Here’s What Happens When You File a Pet Insurance Claim

This post may contain affiliate links which may compensate us based on your interaction. Please read the disclosures for more information.

Each pet insurance company works differently when processing claims. But read on for a general idea of what to expect. 

When you use human health insurance, what often happens is that you present your insurance card at the time of your appointment and your insurance company is billed directly by your medical provider. Once your insurance company approves (or denies) your claim, you’re sent a bill for the portion you owe. (In the case of a denial, that bill will be 100% of the cost of the services you received.)

Pet insurance works a bit differently, 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 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’s important 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 understand how the claims process works with your insurance company, what sort of reimbursement you’re eligible for, and how long you should expect to wait to get your money.

Our picks for the best credit cards

Our experts vetted the most popular offers to land on the select picks that are worthy of a spot in your wallet. These best-in-class cards pack in rich perks, such as big sign-up bonuses, long 0% intro APR offers, and robust rewards. Get started today with our recommended credit cards.

We’re firm believers in the Golden Rule, which is why editorial opinions are ours alone and have not been previously reviewed, approved, or endorsed by included advertisers.
The Ascent does not cover all offers on the market. Editorial content from The Ascent is separate from The Motley Fool editorial content and is created by a different analyst team.The Motley Fool has a disclosure policy.

 Read More