16. Can I afford the monthly premium, deductible, and required co-pay?

Don’t think this question needs much explaining..but, just make sure you think about the different costs and what the co-pay would mean to you.

17. Is there any penalty if I cancel my policy?

It’s my understanding that with insurance, you’re always owed back any premium that you’ve paid ahead of time. However, make sure to check with each company just in case you decide you don’t like the coverage. And, as in most pet insurance companies, if you decide to switch, any conditions that began with one company will likely not be covered by another.

I hope you have found these questions helpful. I’d love to take credit for them, but they did come from The American Animal Hospital Association, so you can thank them;)

13. How are claims submitted? How long do I have to submit a claim? Will my costs change based on the number of claims I submit?

This is an important process to understand, since, duh, this is how you get your money back! Make sure you understand what you have to do, what your veterinarians has to do, and exactly how long you have to do it. Some companies require you submit your claim within 30 days of the treatment, some 3 months, some a year, but make sure you understand that time line. The last thing you’d want is a denied claim simply because you exceeded the amount of time you have to submit!

14. How long does it take, on average, to be reimbursed?

This is a little trickier to get a straight answer. There aren’t many rules regulating how long a company has to reimburse a client. Some companies will advertise their average turnaround time, while others will dance around the question. Either way, do your best and see what you can get out of them.

15. Does this policy use a list of “usual and customary fees” to determine how much I will be reimbursed? Is that list up-to-date? Are the fees consistent with what my veterinarian expects to charge?”

For this I would recommend getting this answer in writing. Find out exactly how much you will get reimbursed on an approved claim, and even think about taking those costs/fees into your veterinarian to see if they make sense. If your veterinarian says “no way, these prices are way too low” then you might want to consider another company.

9. Do I understand exactly what the policy covers?

This is to reiterate the importance of understanding what you’re getting! Too many pet owners get into pet insurance without fully understanding, then get angry for not understanding! Now, true, there are some companies that try to take advantage of the unknowing consumer, but if you don’t do you research thoroughly, you can’t blame anyone but yourself!

10. How much coverage does this policy provide for chronic, hereditary, or pre-existing conditions?

This is a really important question to ask and be made aware of, especially if you own a breed that is prone to certain conditions. Most companies will not cover any pre-existing conditions, so if your pet has had a medical history make sure to ask how that will affect future coverage.

Chronic conditions is also a really important topic. Please read all the fine print. Many companies start a brand new policy upon renewal, making anything in the previous policy term pre-existing and NOT covered. For example, if your cat were to get diabetes and treatment was covered, then you renewed your policy 3 months later, there is the possibility that treatment would no longer be covered. This is a BIG one, so please, please ask the provider how they handle chronic conditions!

That brings me to my next question…

11. How does this provider handle renewals?

As mentioned above, some policies are annual policies, and therefore have to be renewed each year. Make sure to find out how renewal will affect your coverage. The last thing you’d want is to be paying into insurance for 4 years to have your dog develop skin allergies in the 4th year, only have them covered in that 4th year, but then being stuck with that insurance company because you’ve already put so much money into it and his skin allergies would be pre-existing anywhere else. Talk about frustration.

NOTE: There are companies that have continuous policies or that offer additional coverage for chronic or recurring ailments.

12. Are there certain types of accidents or health problems that aren’t covered?

Again, this goes back to making sure you know what is and isn’t covered. Specifically ask what incidents would be excluded for coverage. For example, most companies don’t cover accidents to working dogs (guard dogs, police dogs, etc.) or any complications from breeding or pregnancies. Since intact pets are more prone to certain cancers and other ailments, there are often exclusions if your pet isn’t spayed or neutered, so make sure to also inquire about that.

I would love to hear additional feedback: comments, suggestions, further questions, etc. Until next time…

7. Will this provider reimburse services provided by my veterinarian or am I required to use a veterinarian in this provider’s network?

I really only know of one or two companies that require you to use a veterinarian within their provider network. Since most pet insurance reimburses the pet owner, the pet owner can see whichever veterinarian they choose. However, make sure to double check when picking out a provider.

8. Does this provider have an appeals process I can use if my claim is denied?

Many pet insurance providers will offer you the opportunity for you and/or your veterinarian to appeal a denied claim. This usually gives the veterinarian (if they’re willing) the chance to further explain the pet’s history or chosen treatment. Some providers will then even send the claim and appeal to a third part group of veterinarians for review. I think this is a good system to have in place, and offers pet owners extra peace of mind.

Again, please feel free to ask questions or embellish on anything I have mentioned here.

4. Does this provider offer a variety of deductibles?

The American Animal Hospital Association suggests going with a company that allows for high deductible plans, but this is entirely up to you. Their reasoning is that it keeps monthly premiums down, while still covering those major accidents or illnesses. If you would prefer to only cover those really expensive trips to the vet, then I would also recommend finding a company that lets you have a high deductible.

5. Does this provider exclude coverage for pets the same species, breed, and age as mine?

You should be aware that there are companies that will have certain breed-specific exclusions. If you have a breed that may be prone to certain conditions, you might want to ask the provider if they have any exclusions for your specific pet.

6. Did this provider respond quickly and thoroughly when I requested more information?

This is another question to get the feel for the company. If they were slow in getting you more information, chances are they will be slow at processing any claims that you make. I would suggest going with a company that is very upfront and honest about giving you the right information, and giving you the information that you specifically ask for.
Again, please feel free to ask questions or embellish on anything I have mentioned here. Stay tuned next week…

I’m going to break up the questions so that I am able to explain what each one means.

Today I’ll start off with some basic company questions.

1. Are there any complaints about this provider on record at the Better Business Bureau?

I think that this one is pretty straightforward, and may be something that you’re in the habit of doing already. Simply visit the BBB’s website and see what, if any, complaints exist about the company.

2. Does this provider have good ratings at independent websites that review and/or publish customer ratings of pet health insurance companies?

I know of one really good independent website called Pet Insurance Review. They have made sections where policy holders can go under their given company and write a review. You can view the reviews by visiting their website, here. I would also appreciate any other suggested websites that you might know of.

3. Is this provider selling the insurance licensed in my state?

You shouldn’t worry about this question too much, as either you’re able to get the insurance or you’re not. Each company is required to jump through hoops with each state’s department of insurance, and if they have and they’re approved then you’ll be able to get insurance. Typically, once you have the insurance, the company will cover any veterinarian that you visit (even if they’re outside of your home state).

Please feel free to comment with questions or concerns. And, as I mentioned, I would also love to hear any embellishments on either question, or other suggested pet insurance review sites!