What Does Pet Insurance Cover?

Pet insurance typically covers accidents, illnesses, emergency care, and prescription medications, though coverage varies significantly between providers and plan types. Despite the financial protection it offers, fewer than 5% of US pets have insurance coverage, according to the North American Pet Health Insurance Association (NAPHIA), leaving most owners vulnerable to unexpected veterinary bills.

"As a veterinarian who has worked in both Emergency Room and General Practice settings, I've seen clients struggle with unexpected bills ranging from critical bloat cases to routine laceration repairs. Many veterinary practices now require upfront payment, and without the means to pay, pets often don't receive the care they need," says Dr. Loke Jin Wong, Associate Veterinarian at Murraysville Veterinary Associates.

This guide breaks down what the top pet insurance companies cover, common exclusions, and tips for choosing the right plan before an emergency strikes.

What Does Pet Insurance Typically Cover?

Pet insurance typically covers six main areas: accidents and injuries, illnesses and diseases, emergency care, diagnostic tests and procedures, surgeries, prescription medications, and specialist treatments. Here's what each area includes:

Pet Insurance Covered vs. Non-Covered Services

Accidents and Injuries

• Broken bones and fractures: Emergency orthopedic injuries from falls, car accidents, or high-impact activities that require immediate surgical intervention.

• Cuts, wounds, and bite injuries: Lacerations from fights with other animals, sharp objects, or accidents that need stitches or wound care.

• Swallowed foreign objects: Emergency removal of toys, socks, bones, or household items that cause intestinal blockages requiring surgery.

• Poisoning incidents: Treatment for ingestion of chocolate, xylitol, antifreeze, or other toxic substances requiring immediate veterinary intervention.

• Burns, sprains, and traumatic injuries: Heat burns, chemical exposure, ligament tears, and other sudden physical trauma needing medical treatment.

According to Dr. Wong, common veterinary procedures can vary significantly in cost:

Here's how pet insurance can help with these costs:

* Assumes $500 annual deductible already met and 80% reimbursement rate

Illnesses and Diseases

• Cancer treatment: Comprehensive care including chemotherapy, radiation therapy, tumor removal surgery, and ongoing oncological monitoring.

• Chronic conditions: Long-term management of diabetes, arthritis, heart disease, kidney disease, and other conditions requiring lifelong treatment.

• Infections: Bacterial, viral, and fungal infections affecting the ears, urinary tract, respiratory system, and other body systems.

• Digestive problems: Gastrointestinal issues, including inflammatory bowel disease, gastroenteritis, pancreatitis, and food allergies.

• Skin conditions: Dermatological issues like severe allergies, dermatitis, hot spots, and autoimmune skin disorders.

• Hereditary and congenital conditions: Breed-specific genetic disorders like hip dysplasia, heart murmurs, and eye conditions (coverage varies by policy).

Emergency Pet Insurance Coverage

• Emergency room visits: After-hours urgent care for life-threatening conditions, severe injuries, or sudden illness requiring immediate attention.

• Overnight hospital stays: Multi-day intensive care monitoring for critical conditions, post-surgical recovery, or stabilization treatment.

• Emergency surgery: Urgent surgical procedures for bloat, internal bleeding, severe trauma, or other conditions requiring immediate intervention.

• After-hours veterinary care: Weekend and holiday emergency services when regular veterinary clinics are closed.

Diagnostic Tests and Procedures

• X-rays and imaging: Digital radiographs, MRIs, CT scans, and ultrasounds are used to diagnose internal injuries, tumors, or organ problems.

• Blood work and laboratory tests: Complete blood panels, urinalysis, thyroid testing, and specialized lab work to identify diseases and monitor health.

• Biopsies and tissue samples: Surgical removal and laboratory analysis of suspicious lumps, skin lesions, or organ tissue for cancer diagnosis.

• Endoscopy and other diagnostic procedures: Internal camera examinations of the digestive tract, airways, or other body cavities to identify problems.

Surgeries

• Emergency surgical procedures: Life-saving operations for trauma, bloat, internal bleeding, or other critical conditions requiring immediate surgery.

• Tumor removal and cancer surgery: Surgical excision of cancerous masses, lymph node removal, and reconstructive procedures following cancer treatment.

• Orthopedic surgery: Bone fracture repair, ACL reconstruction, hip dysplasia correction, and other skeletal system surgical interventions.

• Soft tissue surgery: Internal organ repairs, spleen removal, gallbladder surgery, and other procedures involving internal organs and tissues.

Prescription Medications

• Antibiotics and pain medications: Essential drugs for treating infections, managing post-surgical pain, and providing comfort during illness recovery.

• Long-term medications: Daily medications for chronic conditions like diabetes insulin, heart medications, and arthritis management drugs.

