When Yenni Desroches and her partner adopted a puppy a few years ago, they looked into getting pet insurance. They couldn’t believe that most insurers didn’t cover preventative care.
“We expected to find more options regarding regular vet care, even if it was just to help spread the basic cost of care out over the year,” says Desroches, who owns a dog walking and pet sitting business in Worcester, Massachusetts.
While you care for your pet and want it to be as healthy as possible, you might want to hit “pause” before hopping on a pet insurance plan. These policies work differently than health care plans for humans. So you’ll want to know the ins and outs to see whether it’s worth the expense.
Here are six situations when you probably shouldn’t get pet insurance:
For preventative care
A pet policy primarily covers accidents and illnesses. Let’s say your pet gets injured in a car accident, gets poisoned, suffers an infection, or develops a chronic illness. In these instances, pet insurance will foot the medical bill. But only after you’ve met your deductible.
If you want your policy to cover routine check-ups, flea and tick medication, and vaccinations, you could buy a wellness plan. While most pet insurers offer wellness plans, it’s offered as an add-on policy. So you’ll still need to sign up for an accident and illness plan.
If your pet has a pre-existing, congenital or hereditary condition
Most policies have a waiting period for accidents and illnesses. So if your dog gets into a brawl with another canine and suffers injuries, you can’t buy a policy soon after to lower the vet bill.
Most pet insurance companies also won’t cover congenital conditions, which are present since birth. They also won’t cover hereditary conditions, which are genetic disorders transmitted from your pets’ parents.
Common congenital disorders for dogs are hip dysplasia, heart disease, and brachycephalic syndrome. For the breeds that have a “smushed face,” this could make them more prone to breathing complications, dental issues, and skin problems.
Cats suffer from genetic disorders like feline lower urinary tract disease, diabetes, deafness, and polycystic kidney disease.
Because the mother of Desroches’ pup developed hip dysplasia at the age of three, they wanted to get a policy as early as possible.
“The thing is, pretty much every pet insurance company has a pre-existing conditions rule, which can prevent owners from switching insurance if they do take issue with the initial company,” Desroches explains.
If your pet is older
Most pet insurers have an age cap of 14 years. But it does vary slightly between dogs and cats. Typically the older your pet is when you initially sign up, the more expensive your premium.
Premiums also usually increase each year, and the age of your pet usually factors into the spike in premium costs. If you’re getting insurance for an older pet, they might be eligible for an accident-only plan.
If you have a pet emergency fund
Given the long list of exclusions with these policies, if you have a robust emergency fund for your pet, those monthly premiums might not be worth it.
According to the North American Pet Insurance Association’s (NAPHIA), the average cost of premiums in the U.S. for dogs was about $534, or $43 a month. For felines the average was $335, or about $28 a month. When it comes to claims, the average was $278 per claim.
Say you buy a policy when your pet is young and healthy, and pay premiums for 10 years. If your premium doesn’t go up every year (which it most likely will), you’ll be paying roughly $5,340 for 10 years of insurance for a dog. And you’ll pay $3,350 for a cat. You’ll also need to meet your deductible. This could be either per incident or annual.
It might make more financial sense to squirrel away funds into an emergency pet fund for medical bills. You’ll have cash stashed away for when your pet gets older. That’s when they’ll need more medical attention.
If your vet’s not covered
A benefit of pet insurance is that unlike human health insurance, there’s no network of providers. You can go to any licensed vet you like. And you get reimbursed for covered services. You should check with the insurer what they deem as a primary vet.
There’s a distinction here. Some insurers define a primary vet as being licensed and a member of the American Veterinary Medical Association (AVMA). But joining the AVMA is voluntary. Some vets join the Humane Society Veterinary Medical Association (HSVMA) instead.
It’s something you might want to check in case the pet insurer requires your vet to be part of the AVMA, not the HSVMA.
If you haven’t done your homework
Unlike health care for humans, which has tiers with comparable premiums, co-pays, and deductibles, there are no standard tiers among pet insurers.
It might feel like comparing apples to oranges.
Pet insurance might not cover what you think it does. While shopping around, check the exclusions for each policy, and what the benefit schedule is. Depending on the company, certain payouts might have a quarterly maximum, annual, or per incident cap. These predetermined limits break down into condition or illness.
Is pet insurance worth it?
Before you decide whether you want to buy pet insurance, download sample policies from insurers. Carefully review each policy for limitations, exceptions, and co-payments. You can also reach out to a rep with questions.
Pet insurance is a personal choice. If you can’t pay out of pocket for emergency care, you should consider buying pet insurance.
Buying a policy for your pet also gives you peace of mind when your pet unexpectedly falls ills. You could also decide that’s it’s worth it just to create an emergency fund for your pet instead.
Understanding how pet insurance works, and what it covers and doesn’t, will make it easier for you to make the best decision for you and your furbaby.