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Understanding Pet Insurance & the Risk of backdating claims

4 Mins read

Pets are considered by many to be beloved members of the family, and rightfully so. Our furry little friends have been linked by research to significantly reduce stress levels, as well as, help an individual cope with difficult situations. It is highly uncommon for a pet to not bring happiness to the owner’s world. However, with all the benefits and fulfilling experiences of being a pet owner, there are also important factors to consider when researching and understanding pet insurance, and making the decision to purchase it.

Pet Insurance Costs

Pet insurance works similar to health insurance for a human, in that, the price is determined by standard things like age, gender, and location. Prices are also affected by the level, or tier, of coverage being purchased. Most insurance companies for pets will have different tiered plans available, and the costs will be affected accordingly. Lower-end (cheaper) plans will mainly cover the pets medical bill(s) in the event of an emergency, such as a broken bone, or a foreign body ingestion; higher-end (more expensive) plans will often include the same benefits, as well as, regular visits to the veterinarian. So how much will a pet owner pay to insure and protect their treasured furry friend(s)? Well – it depends on all the above mentioned, and your budget. According to the Business Insider, most pet owners will end up paying an average of about $30-$50 a month for each pet covered, however, certain plans can go higher than $100 a month, so researching and understanding what is being purchased is imperative.

Cash In-Hand

An important bit of information to take note of is: a vast majority of companies offering pet insurance operate on a “self-pay/reimburse” model, in that, the owner pays upfront for the cost then submits a claim for reimbursement. This leaves the pet owner responsible for submitting the claim to the insurance company after the visit, in a timely manner, while meeting all the requirements on how to submit said claim – this can be a daunting task for an unseasoned insurance holder. In turn, the insurance company sends payment for covered expenses via a payout by direct deposit, or a physical check mailed to the owner. Therefore, it is always prudent to have extra money in-hand, or set aside, for any unexpected expenses from a scheduled, or an emergency visit so that it won’t hurt the “wallet” too much.

Can Pet Insurance Be Backdated? 

In short, the answer is no. Although there might be a few unique situations where there may be an exception to the rule, usually the term most commonly referenced across all major pet insurance companies is – unforeseen. Meaning that insurance policies are intended for unexpected, unanticipated, or emergency situations that a pet might experience in the future – not the past. For example, it wouldn’t be very rational for one to purchase home insurance today then expect to be reimbursed for the ceiling repairs completed a year ago. It would be highly advised to inquire if your veterinarian’s office, or emergency pet hospital, can file the claim at the time of services. If not, make sure to file the claim immediately and in accordance with the process the insurance company requires.

What About Pre-Existing Conditions?

This is a tricky area; generally speaking, most pet insurance companies will not cover any pre-existing conditions. Nonetheless, it might be possible to obtain coverage for the pre-existing condition in the future. Usually, approved coverage is determined based on: how severe the condition is and whether or not it’s curable. Many pet insurance companies will evaluate the condition of the pet, and at their own discretion, will determine if the pet is shown to be cured, symptom-free, and without the need of future treatments. The insurance company may award coverage for the condition based on the needs of the condition going forward, however, this is an area of the policy where it would be sagacious of the owner to take time to read between the lines in order to avoid surprises. 

Savings VS Insurance

A great question a pet owner should ask themselves after researching if it may be a good fit for their situation is – is pet insurance worth it? Or would it be more beneficial to save rather than paying for an insurance policy? On that point, the answer is – possibly. It really does depend on each individual pet, and owner, circumstances, and capabilities accordingly. With that said, it is always judicious for pet owners to be aware of their veterinarian costs, and the impact of the lack of information can be to their wallet. 

A routine veterinary visit, in most U.S. cities, can range between $45-$60 (or more) per pet – per visit; not a big deal, right? Well, consider this, the average cost for an emergency visit is about $1,783 and that’s out of pocket if there is no insurance plan in place. In addition, if a pet unfortunately needs more than one emergency visit to their veterinarian within a year, either because they executed a jump off a sofa unsuccessfully leading to a broken bone, or decides that a toy soldier tastes better than their food resulting in a “foreign object ingestion”, then a pet owner could easily be looking at spending at least $5,000 within a year. This is where pet owners will need to be objective, understand their pet and the pets’ possible needs, and do the research by comparing the benefits, and risks, of pet insurance for their situation.

Can you afford to save a couple thousand dollars each year to have on reserve if needed, or afford a sudden cost of an emergency visit? If the answer is yes, then a savings account for unexpected and planned expenses could be better for your state of affairs. If the answer is no, then an insurance policy might be the way to go. Either way, understanding your pet, and their needs, and creating a budget for both options, is the sensible way to approach the insurance question no matter what the choice ends up being.  

Also Read: Does pet insurance cover x-rays?

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Does Pet Insurance Cover X-Rays?