Most pet insurance companies work on a reimbursement model, while some pay your veterinarian for covered costs. Let’s dig into the details of all things reimbursement and how to choose the best rate.
What Is Pet Insurance Reimbursement?
Reimbursement is how much you get back for covered veterinary costs. Your pet insurance provider issues this repayment after you meet your deductible.
How Does Pet Insurance Reimbursement Work?
When your pet receives veterinary treatment, you will get an itemized bill from the clinic you visited. You will pay the vet bill upfront and submit a claim to your insurer afterward. From there, your insurer will review the claim. This process can take a few days or weeks, depending on the insurer and how complicated your claim is. If approved, you’ll receive a check or direct deposit to your bank account.
Example Reimbursement Scenario
Let’s say your pet needs a life-saving surgery, but it will cost a total of $10,000. Thankfully, you have a pet insurance plan with a 90% reimbursement percentage and a $200 deductible. After meeting your deductible and filing a claim for your pet’s surgery, your insurer will reimburse you $8,800.
Choosing the right reimbursement rate can make a difference in the affordability of care for your pet. Without pet insurance, you would either have to find a way to pay $10,000 or decline the surgery.
What Does Reimbursement Rate Mean for Pet Insurance?
After you meet your deductible, your pet insurance provider will pay back a percentage of your veterinary bills. This percentage is your reimbursement rate. Most pet insurance companies offer percentage options like 70%, 80%, or 90% (some even offer as low as 50% or as high as 100%).
It’s important to remember that your reimbursement is also subject to a coverage limit. Annual, per-incident, or lifetime maximums cap the total amount your insurer will pay. Even with a high reimbursement rate, your total payout won’t exceed the maximum amount of these limits.
Does Reimbursement Rate Affect Overall Pet Insurance Cost?
Yes. If you choose a higher reimbursement rate, your plan will be more expensive. This is because you’ll pay less out of pocket after filing a claim. A plan with a lower reimbursement rate will cost less. This is because you will take on more financial responsibility for your pet’s care.
How to Choose a Pet Insurance Plan With the Right Reimbursement Options
Choosing the reimbursement rate that’s right for you is about balance. Ask yourself what you can afford each month and how much you’re willing (or able) to pay out of pocket if your pet needs care.
A higher reimbursement rate means your insurance covers more of the vet bill. However, your monthly rate will also be higher. A lower rate will save you on monthly costs, but you’ll pay more out of pocket when your pet gets sick or injured.
If you are looking for more predictable costs and less financial risk, a higher reimbursement rate might make sense. If your pet is young and healthy and you're comfortable covering a larger share of vet bills, a lower rate may be fine.
What’s the Best Reimbursement Rate?
We recommend choosing a balanced reimbursement rate of 80%. It covers most of the costs by the insurer while fostering financial responsibility on your end.
How Long Does It Take to Get Reimbursed?
Reimbursement times can vary by insurer. Many pet parents receive their reimbursement within 5 to 10 business days after submitting a complete claim. Some companies even offer faster turnaround, especially if you submit claims digitally and opt for direct deposit.
To help speed up the process:
- Submit your claim as soon as possible
- Include itemized vet bills and medical records, if requested
- Sign up for direct deposit to avoid potential mailing delays
Some insurers, like Fetch and Lemonade, offer app-based submissions. This can make the process of making a claim even easier.
Common Mistakes to Avoid With Pet Insurance Reimbursement
Pet insurance can be a great safety net—if you understand how it works. Here are a few common missteps to watch for:
- Not submitting claims on time. Most insurers have a deadline for filing (e.g., 90 days from the vet visit).
- Missing documentation. Always submit an itemized invoice and any requested medical records.
- Choosing the wrong reimbursement rate. A lower rate can mean bigger out-of-pocket surprises later.
- Assuming that pet insurance covers everything. Routine care and certain treatments aren’t always part of a plan unless you have specific add-ons.
Reading the fine print and asking questions before you buy can help avoid surprises when it’s time to file a claim.
Does Reimbursement Rate Cover Preventative and Routine Care?
Most standard pet health insurance plans focus on unexpected vet costs—things like injuries, illnesses, and emergencies. Accident and illness coverage doesn’t include routine and preventative care.
If you're interested in coverage for routine visits, look for insurers that offer wellness plans as optional upgrades. Keep in mind, these plans typically reimburse a set amount per service and may have annual caps.
What is Vet Direct Pay?
This is a claims method offered by some pet insurance companies. They will reimburse the care provider directly, meaning you don't need to pay the vet bill upfront at checkout.
Reimbursement vs. Vet Direct Pay
In pet insurance, reimbursement and vet direct pay are the two main ways to handle claims. When you have an insurance plan that uses a reimbursement model, you pay for your pet's care upfront. Later, you can get money back for covered expenses from your insurer.
Vet direct pay, on the other hand, means your insurer pays the vet directly for covered expenses. You’ll just need to make sure you cover any deductibles or co-pays you’re responsible for. It's easier on your wallet upfront, but the only hangup is that not all veterinarians accept vet direct pay.
Final Thoughts on Pet Insurance Reimbursement
Understanding how pet insurance reimbursement works can help you choose the best plan for your best friend—and your wallet. Remember, reimbursement rates, claim processes, and pet insurance coverage can differ a lot between insurers. So, it’s important to read the fine print and ask questions.
Enrolling early, choosing the right reimbursement rate, and keeping your claims organized will make the process smoother. And, it helps ensure you get the support you need when your pet needs care.
Ready to find a plan that fits your budget and gives you peace of mind? Start comparing your pet insurance options today and see how reimbursement rates impact your coverage and costs.
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