Benefit Schedule

 

Overview

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 Example

Let’s assume your dog has been limping and has been diagnosed with hip dysplasia. 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.

With a Benefit Schedule
Cost to Treat: $5,000
Deductible: $250
Reimbursement: Schedule
Max Payment for Hip Dysplasia Surgery: $2,150
Total Paid by the Company: $1,900
Total Out-of-Pocket: $3,100

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

NO Benefit Schedule
Cost to Treat: $5,000
Deductible: $250
Reimbursement: 90%
Max Payment for Hip Dysplasia Surgery: No Limit
Total Paid by the Company: $4,250
Total Out-of-Pocket: $750

 

Learn More: How Pet Insurance Claims Work

 

Conclusion

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.

 

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