• Specialty medications: Expensive targeted therapies for cancer treatment, autoimmune disorders, and rare conditions requiring specialized drugs.

• Therapeutic diets: Prescription foods designed to manage specific health conditions like kidney disease, allergies, or digestive disorders (coverage varies).

Specialist Treatment

• Dermatology: Advanced skin condition treatment for severe allergies, autoimmune disorders, and complex dermatological diseases requiring specialized care.

• Cardiology: Heart condition diagnosis and treatment, including echocardiograms, cardiac catheterization, and management of congenital heart defects.

• Oncology: Comprehensive cancer care including staging, chemotherapy protocols, radiation therapy, and ongoing cancer monitoring by veterinary oncologists.

• Orthopedic specialists: Advanced bone and joint surgery for complex fractures, joint replacements, and specialized procedures beyond the general practice scope.

• Ophthalmology: Eye surgery and treatment for cataracts, glaucoma, retinal detachment, and other vision-threatening conditions requiring surgical intervention.

Alternative and Specialty Therapies

• Acupuncture and chiropractic care: Traditional Chinese medicine and spinal manipulation therapy for pain management, mobility improvement, and holistic wellness.

• Physical therapy and rehabilitation: Structured exercise programs, underwater treadmills, and therapeutic activities for post-surgical recovery and chronic condition management.

• Hydrotherapy treatments: Water-based exercise therapy in specialized pools or underwater treadmills for joint mobility and muscle strengthening.

• Behavioral therapy sessions: Professional counseling for anxiety, aggression, and other behavioral issues that require specialized intervention beyond basic training.

• Holistic and integrative treatments: Complementary medicine approaches including herbal medicine, massage therapy, and other alternative healing modalities.

Pet insurance eliminates the financial worry when specialty care becomes necessary. Dr. Wong explains that as a general practitioner, he sometimes encounters cases beyond his clinic's capabilities. "When we can't adequately diagnose or treat a patient's condition, we refer to specialist partners," he says.

While specialists cost more than general practice visits, they offer targeted expertise that makes the difference for complex cases. These veterinary specialists have access to advanced imaging like MRI and CT scans, and they follow specialized protocols. "Whether it's chemotherapy for cancer patients or long-term management of chronic dermatologic conditions, specialists provide care that general practices simply can't match," says Dr. Wong.

What's NOT Covered By Pet Insurance?

Pet insurance typically excludes five main categories: pre-existing conditions, cosmetic and elective procedures, routine wellness care, breeding and pregnancy costs, and behavioral issues. Understanding these exclusions is crucial for setting realistic expectations:

Pre-Existing Conditions 

Any health issue your pet had before coverage begins is typically excluded permanently. This includes:

• Diagnosed conditions: Any illness, injury, or disease that appears in your pet's medical records before the policy's effective date.

• Symptoms: Clinical signs or symptoms that were noted by a veterinarian before coverage started, even if not yet diagnosed.

• Conditions: Related health issues that develop from or are connected to pre-existing problems, often called "bilateral conditions."

"A pre-existing condition is any illness or medical issue that's been previously seen and treated by a veterinarian. In veterinary medicine, there's a gray area—an acute upset stomach shouldn't count as pre-existing unless it's part of a chronic GI condition. True pre-existing conditions are typically chronic diseases requiring ongoing monitoring and treatment," says Wong.

Cosmetic and Elective Procedures

• Tail docking and ear cropping: Surgical procedures performed for appearance rather than medical necessity, typically done on young puppies.

• Declawing: Surgical removal of cat claws that's considered elective and is banned in many jurisdictions for ethical reasons.

• Cosmetic dental procedures: Teeth cleaning, whitening, or other dental work performed purely for aesthetic reasons rather than health necessity.

• Grooming and nail trimming: Routine maintenance procedures that are considered part of regular pet care rather than medical treatment.

Routine Wellness Care

Most basic plans exclude preventive care, though some insurance companies provide reimbursement/coverage for routine wellness care through add-on plans. For example: 

• Annual vaccinations: Core vaccines like DHPP, rabies, and bordatella that prevent common diseases and are required by law in many areas.

• Flea, tick, and heartworm prevention: Monthly preventive medications that protect against parasites but are considered routine maintenance rather than treatment.

• Routine dental cleanings: Annual professional teeth cleaning performed under anesthesia to prevent dental disease and maintain oral health.

• Spaying and neutering: Elective surgical sterilization procedures are typically performed on young, healthy animals for population control.

• Microchipping: Permanent identification implants that help reunite lost pets with owners but are considered elective rather than a medical necessity.

Breeding and Pregnancy

• Breeding costs and stud fees: Expenses associated with intentional mating, artificial insemination, and fees paid for breeding services.

• Pregnancy and whelping complications: Medical issues during normal pregnancy, labor complications, and routine birthing assistance for planned litters.

