Getting the Right Kind of Medical Coverage for Your Pet

PetMD Editorial
Written by:
PetMD Editorial
Published: April 19, 2011

Types of Pet Insurance Medical Coverage

By Frances Wilkerson, DVM

By educating yourself on the types of medical coverage available, you can make sure you select a plan that meets your specific needs.

The main categories for medical coverage are:

1. Accident and Illness Plans
2. Accident-Only plans

Accident and Illness Plans

If you want comprehensive coverage, you will need to purchase a plan that covers accidents AND illnesses. The illness portion of the plan you select should have the following components:

a. Coverage for cancer

Cancer is very common in veterinary medicine. Coverage in this area is very important.

b. Coverage for chronic disease

Chronic diseases are illnesses that have long duration and generally slow progression. Examples include: cancer, heart disease, chronic kidney disease, and chronic liver disease.

c. Continual coverage for chronic disease

If you do not get this coverage, the chronic disease will only be covered in the policy year it was diagnosed; after that, you will have to pay for any continuing medications or diagnostic monitoring yourself. Treatment for almost all chronic diseases will last beyond the first year of diagnosis.

d. Coverage for hereditary and congenital diseases

Some plans only cover hereditary medical conditions. Make sure your plan has both hereditary and congenital disease coverage. Examples of these types of diseases include:

  • Hip Dysplasia, Patella Luxation, Entropion, Liver Shunt

e. Coverage for diseases that are common to your pet's breed and species

Examples of breed-related diseases:

  • Golden Retrievers are more likely to develop Hypothyroidism and Hemangiosarcoma.
  • Miniature Poodles are more likely to develop Bladder Stones, Diabetes Mellitus, and Cushing's Disease.

Examples of species-related diseases:

  • Older dogs are more likely to develop Osteoarthritis.
  • Older cats are more likely to develop Hyperthyroidism, Diabetes Mellitus, and Kidney Disease.

Accident-Only Plans

As the name states, Accident-Only plans cover medical conditions that occur due to accidents. They do not cover medical costs caused by illnesses. Accident-Only policies tend to be much cheaper than comprehensive accident and illness policies because they do not cover costly illnesses. Also, as a pet ages, the number of accident related injuries decreases in comparison to the number of illness related conditions.

In addition, what a pet owner considers to be an accident is not necessarily what a pet insurance company considers to be an accident. For example, some companies will not cover conditions like foreign body ingestion or cruciate injuries in their Accident-Only policies.

If you intend to buy an Accident-Only policy, make sure you know what you are getting for your money.

Additional Medical Coverage You May Want to Consider

Behavioral Therapy Coverage

Behavior Therapy treats behavioral issues such as separation anxiety, aggression towards people, aggression towards other animals, peeing inappropriately in the house, and excessive destructiveness.

Not all companies offer behavioral therapy coverage. If it is offered, the types of behavior problems covered will vary. If you are interested in this type of coverage, ask the company what types of behavior problems are covered. Also, make sure you understand what the monetary limits are.

Alternative Therapy Coverage

Alternative Therapies are products and practices that are outside the practice of conventional medicine. These include but are not limited to chiropractics, herbalism, homeopathics, and acupuncture.

Not all companies offer Alternative therapy coverage. If it is offered, the type of alternative therapy that is covered will vary. If you are interested in this type of coverage, ask the company what types of alternative therapy are covered. In addition, make sure you understand what the monetary limits are.

Wellness & Routine Care

Wellness & Routine Care refers to preventive procedures such as vaccinations, annual exams, heartworm testing/medications, spaying/neutering, dental cleanings as a prophylaxis, and routine diagnostic tests (CBC and Chemistry Panel).

These procedures are very important in maintaining the health of your pet, as they prevent disease or help diagnose a disease early. This helps keep your pet healthy and in turn reduces your veterinary bills.

Most companies offer Wellness & Routine Care as an optional add-on for an additional cost. Make sure you ask the insurance company what type of procedures are covered and what the monetary limits are.

Sometimes the cost of adding Wellness & Routine Care to your plan ends up being more than it would cost you if you paid for these procedures out of your own pocket, so do the math before you purchase the plan. Ask your veterinarian for assistance if you need help determining your out-of-pocket costs for Wellness & Routine Care.

Prescription Drug Coverage

This is coverage for drugs that you take with you to treat your pet at home. Most companies include prescription drug coverage in their policy. Some provide it as an extra add-on that you must purchase. If you decide to get this coverage, make sure you know what the exclusions and monetary limits are.

Dr. Wilkerson is the author of Her goal is to help pet owners make informed decisions regarding pet insurance. She believes that everyone can make great decisions when given good, reliable information.

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