehensive pet insurance plan can save you lots of money in the long run. A good pet insurance policy should allow you to cover major medical or surgical procedures. Chronic conditions persist over a long period, many with no cure, but can be treated with medicine. These conditions may include:

  • Diabetes
  • Epilepsy
  • Hypothyroidism
  • Cancer
  • Pain (also a chronic condition)
  • Osteoarthritis
  • Hip dysplasia
  • Congestive heart failure
  • Kidney failure
  • Eye failure
  • Hearing loss
  • Cognitive dysfunction Syndrome

Getting Payment From The Pet Insurance Company

  1. Pay the vet bill during your visit.
  2. Submit a claim to your insurance company.
  3. Get reimbursed for a percentage of covered expenses (after your deductible is met)

Insurance companies (also known as “providers” or “carriers”) may need paperwork or a medical history review from your veterinarian to process your claim, so be sure to save all receipts and documentation you receive from your vet appointment.

💡 NOTE: Some providers will pre-approve you for an upcoming procedure and offer to pay the veterinarian directly, alleviating the initial financial burden.

What Does Pet Insurance Cover?

Pet insurance covers various veterinary expenses, providing financial protection and peace of mind for pet owners. Here are the details of the coverage options provided by Odie Pet Insurance:

Illness & Injury Plan

The Illness & Injury Plan is an all-inclusive insurance plan designed to cover a wide range of medical needs for your pet. This plan includes comprehensive coverage for various illnesses, injuries, and veterinary services. Some of the covered items include:

  • 24/7 Televet Chat
  • Emergency vet visits
  • Overnight hospital stays
  • IV Fluids & Medications
  • Medical Supplies
  • Surgeries
  • MRI/CAT Scans
  • Rehabilitative Care
  • Prescription Medications
  • Gastrointestinal issues
  • Laboratory Tests

Accident-Only Plan

The Accident-Only Plan is designed for pet owners seeking coverage specifically for accidents. This plan provides financial protection for emergency veterinary care resulting from accidental injuries. It includes 90% reimbursement up to $10,000 each year, with a $250 annual deductible. 

Here’s an overview of the Accident-Only Plan:

  • Coverage for broken bones, sprains, eye injuries, and traumatic dental fractures.
  • Coverage for wounds, including bite wounds, lacerations, snake bites, and bee stings.
  • Veterinary treatments covered for accidental injuries include X-rays & ultrasounds, laboratory tests, emergency care, hospitalization, CT scan & MRI, and surgery.

The Wellness Plan Add-on

The Wellness Plan is an add-on for routine care coverage you can purchase with an insurance policy. It focuses on preventive care and covers routine veterinary services. Odie has two wellness plan options available: 

 Basic Plan:

  • Covers services such as spay/neuter and teeth cleaning, rabies vaccination, flea & tick prevention, heartworm prevention, vaccination/titer, wellness exam, heartworm test or FELV screen, blood, fecal, parasite exam, microchip, urinalysis or ERD, and deworming.
  • Reimbursement up to $305 per year.

Plus Plan:

  • Ideal for puppies and kittens.
  • Covers services such as spay/neuter and teeth cleaning, rabies vaccination, flea & tick prevention, heartworm prevention, vaccination/titer, wellness exam, heartworm test or FELV screen, blood, fecal, parasite exam, microchip, urinalysis or ERD, and deworming.
  • Reimbursement up to $535 per year.

What Does Pet Insurance Not Cover?

While pet insurance provides invaluable coverage for many veterinary expenses, it’s essential to be aware of its limitations and exclusions. Understanding what’s not included can prevent unpleasant surprises down the line.

Like most insurance companies, Odie pet insurance does not cover pre-existing conditions, which refer to illnesses or injuries your pet experienced prior to the effective date of the policy. This includes symptoms, diagnoses, or treatments which occurred before its launch date. It should be noted that definitions can differ depending on which insurance provider is chosen, so reviewing your policy thoroughly for implications that apply specifically is recommended.

