Pet Insurance and Surgery: What Types Are Covered, How It Works – Business Insider

Insider’s experts choose the best products and services to help make smart decisions with your money (here’s how). In some cases, we receive a commission from our our partners, however, our opinions are our own. Terms apply to offers listed on this page.
Pet owners know that owning an animal can be costly, especially if it requires surgery at some point. Not all surgeries are covered under pet insurance plans, so it’s best to plan wisely so you can avoid choosing between your pet’s health and your financial well-being.
Before taking out a pet insurance policy, study the policy details and determine whether you’ll need accident-only or comprehensive insurance. Your pet’s age, pre-existing conditions, and likelihood of needing surgery can help you choose a plan. 
When shopping for pet insurance, you’ll come across two main types: accident-only and comprehensive. Accident-only insurance covers surgery for animals after an accidental injury (e.g., this would apply if a pet were hit by a car). Comprehensive pet insurance covers a broader range of veterinary needs, including treatment for disease and chronic illness, as well as accidental injuries.
Accident-only insurance policies enable pet owners to save money on premiums while getting coverage for unexpected health issues. However, comprehensive pet insurance can be a safer bet if you anticipate numerous health issues for your cat or dog. 
The North American Pet Health Insurance Association (NAPHIA) reported that by the end of 2021, accident and illness premiums for dogs averaged roughly $49 per month or $583 annually. For cats, owners paid an average monthly premium of $29 per month or $343 annually. 
Within a pet insurance plan, certain aspects of surgical procedures are covered, while others may not be. Embrace Pet Insurance, for example, says it covers all parts of pet surgery, which can include the following:
Some pet insurers, like Embrace, also offer optional, additional coverage. This may include spaying and neutering as well as dental cleanings. 
As an example of how much various surgeries and other veterinary procedures might cost pet owners (without insurance), Woody Mawhinney, licensed insurance producer and CEO of Pawlicy Advisor, offers a range of prices. 
Since spaying and neutering are generally viewed as non-emergency procedures that aren’t covered, you might need to budget for that expense as well. Dr. Megan Conrad, BVMS and telehealth practitioner at HelloRalphie, says spaying or neutering for dogs can range in cost from $150 at a low-cost clinic up to $600 or more at a veterinary hospital. 
Keep in mind that even with a pet insurance policy, you typically will pay the full cost of treatment up front. It’s best to submit your reimbursement requests after the fact.
The cost of surgeries can vary widely depending on the clinic’s price plan, animal size, and treatments needed, explains Dr. Linda Simon, MVB MRCVS and FiveBarks consultant.
“Things like a pre-anaesthetic blood test, intra-op intravenous fluids and imaging will all bump up the price of a surgery.”
Even with pet insurance in place, not all types of surgeries are covered. For example, spaying and neutering isn’t typically covered as an elective surgery. Unless it’s needed to treat a life-threatening condition, insurers won’t pay for it. 
Life-threatening issues are those that “require immediate medical attention to avoid fatal results,” according to Advanced Care Veterinary Hospital in Oklahoma. Emergency and comprehensive pet insurance policies will cover surgeries deemed necessary to save your pet’s life.
Much like health insurance for humans, pre-existing conditions are treated differently under an insurance policy. As Dr. Conrad explains, surgeries for conditions your pet had prior to taking out the policy are usually not covered. 
With all of these types of surgeries, the general guideline is that pre-existing conditions are not usually covered, while newly occurring issues are covered. Pet insurance covers the following:
Before taking out a pet insurance policy, be sure to pay attention to the fine print. Look into common illnesses and conditions for your particular breed or type of pet, as you may want to take out a policy that covers it before any diagnosis occurs. 
Quick tip: Mawhinney notes that waiting periods vary by insurance providers. One may offer coverage for knee-related treatment after 14 days, for example, while another may require a 180-day waiting period before surgery or other treatment.
Mawhinney also says, “It’s important to analyze the fine print when comparing options and ensure that the policy covers your pet’s breed-specific health risks well.” Breed, animal size, type of veterinary clinic or animal hospital, and severity of health issues all affect the veterinary bill. 
It’s also good to remember that it’s rare to get your pet’s entire surgical bill covered by insurance. Pawlicy Advisor notes that most plans have a deductible you must meet before any coverage, and the most comprehensive plans cover between 80% and 100% after the deductible.  
As mentioned before, most pet insurance providers don’t cover certain surgeries. Procedures that don’t make the cut include: 
This means that even if a type of pet surgery is listed under those commonly covered by insurance, that won’t likely apply if your dog or cat already had the illness prior to taking out the policy.
In addition to recognizing that only certain surgical procedures will be covered by insurance, keep in mind that routine veterinary examinations and vaccinations are also excluded from coverage. 
Some insurers offer optional coverage (at additional cost) for elective procedures typically not covered, like spaying or neutering. 
Important: Think about timing when buying pet insurance. Earlier in your pet’s life, they are less likely to have major illnesses diagnosed, and by delaying coverage, you risk your pet having a pre-existing condition that’s not covered.
As with any insurance policy, it’s not worth anything if you don’t file a claim when needed. Here are a few simple steps to make the process as painless as possible. 
As soon as you bring your dog or cat home, begin maintaining records of veterinary care. Dr. Simon notes that your insurance carrier will want copies of your pet’s medical records along with treatment notes. 
Secondly, don’t hesitate to speak to your veterinarian or vet technician about the process. Your veterinarian can likely provide details on how to file your pet insurance claim. 
Mawhinney advises, “Always ask your vet for an itemized invoice so the insurance company sees every treatment provided and associated costs.” In other words, invoices prove what treatment your pet received. 
Quick tip: Even if you don’t expect to meet your deductible or receive any reimbursement, submit your pet insurance claims for a chance at reimbursement for surgical expenses. 
As with filing your income taxes, you can save time by filing your insurance claim digitally. Mailing a paper claim could cause delays due to the postal system, so if possible, use the insurance provider’s website or online application instead. 
Mawhinney suggests reducing your burden by paying with a credit card that offers good rewards. Another tip is to finance expensive vet bills with a low-interest veterinary financing program like CareCredit while you wait for insurance reimbursement. 
A pet’s health is a priority, but that doesn’t mean pet owners want to spend an arm and a leg on pet insurance or costly surgeries. 
For pet owners who would rather avoid insurance premiums, a workaround is to start a savings account specifically for pet care. That way, instead of spending the money on insurance, you can build up an emergency fund for Fido. 
This strategy doesn’t guarantee coverage, though, and since surgeries can creep into the thousands of dollars, it’s worthwhile to consider the benefits of pet insurance. 
Think about how much you’d be able — and willing — to pay in the event of a pet health emergency. Some pet owners prefer to spend a relatively small amount monthly for the peace of mind insurance brings, while others might prefer absorbing larger veterinary bills as they come. 
Pet insurance can be a useful tool for owners looking to save money while protecting their beloved pets. However, if you take out a pet insurance policy, it won’t necessarily cover everything your pet needs (including certain surgeries). But an accident-only or comprehensive plan may be a better fit. 
Remember that instead of covering routine procedures and checkups, pet insurance policies apply to major emergency expenses (e.g., life-saving surgeries).  It’s wise to keep this in mind as you compare different insurance options.

Editorial Note: Any opinions, analyses, reviews or recommendations expressed in this article are those of the author’s alone, and have not been reviewed, approved or otherwise endorsed by any card issuer. Read our editorial standards.
Please note: While the offers mentioned above are accurate at the time of publication, they’re subject to change at any time and may have changed, or may no longer be available.
**Enrollment required.

source