Is Coverage For Wellness Care Worth It?

Doug Kenney, DVM
Published: June 16, 2011
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Sometimes called routine care, wellness care coverage includes things like wellness examinations, vaccinations, heartworm testing, heartworm preventative, flea and tick prevention products, teeth cleaning, wellness lab testing, and spaying or neutering. These expenses are expected and can be planned and saved for in advance. However, since pet insurance is primarily recommended for unexpected and unplanned events that you would have trouble paying for out-of-pocket, does buying coverage for wellness care make sense?

First of all, you need to know what is included in the wellness protocol your veterinarian recommends for your pet. This might vary depending on where you live and your pet’s age and lifestyle.

It's also important to learn what the fees are for this plan or protocol. How often will you be getting each vaccine, wellness testing, etc? How much will you spend annually on heartworm preventative and flea/tick products? With this information, depending on the company, you can actually calculate whether it will be worthwhile for you to purchase these benefits.

For example, if a company has a list of wellness procedures/products that they cover on their website or in a sample policy along with how much they reimburse for each, it’s easy to do. You simply add up the amount the company will reimburse for each procedure/product that your veterinarian recommends for your pet and then subtract the extra premium you pay for this coverage to see if you will come out ahead.

In the above example, you will come out $121 ahead this particular year by having wellness coverage. This may not be true every year. You may not need or get every procedure/product that is covered every year. For example, you will only get your pet spayed or neutered once. Your pet may not need every covered vaccine every year.

Some companies include their wellness coverage in their accident and illness policies and not as a separate option. Therefore, it may not be known what part of the premium is for wellness coverage. Some companies pay benefits according to what is usual and customary for your region of the country and reimbursement amounts aren’t known prior to filing a claim. In these cases, you may not be able to figure out if purchasing wellness coverage will be worth it ahead of time. Also, with some companies, wellness care claims are subject to your deductible and co-pay just like your accident and illness claims.

If you want to purchase a policy that includes wellness benefits, be sure you know exactly what is and is not covered, and any restrictions on the timing of when you can have the service done and get reimbursed for them.

If you purchase wellness benefits as an optional rider, and then later decide to drop it, ask if doing so will negatively affect your accident/illness policy in any way and if there are any restrictions if you want to repurchase wellness care benefits again later.

If you purchase a policy where the wellness benefits are included in the accident/illness policy, you should be careful about downgrading later to a policy that doesn’t include wellness benefits. If you have filed claims for accidents or illnesses, be sure to ask whether these conditions will be considered pre-existing and not covered if you switch to a new policy.

It is my perception that pet owners want wellness care coverage, and that pet insurance companies are under pressure to provide it in order to stay competitive. Wise pet owners know that wellness care is essential to keeping their pets healthy. It is far less expensive to prevent a problem than it is to treat it. Additionally, treatment is often more successful if a chronic disease is diagnosed early, before complications develop.

Sometimes, certain wellness procedures (e.g., wellness exams) are required by the insurance company to renew and maintain your accident and illness coverage. All such requirements can usually be found by reading your policy or a sample policy prior to purchase.

You’ll find that pet insurance companies generally won’t cover something that is preventable if you don’t follow your veterinarian’s recommendations for wellness care. For example, let’s say you live in an area where Lyme disease is prevalent and your veterinarian recommends an annual Lyme vaccine and products for tick control, but you refuse these recommendations. If your dog gets Lyme disease it most likely won’t be covered.

While doing your research, you may discover that the best company to cover your pet for accidents and illnesses doesn’t offer wellness coverage. In my opinion, coverage for wellness care should never be the primary reason for purchasing pet insurance. Coverage for accidents and illness should always take precedence.

Dr. Doug Kenney

Pic of the day: Comprehensive physical exam by Priority Pet Hospital

Cat undergoing a physical exam at the veterinarian's office, wellness care, pet insurance, keeping pets healthy