Pet insurance typically does not cover elective procedures like cosmetic surgeries or breeding-related procedures, as these are considered discretionary and not essential to your pet’s well-being.

Benefits of Pet Insurance from a Vet’s Point of View

White Labrador Retriever at the vet office on medical table during ear examination.

Here are some of the benefits of pet insurance from a vet’s point of view:

  • Save money when your pet is sick.
  • You can focus on your pet’s health.
  • Increase your options for treatment.
  • Expensive treatments are covered. 
  • Visit any vet of your choice. 
  • Coverage is obtainable for all pets.
  • Get peace of mind. 
  • Budget for the cost of pet care. 
  • An alternative to using your savings. 
  • Choose the plan that is best for you and your pet. 

Coverage Limits in Pet Insurance

When it comes to pet insurance policies, coverage limits are essential in establishing how much money the policy can pay out each year in medical costs for your pet. This knowledge is key to effectively managing expectations and making informed decisions regarding his healthcare expenses.

Let’s use an example to demonstrate how annual limits work. Imagine that you have a pet insurance plan with an annual limit of $10,000 – this means the insurer will cover eligible claims up to a maximum of this amount during each policy year, such as expenses related to vet treatments, surgeries, medication, or any other covered services.

Note that an annual limit does not refer to individual incidents or conditions but represents an overall cap on reimbursements within a policy year. As claims are submitted throughout the policy year, reimbursement will continue up until it reaches this maximum amount – in this case, $10,000. Many insurance policies also include a per-condition cap. Odie plans do not have these limits in place, so your pet will be covered regardless of their particular condition. 

Notably, your policy’s annual limit resets every year on its anniversary date. At this point, your coverage can continue uninterrupted for another year.

How Much Does Pet Insurance Cost?

Pet insurance costs vary based on various factors, such as its type, coverage type, breed of your animal, age, breed, location, and which provider you select. At Odie, we offer various plans designed to meet all these needs at the most affordable rates in the industry. Here are the starting prices for each plan: 

Illness & Injury Plan

  • Cats: Plans average $25 per month.
  • Dogs: Plans average $45 per month.

The Illness & Injury Plan offers comprehensive coverage for various illnesses, injuries, and veterinary services. It provides financial protection for unexpected medical expenses, including emergency vet visits, surgeries, medications, and diagnostic tests.

Accident-Only Plan

  • Cats: Starting at $6 per month.
  • Dogs: Starting at $9 per month.

The Accident Only Plan is designed to cover emergency veterinary care resulting from accidents. It offers an affordable option for pet owners looking for coverage for accidents such as broken bones, wounds, or traumatic dental fractures.

Pet Insurance Claim Process

Submitting a claim on pet insurance should be an effortless experience that helps reimburse eligible veterinary expenses. Understanding what steps are involved will allow for an efficient filing experience – here’s our guide for filing pet insurance claims:

  • Collect Documentation: After providing your pet with veterinary treatment, be sure to collect and keep all documents that pertain to his or her care – such as invoices, receipts, medical records, or any other supporting documentation.
  • Review Your Policy: Be familiar with your pet insurance policy to understand its specific requirements and guidelines for filing claims, such as its deductible amount, reimbursement level, coverage maximum amount, and any upcoming submission deadlines.
  • Complete a Claim Form: Ask your insurance provider how you can access the claim form online in your account portal. Fill it out accurately, providing all requested information, such as your pet’s details and treatment information.
  • Attach Supporting Documents: Together with your completed claim form, provide all supporting documents, such as invoices, receipts, or medical records, as evidence that illustrate the services rendered and associated costs. Make sure they are legible.
  • Submit Your Claim: Once you have collected all required documents, submit them to your insurer. Many offer online claim submission options to make the process simpler, or you may mail or email the claim as per their instructions.
  • Follow up on Your Claim: It is crucial that once your claim has been filed, its status be monitored regularly. Contacting your insurance provider about its progress or any additional information needed could speed up processing time and ensure swift reimbursement of claims.

