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 companies 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 dog or cat and want it to be as healthy and happy as possible, you might want to hit “pause” before hopping on a pet insurance plan. After all, pet insurance policies work a bit differently than health care plans for humans, so you’ll want to know the ins and outs to gauge whether it’s worth the expense.
Here are six situations when you probably shouldn’t get pet insurance:
For preventative care
A pet insurance policy primarily covers accidents and illnesses. Let’s say your pet gets injured in a car accident or dog fight, gets poisoned, suffers an infection, or develops a chronic illness. In these instances, pet insurance will foot the medical bill after you’ve met your deductible.
If you’d like your policy to cover routine check-ups, flea and tick medication, and vaccinations, you could buy a wellness plan. While most pet insurance companies offer wellness plans, it’s usually 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 gnarly brawl with a neighborhood canine and suffers injuries, you can’t purchase a policy soon after to lower the vet bill.
What’s more, most pet insurance companies won’t cover congenital conditions, which are present since birth; or hereditary conditions, which are genetic disorders transmitted from your pets’ parents.
Common congenital disorders for dogs include 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 typically can suffer from genetic disorders such as 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, she and her partner wanted to get a pet insurance plan 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
While most pet insurance companies have an age cap of 14 years (it varies slightly between dogs and cats), typically the older your pet is when you initially sign up, the more expensive your premium.
Let’s not forget that premiums 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 tucked away
Given the typically long list of exclusions with pet insurance 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.
Let’s say you purchase a pet insurance 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 $3,350 for a cat. You’ll also need to meet your deductible, which 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 and will likely need greater 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 pretty much go to any licensed vet you like, and you can get reimbursed for covered services. While this might seem like a no-brainer, you should check with the insurer what they deem as a primary vet.
There’s a slight distinction here. Some insurers define a primary vet as being licensed and a member of the American Veterinary Medical Association (AVMA). However, joining the AVMA is voluntary. Some vets opt to join the Humane Society Veterinary Medical Association (HSVMA) instead.
It’s a nitty-gritty thing, but it’s something you might want to check in case the pet insurance company 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 such as “bronze,” “silver,” and “gold,” with comparable premiums, co-pays, and deductibles, there are no standard tiers among pet insurance companies.
So it might feel like comparing apples to oranges.
Pet insurance might not cover what you think it does. While shopping around, it’s key to 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 or not you want to buy pet insurance, download sample policies from insurance companies. Be sure to carefully review each policy with a fine-toothed comb for limitations, exceptions, and co-payments. You can also reach out to a representative with any questions.
Pet insurance is very much a personal choice. If you can’t pay out of pocket for emergency pet care, you should consider buying pet insurance. Buying insurance 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 for you just to create an emergency fund for your pet instead.
In the end, 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.