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- Most family pet insurance coverage prepares enable you to pick your veterinarian.
- You’ll be repaid based upon your policy, however you need to pay your veterinarian initially.
- Pet insurance can offer unlimited coverage to protect your pet.
Over years of working as a veterinarian, Dr. Brian Evans has seen significant advances in how well the veterinary system can care for pets. While that is good, it has one major downside: increased costs. Those costs are leading more and more pet parents to purchase pet insurance, something Evans sees as a no-brainer.
“One bad weekend in an emergency room can cover years of the insurance premiums, plus give you the peace of mind that you don’t need to sacrifice care for your pet,” Evans says.
Unlike human medical insurance, which pays the providers directly, even the best pet insurance plans provide reimbursements. That means you’ll pay for the care up front, then receive a portion of the cost back from your insurer after you file a claim. The exact number will vary based on your deductible, coinsurance, and policy limits. Here’s how to file a pet insurance claim in six steps.
Know your pet insurance plan inside and out
Before you can file a claim, you need to know what your pet insurance does and doesn’t cover. There are a lot of variations in pet insurance plans. So do your due diligence before you need coverage.
“Make sure to check the fine print,” says Dr. Rebecca Greenstein, a veterinarian with Rover.
There’s no sense in submitting a claim for routine vaccinations, for example, if your plan only covers emergencies. Likewise, some accident and injury policies cover things like acupuncture, chiropractic care, and other alternative treatments. If your insurance plan doesn’t, you can factor that into your budget before signing your pet up.
Finally, every pet insurance company defines “preexisting conditions” differently. Some companies cover “curable” preexisting conditions with a specific waiting period. Check the details of your plan when you buy it, and review it once a year to keep it fresh in your mind. Knowing these details can save you a lot of frustration and unexpected expenses.
Be clear about your pet insurance reimbursement
If you’re making snap decisions about which treatments to authorize for your pet, the last thing you want to consider is finances. Unfortunately, Greenstein says, “Pet owners consistently underestimate the cost of emergency care, which can leave them in a precarious financial position.”
Knowing the details of your insurance plan can keep you financially savvy even when emotions are high. Plans typically reimburse between 70-90% of the cost of eligible services. Pet parents should also pay attention to the maximum limits. For example, if your policy caps out at $10,000, you could quickly exhaust your annual limits with one major emergency. On the other hand, unlimited benefits will cover you if you can afford the 10-30% that your coinsurance demands.
When you have those numbers in mind, you can be realistic about what procedures you can and can’t approve.
Pay your vet’s invoice
Before filing an insurance claim, you must pay the veterinarian for their services. You can pay via cash, check, or credit card with most vets. Many vets will also work with CareCredit or other short-term loan programs to help you fill the financial gap while your claim is processing. Just be sure to get an invoice detailing your pet’s treatments or services and the cost of individual services. The bill will be the basis of your reimbursement claim.
You should also ask your veterinary office for a copy of the SOAP (subjective, objective, assessment, and plan). This is a written document showing why a treatment was used, and you can use it to justify the treatment to your insurance company.
Get your pet’s medical records
Many pet insurance plans only cover conditions diagnosed after you purchase the plan. A waiting period on certain conditions may also apply. In other words, your dog cannot be covered if diagnosed with certain conditions within your first year of pet insurance coverage. Most plans also don’t cover pet dental care.
To prove a specific condition should be covered, you must send in your pet’s medical record to confirm it’s a new ailment. This could be as simple as sending the results of your pet’s most recent annual exam. If it’s been a while, a pet insurance company may wait for your next vet visit.
Of course, the best way to simplify the conversation about what pet insurance covers is to buy a plan when you bring your furry friend home for the first time. Choose carefully, as any known condition becomes a preexisting condition if you switch insurance companies. You can change plans without triggering this issue, but not companies.
“I highly recommend purchasing pet insurance the day you get your puppy,” Evans says. “If you wait until they get sick, it will be too late and could potentially exclude them from coverage for the rest of their life.”
Fill out a pet insurance claims form
Now that you have your supporting documents, you must file a claim. What this looks like depends on your insurance company. Some allow you to fill out a form via a mobile app, while others require you to print out and fax or mail the claim form to a set address. Lemonade allows pet parents to record a short video to describe their pet’s medical claim.
Whatever method you’re using, follow directions closely and attach all the supporting documents, including your paid invoice, SOAP, and pet medical records. Most importantly, don’t delay., It’s easy to miss deadlines, especially when your furry family member experiences a medical crisis. But most insurers will only process claims filed within 90 days of treatment. To ensure you don’t miss out on reimbursement, contact the company to confirm your claim was received.
Be patient
Many pet insurance companies brag about processing claims in one to two days. But, especially the first time, this probably won’t happen. We recommend calling your pet insurance company if you’re unsure at any point in the claims process. You can ask about expected timelines, see if they need more information from you, etc.
The trickiest part for many customers is determining what is and isn’t a preexisting condition the first time and evaluating the cost of pet insurance before they need it. After that, everything else should follow your policy documents. So if you have a 90% coinsurance rate, you’d be repaid for 90% of the bill after your deductible is satisfied. Your policy documents are like a roadmap, offering a guide to what specific services are covered, common exclusions, etc.
You’ll get a check or direct deposit if your claim is approved. If you took a loan with CareCredit or a similar organization, you could repay all or part of your loan with the reimbursement.
Sometimes, insurers will deny a claim. If that happens, check out your insurer’s appeal process. First, get as much detail as possible on why the claim was rejected. Then ask your veterinarian if they can provide additional information to address the issues leading your insurer to deny the claim.
While filing a pet insurance coverage claim might seem like a hassle initially, it’s well worth the effort. Filing your claim and getting reimbursement allows you to provide the best care possible for your family pet without compromising your monetary health.