Remember, every insurance provider may vary their claim process slightly; to get the best results and guidance specific to your pet insurance coverage, it is a good idea to consult your policy or reach out directly.

To explore the coverage options available from Odie, get a quote today. 

Minimizing the Risk of Claim Payment Surprises

To minimize claim payment surprises, it’s crucial that you carefully read and comprehend your pet insurance policy’s terms and conditions. Below are a few key points you should keep in mind:

  • Understanding Your Deductible: Be familiar with the deductible stated in your policy. A deductible is an out-of-pocket expense you must cover before your insurance coverage kicks in, so understanding this amount helps anticipate potential financial obligations when filing claims.
  • Reimbursement Level: When considering pet insurance coverage, make sure your provider offers a reimbursement percentage of at least 70%; this will determine how much eligible expenses the insurer will cover – for instance, if the reimbursement level is 80%, they’ll cover 80% while you remain responsible for covering 20%.
  • Coverage Maximums: Review the coverage maximum stated in your policy to know the maximum amount the insurance company will cover for eligible claims within a given period, typically your policy year. Knowing your maximum will help you manage expectations and plan appropriately.

By understanding and considering these factors early, you can make informed decisions for your pet’s healthcare and finances, reducing any surprises when filing claims.

Comparing Pet Insurance Providers

When researching different pet insurance providers, it’s essential to remember certain factors to select an ideal policy for your furry companion. Here are a few key points you should keep in mind when making this important decision:

  • Price: A primary consideration in selecting an insurance policy for your pet should be its overall monthly or annual price. Review various provider plans until you find one that suits your budget and coverage needs.
  • Coverage for All Pets: Before choosing a provider, research if their coverage extends to dogs of all ages, breeds, and diagnoses. Selecting such plans ensures your pup receives the care he/she requires.
  • Routine Care Reimbursement: Pet insurance does not include the option for routine Care coverage in their policies. If you have any to get help covering routine veterinary expenses such as vaccinations, wellness exams, and preventive treatments, you will need to purchase an additional wellness plan for reimbursement. 

To better understand the different pet insurance providers and compare their offerings, you can refer to our comprehensive Pet Insurance Comparison Guide.

Final Thoughts 

Pet insurance can be an invaluable resource in safeguarding the health and well-being of your furry companion while offering financial security. Odie offers several plans designed to offer protection, including the Illness & Injury Plan and Accident Only Plan. Consider getting a quote now to protect your best friend! 


What Is Pet Insurance and How Does It Work? 

Pet insurance is a type of coverage designed to pay for veterinarian expenses when your pet becomes ill or injured by providing reimbursement of eligible veterinary costs after you’ve paid directly for them from your veterinarian. 

Is Pet Insurance Worth It?

Pet insurance can provide financial security while guaranteeing your pet receives medical attention. To learn more about the benefits of pet insurance, read our article on Pet Insurance: Top 10 Benefits of Pet Insurance from a Vet’s Point of View.

How Do You Use Pet Insurance? 

Utilizing pet insurance is a straightforward process: after paying the veterinary bill, submit a claim with all required documentation to your provider, who will review and reimburse eligible expenses according to your policy coverage. Please refer to your policy documents or provider for instructions on filing claims.

How Does a Pet Insurance Deductible Work?

Your deductible for pet insurance refers to the out-of-pocket expense you must meet before coverage kicks in. Once this threshold has been reached, insurance providers reimburse eligible expenses according to policy terms, annually or biannually reset. For more details, please consult your policy documents or reach out directly.

What Is the Best Pet Insurance?

The best pet insurance provider and plan depend on your unique requirements and preferences. Odie provides two insurance plans: the Illness & Injury Plan and the Accident Only Plan. Factors to consider include coverage, pricing, deductibles, and reimbursement levels when making this choice. 

How Do You Know Which Vets Accept Pet Insurance? 

Most veterinary clinics and hospitals do not accept pet insurance policies directly. Instead, you will need to pay for the visit upfront and get reimbursement from your insurance company afterward. 

