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Last week we looked into the importance of having health insurance for your dog, and some tips on how to choose the right pet insurance plan.

Here we look a bit further into how pet health insurance works, the coverage you can expect from a dog health insurance policy, and importantly what exclusions might be hiding away in the small print.

Why Choose a Pet Health Insurance Plan?

Pet health insurance is designed to protect you from financial losses when your pet gets into an accident or becomes ill.

Just as you might find with your own health insurance, you can never be sure that buying pet insurance will save you money, and if your dog is ideally healthy, you may pay more in monthly premium than you ever get back in benefits.

However, no one would ever begrudge having a healthy dog, and the fact is pet insurance is also designed to give owners peace of mind. Should anything really bad happen to your pet, you want to be covered to give them the best treatment possible.

How does Pet Health Insurance Work?

Pet health insurance works in the same way any other insurance plan you may have operates.

A health insurance plan very often has deductibles, meaning for certain situations the owner has to cover the initial amount of any claim.

There may also be annual or lifetime limits, and some plans will include a cap on coverage for specific types of illness or accidents.

The biggest difference between pet health insurance and cover for humans is that, when your dog falls ill you initially pay for the treatment yourself, (ie veterinarian bill). The insurance company then reimburses you after the claim has been made. The amount of expenses covered will obviously depend on the type of policy you have.

dog health insurance insert

Elements of a Pet Health Insurance Contract

The important issue when shopping for your dog health insurance is to read the contract. You need to purchase a plan that provides the correct cover for you. You are well advised to buy your pet health insurance based on the cover you are receiving, not on the bottom line price.

Cover varies between providers, however aspects of a pet health insurance contract include:

Covered Benefits

This is the section that will explicitly state what is covered within the pet insurance plan. Read this section carefully in order to ascertain exactly what you are buying. The covered benefits of a typical dog insurance plan are split into the following categories:

1. Accident coverage

Accident coverage is the most basic type of pet health insurance you can buy. It simply reimburses you for unexpected accidents and injuries to your pet. The cover should reimburse you for most of the expenses surrounding an accident your dog might have. Diagnostics, hospitalizations, lab fees, medications, surgeries and other treatments related to the accident, should be covered within the plan. (This is an area to ask about all the same..)

Covered accidents may include:

  • Stings
  • Sprains
  • Burns
  • Bone Fractures
  • Allergic Reactions
  • Bite Wounds
  • Foreign body ingestion
  • Lacerations
  • Motor vehicle accident
  • Poison ingestion

2. Illness coverage

Obviously, for complete peace of mind you may wish to insure your pet for illnesses as well.

Policies should again include coverage for diagnostic procedures, treatment, prescription medication, lab tests, x-rays, surgery and hospitalization, however the sheer extent to which your potential health plan does cover these areas, should be something that you clarify. The following illnesses are typically covered in an illness pet health insurance plan:

  • Eyes
  • Digestive system
  • Ears
  • Infectious diseases
  • Cancer
  • Nervous system

3. Routine Wellness and Preventative Care Coverage

This option is for those who wish to have the comprehensive health insurance coverage. Not all pet health plans will be able to offer this additional cover, so again ask these questions as part of your research.

A plan with this type of coverage included will insure everyday vet expenses. The following benefits are typical:

  • Preventative Care
  • Teeth cleaning
  • Vaccinations
  • Prescription flea control
  • Spay/neuter
  • Routine Screenings
  • Veterinarian Exams
  • Behavioral training
  • Heartworm prevention

4. Additional Pet Health Insurance Cover

In some cases your plan may allow for other additional benefits, such as:

  • Advertising and Reward Reimbursement
  • Boarding / Kennel Fees
  • Loss by theft or straying
  • Burial or Cremation

Premium Payment

Premiums are generally paid monthly, although some providers will allow for the entire annual premium to be paid in one lump sum. The cost of your premium will obviously vary depending on the health cover you have arranged, the age, breed and health of your dog, even your location plays a part.

The important issue is to shop around. (Head to our guide on choosing a dog insurance plan here)


The deductible is the amount of money you will be responsible for, before the insurance plan takes effect and reimburses you the remaining expenses.

Obviously a lower deductible is better should a claim need to be made, however cover with a higher deductible will generally have lower monthly premium payments. Deductibles may be annual or per incident, so check with your provider.

Maximum Limits or Caps

As we mentioned above, dog health insurance policies will often have limits/caps on the amount that the plan will pay out. The following small print is one to look out for:

  • Maximum Incident Benefit/Cap: This is the most you can be reimbursed for one incident.
  • Maximum Annual Benefit/Cap: This is the most you can be reimbursed in a year.
  • Maximum Benefit/Cap or Lifetime Limit: This is the total amount you can be reimbursed over the lifetime of your pet.

pet insurance exclusionsPet Health Insurance – Contract Exclusions

And now the important part – what exactly do those crafty insurance companies hold back in the form of contract exclusions. Very often, what you are not covered for is hidden in legal jargon making it difficult to make a truly informed choice on the insurance plan you buy.

The fact is, pet health insurance policies typically exclude coverage for various services or conditions.

The only way around this is to carefully read the contract before signing anything.

Below is a list of the typical exclusions made within a pet health insurance contract.

Pre-existing conditions.

These are injuries or illnesses that occur before your purchased health cover begins.

You should always ask about any pre-existing conditions and make sure to review the policy to see if they are covered. If they are not, they will be listed within the exclusions section of the contract.

If your dog does have a condition, it is important to see whether the policy you are interested in considers the condition to be curable or incurable.

Curable Conditions

For any pre-existing conditions that are considered curable, the insurance provider may choose to enforce a waiting period before coverage begins.

Incurable Conditions

Any conditions that are considered incurable (diabetes or cancer for instance) may be excluded entirely or may be covered on a limited basis.

An insurance provider may also offer cover for any temporary conditions that your dog may have had, as long as they are proven to be cured and treatment-free for 6 months or more.

Another area within the exclusion small print you should take care to look for is the issue of hereditary and congenital conditions. Are these considered as pre-existing conditions under your policy?

Genetic or hereditary conditions

The majority of pet health insurance providers consider genetic conditions to be pre-existing. This means that more often than not, they will not be covered. Genetic or hereditary conditions are diseases and disorders, that unfortunately are inherited by your dog. Genetically, they are predisposed to have them.

Elective procedures/cosmetic surgeries

Understandably, for any non medical necessary treatments and procedures, such as cosmetic surgery, the average insurance policy will not be able to help you. However, if the cosmetic surgeries is considered medically necessary, your chosen pet insurance plan should cover it.

Bottom Line

We can’t stress enough how important it is to read the contract carefully. Only choose your pet insurance cover, based on the benefits you (and your dog) will receive, not on the lowest price you can obtain.