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How Much Can You Claim on Your Pet Insurance?

Are you wondering how much of your vet bill you’ll be able to claim on your pet insurance? Find out how pet insurance works here with Savvy.  

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, updated on August 31st, 2023       

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Woman with labrador puppy and vet

Are you wondering how much you can claim on your pet insurance, and what are the limitations to how much you can claim? When it comes to safeguarding your pet’s health, pet insurance can be a great help with the cost of a variety of vet treatments. Understanding how much you can actually claim on your policy is vital when you’re comparing policies and making decisions about which one may suit your particular budget and pet health needs. 

How does pet insurance work, and how much can I claim?

Pet insurance is designed to help with the cost of providing the best vet care for your furry family members. It functions much like human private health insurance. You pay regular premiums (typically monthly or annually) to a chosen provider in exchange for coverage for veterinary bills. However, most pet insurance policies won’t cover 100% of the cost of taking your pet to the vet.  

Understanding excess amounts 

When making a claim, you'll often encounter the term ‘excess.’ This is the portion of each claim that you're responsible for covering out of pocket. For example, if your excess is $100 and the vet bill is $500, you'll pay $100, and the insurer will cover the remaining $400. You’ll have to pay this $100 excess each time you make a claim on your insurance policy.  

Annual policy limits 

Every pet insurance policy comes with an annual policy limit, which is the maximum amount the insurer will reimburse you within a single policy year. This amount is often between $10,000 and $20,000, although you can choose a higher annual limit. A policy with a higher limit will cost you more in monthly premiums. It's important to choose a policy with an annual limit that aligns with your pet's potential healthcare needs. 

Benefit percentages 

Your policy's benefit percentage determines how much the insurer will reimburse for eligible expenses after you've paid the excess amount. For example, if your policy has an 80% benefit percentage and your eligible vet bill is $1,000, you'll receive $800 in reimbursement. It’s possible to get pet insurance policies which cover from 50% to 95% of the total cost of a claim, with the higher percentage policies costing more.  

Annual condition limits 

Certain policies may have condition-specific limits. These limits cap the amount you can claim for one specific health condition or treatment for that condition. For example, a policy may have an annual limit of $20,000 in total, but a condition limit of $2,000. It's essential to be aware of these limits, especially if your pet has an on-going condition that requires regular treatment.  

Understanding these elements of a pet insurance policy will help you make an informed decision when comparing pet insurance policies

Do I have to pay the vet’s bill up-front?

This will depend on the pet insurance policy you choose to buy. With some policies, you will have to pay the whole vet bill, and then submit a claim to your insurer, who will reimburse you the eligible percentage of the bill. 

However, there are some pet insurance policies that offer the GapOnly pay system, which is similar to the HICAPS system for private health insurance. Rather than paying the full vet bill and waiting for reimbursement, GapOnly calculates your claim while you’re still at the vet clinic, and if it’s approved, you only have to pay the gap upfront. The gap is the difference between the total vet’s invoice, and the claim benefit amount under your specific policy. 

If your pet insurance and your vet are in the GapOnly scheme, you can also get treatment costs pre-approved, so you are aware of how much the treatment will cost in advance. It’s also possible to have your claim submitted and approved prior to you picking up your pet from the vet following treatment, to save you having to wait at the surgery while your claim is processed. On the spot approvals only take 10 minutes. 

What factors affect the cost of my pet insurance?

Several factors influence the cost of your pet insurance premiums. Understanding these elements can help you make an informed decision when selecting coverage for your furry friend. Here are the key factors that affect the cost of pet insurance: 