Can Pet Insurance Cover Neutering?

Pet insurance does not include neutering, but you can purchase an add-on wellness plan to get this coverage. Reviewing policy documents or contacting your provider to get full details of coverage for neutering is advisable.

Can Pet Insurance Drop You? 

Pet insurers do not typically drop or cancel your coverage as long as you make timely premium payments and comply with the terms and conditions of the policy. However, it is crucial that you read your policy documents to understand their cancellation policies and any circumstances that may lead to their discontinuance.

Can Pet Insurance Be Canceled? 

Yes, pet insurance policies may be canceled either by the policyholder or their provider, depending on both parties involved in canceling coverage. Please review your policy documents or contact us directly for canceling coverage instructions.

Does Pet Insurance Cover Antibiotics? 

In general, yes. Most policies include coverage for antibiotics prescribed by veterinarians to treat an eligible condition or illness. Nonetheless, coverage will depend on both policy and provider; please read your policy documents or reach out directly for details of medication coverage.

Where Can I Purchase Pet Insurance?

Pet insurance can be found from various providers, including Odie. To discover and purchase it on our website, visit the Pet Insurance Page and compare various policies until you find one that best meets both your needs and budget.

Why Is Having Pet Insurance Important?

Owning pet insurance provides financial security and peace of mind in case an unexpected accident, illness, or injury should arise that necessitates medical care for your beloved companion. Pet insurance enables you to make decisions that best benefit them without worrying about excessive vet bills. 

Will Pet Insurance Cover My Surgeries for My Pet? 

Pet insurance often covers surgeries but the coverage depends on plan details and terms.

Pet insurance will typically cover necessary surgeries for your pet; however, exact coverage will depend on both policy type and provider. Therefore, reviewing policy documents or contacting them directly is wise to better understand how surgical coverage applies in each situation.

Does Pet Insurance Cover Luxating Patella Treatment in Pets?

Yes, pet insurance will cover treatment of luxating patella – a common orthopedic condition among pets – provided your individual policy covers it. Coverage may differ depending on provider and policy details. 

Does Pet Insurance Cover Hernia Surgery for Pets? 

Pet insurance will usually cover the cost of hernia surgery for pets; however, coverage can differ depending on your specific policy and provider. 

When Can I Submit My Pet Insurance Claim for Vet Bills?

After paying directly for eligible veterinary bills, you can file a claim with your pet insurance provider for eligible expenses. Each provider may have specific requirements and procedures for filing claims, so it’s wise to consult your policy documents or contact them for guidance.

What Are the Main Types of Pet Insurance? 

There are two primary forms of pet insurance plans. They include Illness & Injury and Accident Only Plans. An Illness & Injury Plan covers unexpected illnesses or accidents, and an Accident Only Plan specifically covers accidents. To learn more about these plans from Odie, visit the Illness & Injury Plan and Accident Only Plan pages.

What Is Excluded From Pet Insurance Policies? 

Exclusions in pet insurance policies refer to conditions, treatments, or situations which aren’t covered. Exclusions vary based on policy provider, and specific exclusions may include pre-existing conditions, cosmetic procedures, breeding-related expenses, and certain hereditary conditions. 

Does Pet Insurance Cover Pre-Existing Medical Conditions?

Pet insurance typically does not cover pre-existing medical conditions that were present prior to your insurance coverage being in effect. A pre-existing condition refers to any illness, injury, or symptom experienced before coverage began. You must review the terms and conditions or contact your provider to understand their position on preexisting conditions and any applicable waiting periods or exclusions.

Can Older Pets Be Insured? 

Many pet insurance companies offer options for senior pets.

Many pet insurance providers offer coverage for older pets. Eligibility and coverage options will depend on both the provider and the pet’s age, as some providers have age restrictions or pricing structures for senior pets that must be adhered to. It is highly advised that policy details or contact info from your preferred provider be reviewed thoroughly to confirm coverage for older animals.

Here is a guide on the benefits and limits of pet insurance.

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