how does pet insurance reimbursement work?

How Does Pet Insurance Reimbursement Work? | women filing her pet insurance reimbursement claim with dog by her side
Posted by fetch! blog editors on May 12 2020

Reimbursements work just as their name implies: the pet insurance provider pays you back for your out-of-pocket veterinary expenses. With that said, it’s important to understand the specifics so you have an idea of what to expect should your pet require a sudden trip to the vet.

How do you get reimbursed for vet bills?

Reimbursement is the amount your pet insurance provider pays you for a covered condition when you submit a claim for veterinary bills. 

How does pet insurance reimbursement work?

In short, you must take your injured or ill pet to a licensed vet for treatment and file a claim via fax, web, or the provider’s app before you can expect your reimbursement.

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Can pet insurance pay my vet directly?

While some pet insurance providers can pay your vet upfront, most work within the standard reimbursement system: First, you pay the veterinarian in full and then the paid invoice and all the medical records must be submitted to your pet insurance provider so it can be reviewed for coverage and a reimbursement can be calculated.

Those pet insurance providers who are primarily reimbursement based may still be able to send any eligible reimbursement directly to the veterinary clinic. Written approvals – either digital or hardcopy – are needed from both you and the veterinary clinic.

Your veterinarian's approval must be sent from their vet clinic either through email (example or in a written letter with the clinic’s official letterhead. Once your provider receives these documents, you can file a claim and the clinic will receive the funds for any covered conditions. Keep in mind, any co-pays, deductibles, and other terms and conditions will still apply.

How much reimbursement can I expect?

The amount of reimbursement you receive is based on two policy specifications: the percentage of reimbursement and the deductible. Most pet insurance providers will let you choose these specifications at the time of enrollment. Your selections will impact your policy premium (the amount you pay for your policy either monthly or yearly). 

  • Reimbursement ranges from 70% to 90% of the total veterinary bill (or a 30% or 10% co-pay.)
  • Deductibles can be anywhere from $200 to $2,500.

Calculate your insurance reimbursement

To better illustrate how the pet insurance reimbursement system can financially help your family, let’s take a look at an example.

A Miniature Schnauzer was treated for pancreatitis by her veterinarian and her pet parents paid the total bill of $1,542.43. Luckily, this family enrolled their pup early in a pet insurance policy with a 90% reimbursement rate and $200 annual deductible. 

Total bill = $1,542.43

$1,542.43 x 90% reimbursement = $1,388.19

$1,388.19 - $200 deductible = $1,188.19 reimbursement

In this example, this family’s total out of pocket expense fell around $350 – a fraction of their pup's pancreatitis treatment! The pet insurance reimbursed the rest. Be aware, all pet insurance companies have some items and services that are excluded from coverage.

As you can see, the plan you select can greatly impact how much you are reimbursed and it’s best to choose the most comprehensive pet insurance. When shopping for a plan, it’s important to consider your pet’s potential needs, compare pet insurance providers and review each provider’s terms and conditions before you purchase.

For more information on how your pet insurance policy works or how Petplan handles claims, visit our FAQs.

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