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Benefit Schedule

pet insurance benefit schedule


A benefit schedule sets a fixed payout amount for a given health condition.

It is a long list of healthy conditions and veterinary procedures that includes the amount the pet insurance company will pay for each.

Benefit schedules aren’t very common in the pet insurance industry. In fact, the only plan that still uses a benefit schedule to pay claims is Nationwide’s Major Medical Plan*. All other companies pay claims based a percentage of your actual vet bills.

Real Life Example

Let’s assume your dog has been limping and suffers from a torn cruciate ligament. In order to correct the issue he will need to undergo corrective surgery.

Here is what you would get if you had a reimbursement schedule…


Benefit Schedule

$5,000   cost to treat
-$250     deductible
$2,750   max reimbursement
$2,750   total claim paid
$2,250   out-of-pocket


And here is what you would get if you had a standard pet insurance policy with no benefit schedule…


Standard Plan

$5,000   cost to treat
x 90%    reimbursement
-$250     deductible
$4,250   total claim paid
  $750    out-of-pocket


Learn More: How Pet Insurance Claims Work



Before you buy a pet insurance plan make sure you understand how the company pays claims because if they use a benefit schedule it will drastically limit how much you get paid for claims. For that reason, we don’t recommend you select any pet insurance plans that are governed by a benefit schedule, instead, enroll in a plan that pays a standard percentage of your actual vet bills.


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