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Pet insurance can help offset expensive vet bills, but it doesn't cover everything.
Navigating the fine print can be a major hurdle, and may contribute to why so few pet owners see it as a must-have. Currently, only about 4% of U.S. cats and dogs are insured, according to the latest data from the North American Pet Health Insurance Association (NAPHIA).
Still, the industry is growing rapidly, and there are more options available than ever. Here's a breakdown of what’s typically covered, what’s not, and how to choose the right fit for your pet.
What is covered by pet insurance?
Most pet insurance plans are designed to help pay for unexpected vet bills related to accidents, injuries and illnesses. Costs for surgery, medication, X-rays, blood work and emergency care are typically included.
That said, coverage isn’t guaranteed for every vet bill. A claim may be denied if the pet insurer can establish a connection between the injury and the owner's negligence. Certain illnesses may also be excluded if the animal hasn't received proper preventative care.
Here's a breakdown of the injuries and illnesses most pet insurance providers will cover:
Accidental injuries | Illnesses |
|---|---|
Broken bones | Cancer |
Food poisoning | Diabetes |
Gastric bloat | Allergies |
Trauma | Hip dysplasia |
Bite wounds | Eye and ear infections |
Torn ligaments | Inflammatory bowel disease |
Swallowed foreign objects | Arthritis |
Fractured teeth | Gum disease |
What pet insurance usually doesn’t cover
Coverage varies by insurer, but most pet insurance plans don’t cover:
Pre-existing conditions
Pre-existing conditions, or health issues your pet had (or, in some cases, showed symptoms of) before coverage began typically aren’t covered. This exclusion also applies to new medical complications that can be linked to a pre-existing issue.
Some conditions — infections, allergic reactions and stomach bugs, for example — may eventually be covered, provided your pet is symptom-free and deemed to be cured for a certain length of time (often 180 days). Every insurer has a different definition of what constitutes a curable pre-existing condition, so make sure to dig into the details before you buy a policy.
Routine and preventative care
Most standard pet insurance plans don’t cover routine care, such as vaccinations and teeth cleaning, or elective procedures like grooming and nail trimming.
Owner-caused injuries and neglect
Pet insurance won’t cover injuries or illnesses that result from the owner’s own actions, such as intentionally harming a pet or subjecting them to organized fighting or racing.
Veterinary bills related to breeding or breeding-related complications are also generally excluded from standard pet insurance policies.
Types of pet insurance plans
Most pet insurance policies offer two main coverage options: accident-only and accident and illness coverage. Some companies also sell wellness add-ons, but these plans typically cover routine care and aren’t considered pet insurance.
Your premium will vary based on the type of plan you choose, among other factors.
1. Accident and illness coverage
Accident and illness plans (also called “comprehensive policies”) cover a wide range of illnesses, from minor issues like vomiting and diarrhea — even if the cause is unknown — to serious conditions like cancer.
Covered services typically include diagnostic testing (X-rays, MRIs and blood work), hospital stays, surgery, medications, chemotherapy and alternative therapies (acupuncture, laser and stem cell treatment.)
Coverage for cancer and specialty care is standard with most accident and illness plans. Here are a few other conditions these policies typically cover:
Dogs | Cats |
|---|---|
Arthritis | Skin allergies |
Inflammatory bowel disease | Hip dysplasia |
Hyperthyroidism | Elbow dysplasia |
Diabetes mellitus | Hypothyroidism |
Hip dysplasia | Type II diabetes |
Cruciate ligament injuries | Congenital eye defects |
Hepatitis | Polycystic kidney disease |
Common coverage restrictions
As with most other treatments, hereditary and congenital conditions are covered only if a vet identifies the issue after the policy is in place. If a pet showed signs of one of these conditions before enrollment, insurers usually classify it as pre-existing and exclude it from coverage.
Some pet insurance policies only cover specific conditions after a waiting period has elapsed. A policy may only cover surgery for hip dysplasia if the condition is diagnosed at least six months after the policy takes effect, for example.
Age-based restrictions can apply as well. Treatment for congenital or hereditary dental issues may be excluded if you enroll a pet that's already one year old, and hip dysplasia is often excluded from coverage if the pet is six years or older at the time of enrollment.
2. Accident-only coverage
What accident-only plans typically cover
As the name suggests, accident-only policies reimburse treatment for injuries caused by accidents. Filing a claim under this type of policy won’t increase your monthly premium. Still, your initial rate may be influenced by how accident-prone your pet’s breed is. Labrador retrievers, for instance, often have higher premiums because they’re known for swallowing things they shouldn't.
