AVMA Guidelines on Pet Health Insurance for Pet Owners

[8.8.2013 version]

What You’ll Want to Know If You Are Considering Pet Health Insurance

As veterinary medicine becomes more technologically advanced, the cost of pet care increases. This is due to the higher operating costs associated with the equipment, facilities and training required to provide these more comprehensive services.

Because your veterinarian recognizes the challenges you face with these rising costs for your beloved pet, he/she wants you to be aware that there are programs available to help you manage the costs.  Purchasing pet health insurance is one way to help alleviate these financial anxieties because it reimburses a portion of the veterinary fees related to diagnosing, treating and managing your pet’s illness or injury.

While you should ask your veterinarian to recommend one or two pet insurance companies based on his/her experience, ultimately it’s your decision to purchase a policy.

Listed below is some general information for you to consider about coverage and how costs are determined. This information was developed with the assistance of the North American Pet Health Insurance Association (NAPHIA).  NAPHIA members work together to set industry standards for best practices, promote ethical conduct, and are committed to educating the veterinary community and pet owners about the value and benefits of pet health insurance.

  1. Pet insurance plans are generally reimbursement plans – pet owners pay the bills up front and are reimbursed by the insurance provider. Ask the company how reimbursement is determined, if limits are set per incident or per year, and how quickly you will receive your reimbursement.
  2. Regardless of the insurance provider, your veterinarian should be monitoring the health of your pet as part  of a Veterinary-Client-Patient Relationship.
  3. You should always be allowed to choose your veterinarian, including the specialists and emergency care providers your pet may require.
  4. The insurance provider should clearly spell out the details of your coverage, including any limitations or exclusions (what is not covered under the policy) and additional options that may be offered (for example, wellness care like annual exams, vaccinations, etc.).
  5. Pre-existing conditions (symptoms, diseases or conditions that your pet already has) are generally not covered, but hereditary and congenital conditions may be.
  6. Find out how the policy manages coverage for chronic conditions (ongoing, from year to year).
  7. Find out how your premiums are determined (species, breed, age, your location) and how and when premiums may increase.
  8. Some providers offer discounts if you insure multiple pets.
  9. All of the related costs, including co-pays, deductibles, add-on charges, and other fees, should be clearly explained to you so you fully understand both the benefits (financial reimbursements) and limits of the policy.