What pet insurance covers

Accident coverage pays for the sudden things: a broken leg, a swallowed sock, a torn cruciate ligament, a fight at the dog park, a car strike. In the desert it also means rattlesnake bites, heat stroke, cholla spines in a paw and foxtails in an ear; in the Idaho and Utah mountains, porcupine quills and tick-borne disease. Illness coverage pays for what develops: ear infections, allergies, urinary crystals, cancer, diabetes, kidney disease, and the valley fever that Arizona dogs contract from the soil. Both pay for the diagnostics, surgery, hospitalization and medications that follow. An accident-only plan costs less and covers only the first list.

Three numbers set what comes back. Suppose a plan with a $500 annual deductible, an 80 percent reimbursement rate and a $10,000 annual limit, and a $3,000 surgery in a year with no other claims: the carrier pays $2,000 and you pay $1,000. An annual deductible resets once a year across every condition; a per-condition deductible is met separately for each diagnosis and resets for a chronic one every year, which favors pets with one long-running problem and punishes pets with several. A lifetime limit caps what the plan will ever pay for the animal; an annual limit caps a year and starts fresh.

Anything that showed signs in the medical record before enrollment or during the waiting period is pre-existing and excluded, whether or not it was diagnosed. Some plans distinguish curable conditions, which can be covered again after a symptom-free stretch, from incurable ones, which never are. Bilateral conditions are the trap: a cruciate tear in one knee often excludes the other knee for the life of the plan. Waiting periods run days for accidents and illnesses and often months for orthopedic conditions, and the carrier will read the vet records when the first claim arrives.

A wellness add-on reimburses vaccines, annual exams, dental cleaning, flea and heartworm prevention and spay or neuter, up to a scheduled amount per item. It is a prepayment plan more than insurance: over a year it pays back roughly what it costs, with a small convenience premium. It is worth adding only when the schedule pays more than you would otherwise spend.

Hip dysplasia in a large breed, airway disease in a flat-faced dog, heart disease in a cat of a particular breed: whether these are covered, excluded or covered only after a longer wait varies by plan and is worth checking against your animal's breed before enrolling. Dental illness, meaning extractions and abscesses rather than cleanings, is covered by some plans and not others. Behavioral treatment, prescription food and physical therapy are each their own line in the fine print.