  • Pet's age: Younger pets typically have lower insurance premiums. As pets age, the risk of developing health issues increases, leading to higher insurance premiums.
  • Pet type and breed: Generally cats are cheaper to insure than dogs. Some breeds are predisposed to specific health conditions, which can affect their insurance rate. Breeds with known genetic or hereditary issues may have higher premiums.
  • Your location: The cost of veterinary care varies depending on where you live. Areas with higher living costs generally have higher insurance premiums.
  • Coverage type: The type of coverage you choose plays a significant role in premium costs. Accident-only policies are typically more affordable than accident and illness policies. Comprehensive plans cost the most, but offer the greatest cover for many aspects of your pet’s health needs.
  • Benefit percentage: Policies with higher benefit percentages will have higher premiums, but offer greater reimbursement for eligible expenses.
  • Annual limit: Policies with higher annual limits tend to have higher premiums, but provide more extensive coverage for your pet's healthcare needs.
  • Sub-limit: In addition to an annual benefit limit, there may also be sub-limits for specific aspects of treatment. For example, a policy may have a $20,000 overall annual limit, but a $500 sub-limit for consultation fees.
  • Excess: A higher excess amount can lead to lower premiums, but it means you'll pay more out of pocket when making a claim.
  • Pre-existing conditions: If your pet has a pre-existing condition which was known about before you bought your insurance policy, that condition may not be covered, or there may be higher premiums charged to offer cover for that known condition.
  • Optional add-ons: Adding extra coverage, such as routine care or dental care, will increase your premium cost.
  • Claims history: A history of frequent claims can result in increased premiums upon policy renewal.

By considering these factors and tailoring your pet insurance policy to your pet's specific needs, you can strike a balance between adequate coverage and manageable premiums. It's essential to compare policies from different providers to find the best fit for your pet and budget. 

Frequently asked questions about how much you can claim on your pet insurance

Are there pet insurance policies with no excess?

Yes, some pet insurance policies offer zero excess options, meaning you won't need to pay an upfront fee when making a claim. However, it's important to note that these policies often come with slightly higher premiums to compensate for the lack of excess. 

Are prescription medications included in my claimable amount?

Yes, most pet insurance policies cover prescription medications prescribed by your veterinarian as part of your claimable expenses. However, the cost of routine medication care such as deworming tablets and flea treatments probably won’t be covered unless you have a comprehensive policy with routine care added on. 

Does comprehensive pet insurance offer higher benefit limits?

Generally, yes. Comprehensive pet insurance policies tend to provide higher benefit limits compared to basic plans. These higher limits allow you to claim more expenses for various treatments, making it a valuable option for comprehensive coverage. 

What treatments can I get GapOnly payment for?

You only have to pay the gap amount for all treatments and procedures offered by your vet if they participate in the GapOnly payment system. This can include surgeries, diagnostic procedures, hospitalisations and more.   

Compare pet insurance

Looking into pet insurance for your beloved furry friend? Whether you have a playful pup or a curious cat, you can compare pet insurance options from a range of providers and find the perfect coverage that suits your pet's unique needs and your budget. 

site-logos Fetch Care Plan

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$30,000 $100 80%, 90% or 100% pros-item-petins pros-item-petins

Pet insurance we think you’ll love. 24/7 vet support + dental, physio and behaviour cover added (see PDS) all in one app.

More details
site-logos Petsy Most Popular 80% Cover $150 Excess

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$25,000 $150 80% pros-item-petins pros-item-petins

Protect your furry friend with Petsy's pet insurance policy. Get a free quote.

More details
site-logos Fetch Premium Plan

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$30,000 $0 80% or 90% pros-item-petins pros-item-petins

Pet insurance we think you’ll love. 24/7 vet support + dental, physio and behaviour cover added (see PDS) all in one app.

More details
site-logos Knose Pet Insurance

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$7,500, $12,500 or $25,000 $0 / $100 / $200 70%, 80% or 90% pros-item-petins pros-item-petins

Multi-award winning pet insurance designed with the help of vets.

More details
site-logos Petsy Value Cover 80% Cover $500 Excess

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$10,000 $500 80% pros-item-petins pros-item-petins

Protect your furry friend with Petsy's pet insurance policy. Get a free quote.

More details
site-logos Petsy Top Cover

Annual benefits limit

Excess

% Benefits reimbursement rate

Covers illness?

Covers accidental injuries?

$25,000 $0 / $150 / $500 90% pros-item-petins pros-item-petins

Protect your furry friend with Petsy's pet insurance policy. Get a free quote.

More details

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