Here’s a quick look at what accident-only coverage typically reimburses — and what it usually doesn’t:
Covered | May not be covered |
|---|---|
Motor-vehicle accidents | Poisoning that's caused by owner's negligence |
Ingesting foreign bodies | Intentional harm to the animal |
Sprains and lacerations | Injuries in organized fights or races |
Broken bones | Issues diagnosed as illnesses by the vet |
Accidental, unavoidable poisoning | Injured working animals (herding dogs, service animals, etc.) |
Diagnostic MRIs and X-rays | Organ transplants |
3. Wellness coverage
What wellness coverage typically covers — and doesn’t
Wellness coverage, sometimes called preventative care coverage, is usually offered as an add-on or “rider” to an accident and illness policy, though some insurance companies offer it as a standalone plan. It helps cover the cost of routine veterinary care and, in some cases, grooming, training and other services.
In addition to wellness riders, pet insurers may offer add-ons for things like end-of-life expenses, lost or stolen pet recovery, pet boarding while the owner is hospitalized and liability coverage. Some insurance companies bundle these with wellness coverage, while others sell them separately.
Covered | May not be covered |
|---|---|
Dental exam and cleaning | Pregnancy or other breeding/whelping expenses |
Wellness exams | Routine anal gland expression |
Vaccination | Grooming |
Flea/tick and heartworm preventatives | Euthanasia |
Microchipping | Behavioral evaluation |
Spay/neutering surgery | Training |
Compare pet insurance coverage
Accident-only | Accident and illness | Wellness plan | |
|---|---|---|---|
Hospitalization | ✓ | ✓ | ✗ |
Surgery | ✓ | ✓ | ✗ |
Vaccinations | ✗ | ✗ | ✓ |
Spaying and neutering | ✗ | ✗ | ✓ |
Cancer treatment | ✗ | ✓ | ✗ |
Diagnostic tests | ✓ | ✓ | ✗ |
Grooming | ✗ | ✗ | ✓ |
Prescription medication | ✓ | ✓ | ✗ |
Dental cleaning | ✗ | ✗ | ✓ |
Gum disease | ✗ | ✓ | ✗ |
Tooth extractions | ✓ | ✓ | ✗ |
Allergies | ✗ | ✓ | ✗ |
Ear infections | ✗ | ✓ | ✗ |
Bite wounds | ✓ | ✓ | ✗ |
Fractures | ✓ | ✓ | ✗ |
Digestive issues | ✓ | ✓ | ✗ |
Hip dysplasia and CCL tears | ✗ | ✓ | ✗ |
Pet Insurance Coverage FAQs
Is pet insurance worth it?
Pet insurance tends to be most valuable if your pet develops a serious, long-term condition — like cancer — or experiences a catastrophic accident that requires major surgery. And even if financial payoff is unlikely, insurance can still provide peace of mind for pet owners who want to do everything possible for their pet’s health, regardless of age or severity of illness.
That said, pet insurance may not be worth it if your pet has a mostly healthy life or if you're hesitant to put a very ill animal through chemotherapy or serious surgery, especially if they're old
How much does pet insurance cost?
The average monthly rate for an accident and illness plan is $62 for dogs and $32 for cats, according to the North American Pet Insurance Association (NAPHIA).
That said, the cost of pet insurance depends on your pet's age and breed, your zip code and the type of policy that you choose. Your insurance quote may be higher than the average rates, especially if you are enrolling a breed that's predisposed to chronic conditions or live in an area where pet care is expensive.
Does pet insurance cover vaccines?
Standard accident and illness policies don’t cover vaccines or preventative medications for heartworm, fleas, ticks or parasites. Vaccines are reimbursable only through a preventive care package, which typically caps payout between $20 to $150. In areas with high vet costs, you may pay part of the bill out of pocket.
Does pet insurance cover dental care?
Most insurers cover surgical extractions if the tooth is damaged in an injury or accident. Though rare, some insurers also cover dental cleanings if the service is part of the treatment plan for a covered illness.
Other dental services are considered preventive care and are not covered by standard plans. This includes routine cleanings, root canals, crowns, fillings or illnesses caused by skipping routine cleanings. A wellness rider will typically reimburse up to $150 for one dental cleaning a year, but that might not be enough to break even if your pet needs an extensive procedure or if you live in an area with high vet prices.
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Summary of Money's What Does Pet Insurance Cover?
Pet health care plans cover the cost of treating unexpected accidents and illnesses. This includes surgery, medication, tests, emergency care and long-term treatment plans.
The details of your pet insurance policy will depend on the type of coverage and the provider you choose. There are two main pet insurance coverage options:
- Accident and illness coverage will cover accidents and vet-diagnosed sickness or disease, including congenital and hereditary conditions.
- Accident-only coverage will cover only treatment for accidental injuries such as fractures, bite wounds and poisonings.
You can also add preventive care riders to cover services like routine care, end-of-life expenses, alternative therapies and behavioral modification.
