Takeaways
- A reimbursement level is the percentage of a vet bill your insurance will cover after you’ve met your deductible.
- Reimbursement levels can vary but are typically within 70-90%.
- Some pet insurance plans have a per-condition reimbursement level, which means that you’ll need to hit your deductible for each condition, rather than overall.
- How long it takes to be reimbursed varies depending on your insurance company, but it tends to be around 10 days.
Pet insurance plans come with a reimbursement level, which is how much of a vet bill your insurance company will reimburse you after you’ve met your deductible. In most cases, you’ll need to pay the entire vet bill upfront, then wait for reimbursement after making a claim.
What Does Pet Insurance Reimbursement Mean?
When you purchase a pet health insurance policy, you’ll either choose, or be given, a reimbursement level. The reimbursement level is the amount of a vet bill your pet insurance company will reimburse you, after you’ve met your deductible.
Your deductible and reimbursement level go hand-in-hand. Your deductible is how much of your vet bill you’re responsible for before your coverage will kick in. After that, your reimbursement level is what portion of the bill your insurance will then cover.
Choosing the right pet insurance policy can be daunting! With so many to choose from, and so many variables, it’s easy to get confused.
Dr. Sarah-Jane Molier, Veterinary Surgeon
There will be a policy to suit most needs and budgets, but you do need to do your research to find the best one for you and your pet. Most importantly, read the small print! A low insurance premium may seem enticing, but if you read on to discover that it comes with a high deductible and low reimbursement rate, it may be less appealing after all. You need to decide what works for your budget, and for your pet’s needs.
How Does The Pet Insurance Reimbursement Process Work?
In some cases, your pet insurance company may pay the vet directly, so you won’t need to wait for reimbursement. In most cases though, you’ll need to pay the entire bill upfront, then submit it to the insurance company for reimbursement later.
Here’s a few scenarios to illustrate how the reimbursement process would work:
Scenario 1: Your pet insurance policy has a $500 deductible and a 90% reimbursement rate. You get hit with a $5,000 vet bill, and you haven’t hit any of your deductible yet.
First, you’ll pay your $500 deductible, bringing the remaining balance to $4,500. Your insurance cover will kick in and cover 90% of the bill, leaving you to pay 10% of the bill – $450. This means you’d pay your vet $5,000, and your insurance company would reimburse you $4,050, bringing the amount you have spent to $950.
Your pet insurance policy has a $100 deductible and an 80% reimbursement rate. Fido blesses you with a $1,000 trip to the vet. You’ve already hit your deductible (either for this condition or this year, depending on your policy), so the $1,000 bill stands.
You’d be responsible for $200 (20% of the bill), and your insurance company would reimburse you $800 (80% of the bill).
Scenario 3: Your pet insurance policy has a $250 deductible, a 100% reimbursement rate, and pays the vet directly. Your pup is whimpering in pain, so you take him to the vet and get hit with a $600 bill.
You’d pay $250 to your vet, and your insurance company pays the remaining $350 directly to your vet. Or if you’ve already hit your deductible from previous expenses, your insurance company reimburses 100% of the $600 bill to your vet.
What Is a Normal Reimbursement Level?
Most pet insurance plans have reimbursement levels between 70-90%. However, plans do exist with more and less coverage. For example, Figo offers policyholders up to 100% reimbursement on eligible expenses.
Reimbursement Levels vs. Per-Condition Levels
Some pet insurance plans have a per-condition deductible policy. This means that your deductible is applied for each condition you claim for, rather than applying once per policy year.
For example, let’s say you bring your dog to the vet for an eye infection. You will pay your full deductible, plus the portion of the bill that’s left over after insurance reimburses you. If the infection recurs a few weeks later, you won’t need to pay your deductible again; all other expenses incurred related to the eye infection will be subject to your reimbursement level.
Now, because you’ve already met your deductible for this condition, all other expenses incurred related to the eye infection will be subject to your reimbursement level. However, if you go back to the vet for another condition, you’ll need to hit your deductible again for those expenses.
How Long Does It Take To Be Reimbursed?
It depends. Each pet insurance company will have their own timeline for addressing claims. For example, Healthy Paws takes around 10 days, Embrace takes 10 to 15 days, and Nationwide takes 5 days.
Pet Insurance That Pays the Vet Directly
If waiting for reimbursement isn’t ideal, you can also opt for a pet insurance company that pays the vet directly, such as:
- Trupanion
- Healthy Paws
- Pets Best
- Petplan
- Companion Protect
Before purchasing a policy, consider the pros and cons of a direct payment plan. While convenient, it may not be accepted at all vets and you may be limited to in-network providers.