When you utilize human medical insurance, what typically occurs is that you provide your insurance coverage card at the time of your appointment and your insurance provider is billed straight by your medical company. Once your insurance provider authorizes (or rejects) your claim, you’re sent a costs for the part you owe. (In the case of a rejection, that costs will be 100% of the cost of the services you received.)
Pet insurance coverage works a bit in a different way, though. And it’s important to understand that so you don’t run into a financial jam.
You often have to pay upfront
Some pet insurance coverage companies will pay your veterinarian directly so you don’t have to shell out money for covered services. What’ll happen is your vet will bill your insurer and then get paid once your claim is approved.
But most of the time, pet insurance doesn’t work this way. Rather, what happens is that you need to pay your vet directly for the cost of your pet’s treatment in full. From there, you have to submit a claim to your pet insurance company. You can usually download a claim form from your insurer’s website.
Once you submit the claim (often online), you then wait to get reimbursed from your insurance company. This could take a few weeks or a few months.
You’ll have to contend with deductibles and maximums
Keep in mind that you may not be reimbursed the total amount of your vet bill, depending on your insurance. Many pet insurance plans come with an annual deductible you’ll need to meet, so that amount will be deducted from your first reimbursement check (or possibly subsequent checks, too). In some cases, your deductible might wipe out your reimbursement.
Nationwide says that most of its pet insurance clients have an annual deductible of $250. But if yours is higher — say, $500 — and you’re filing a $500 claim with your pet insurance company, you won’t get any money sent to you.
Remember, too, that you may not get 100% of your claim paid to you even if you’ve met your deductible already. Many pet insurance plans have a maximum reimbursement level that isn’t 100%. If you have a plan that reimburses 90% and you’ve met your deductible already, then submitting a claim for a $500 treatment would only give you $450 from your insurer.
Finally, most pet insurance plans have an annual maximum. Sometimes, this is a blanket maximum for all services, and other times, it’s per type of treatment.
But let’s say your plan pays a maximum of $5,000 per year for all services. If your pet requires a $5,500 surgery, that’s another reason you may not be reimbursed the full value of your claim.
Have cash set aside for pet care
Because pet insurance often requires you to pay your vet bills and wait for reimbursement, and because you may not be eligible for reimbursement in full, it is necessary to have money in your savings account for pet care at all times. Many pet owners opt to maintain a pet emergency fund that’s separate from their general emergency savings so they don’t have to stress about covering their pet’s care when issues arise.
If you have good pet insurance, in many cases, you’ll be reimbursed most of what you’re filing a claim for. But it’s important to have savings to tap in the interim.
Let’s say you have to shell out $2,000 for pet care and are eligible to get $1,800 back. You’ll need a way to pay that $2,000 credit card charge while waiting to get back $1,800 of it. And you don’t want to land in a situation where interest accrues on your balance because you can’t pay it in full. So do your very best to comprehend how the claims process works with your insurance coverage company, what sort of repayment you’re qualified for, and the length of time you need to anticipate to wait to get your money.