• C-sections: Surgical delivery procedures, except when performed as true medical emergencies unrelated to planned breeding activities.

• Puppy/kitten care: Veterinary care for newborn animals, including initial health checks, vaccinations, and treatment of congenital issues.

Behavioral Issues

• Training and behavioral modification: Professional training services, obedience classes, and behavioral therapy sessions to address aggression or anxiety.

• Anxiety medications: Prescription drugs for behavioral issues like separation anxiety, noise phobias, or stress-related disorders (some policies offer exceptions).

• Destructive behavior consequences: Property damage, injuries to other pets or people, and veterinary care resulting from behavioral problems.

Pro tip: Exclusions vary significantly between insurance providers. Always read the fine print and ask specific questions about your pet's potential health risks.

"Pre-existing conditions are a very common category of misunderstood exclusions. A lot of owners only start to think about medical insurance when they run into a chronic medical condition that starts to cost them a lot of money over time. Unfortunately, these conditions are not covered because they’re considered pre-existing. 

Other distinctions that should be clarified are what vaccines are covered, such as core vaccines versus elective vaccines; urgent care visits versus emergency room visits; elective versus medically necessary procedures," says Dr. Wong.

Pet Insurance Optional Add-Ons and Wellness Plans

While basic pet insurance policies focus on accidents and illnesses, many insurers offer optional add-ons and wellness plans that can extend coverage to routine preventive care. These additional riders typically cost extra but can provide valuable coverage for vaccinations, annual exams, dental cleanings, and alternative therapies that aren't included in standard policies. 

Top Pet Insurance Add-Ons

Wellness and Preventive Care Riders

• Routine vaccinations: Core and non-core vaccines, including DHPP, rabies, bordatella, Lyme disease, and feline leukemia administered annually or as recommended.

• Annual health exams: Comprehensive wellness checkups including physical examination, weight monitoring, and early disease detection screenings.

• Flea, tick, and heartworm preventatives: Monthly prescription medications that protect against dangerous parasites and vector-borne diseases.

• Routine dental cleanings: Professional teeth cleaning under anesthesia to remove tartar, prevent periodontal disease, and maintain oral health.

• Spaying/neutering procedures: Surgical sterilization operations are typically performed on young animals to prevent reproduction and reduce certain health risks.

• Microchipping services: Permanent identification implant insertion with registration services to help reunite lost pets with their families.

"Dental care isn't something every pet owner considers, but it's crucial for your pet's health. As pets age, they naturally develop tartar and periodontal disease since we can't brush their teeth daily like our own. Most pets need professional cleanings annually or biannually. 

These procedures can be expensive, especially with extractions, and many owners face large bills when they delay preventive care. Senior pets getting their first dental cleaning—called COHAT—often cost in the high hundreds to low thousands," says Wong.

Enhanced Pet Insurance Coverage Options

• Higher annual limits: Increased maximum coverage amounts or unlimited annual benefits that provide more comprehensive financial protection for expensive treatments.

• Lower deductibles: Reduced out-of-pocket expenses before insurance coverage begins, allowing for more immediate financial relief during treatment.

• Higher reimbursement percentages: Increased coverage rates up to 100% of eligible expenses, meaning less money paid directly by the pet owner.

• Shorter waiting periods: Reduced time between policy enrollment and when coverage becomes active, providing faster access to benefits.

Pro Tip: Calculate whether wellness add-ons are cost-effective by comparing the annual premium increase to your typical yearly preventive care costs.

"Prevention is the best medicine. This is particularly true as we know that as our pets age, the chances of them getting sick increase, which in turn almost always leads us to spend more on their healthcare. In my personal and professional opinion, prevention can help us avoid hefty and unexpected bills in the future. Insurance plans that support and reimburse preventative medicine, procedures, and protocols are the way to go," says Dr. Wong.

How To Choose The Right Pet Insurance Plan

Selecting the right pet insurance policy requires evaluating both your pet's specific needs and your financial situation. With dozens of providers offering different coverage levels, deductibles, and reimbursement rates, the decision can feel overwhelming. 

The key is to systematically assess your pet's risk factors, understand policy details, and consider your budget to find coverage that provides the best value for your situation.

Consider Your Pet's Profile For Pet Insurance Coverage

• Age: Younger pets have fewer pre-existing conditions and lower premiums, while older pets face higher costs but may need coverage for age-related diseases.

• Breed: Purebred animals often have genetic predispositions to specific conditions like hip dysplasia in German Shepherds, heart problems in Cavalier King Charles Spaniels, or eye issues in breeds like Collies that affect coverage decisions.

• Current health: Documenting your pet's clean bill of health before enrollment ensures maximum coverage and prevents future conditions from being labeled pre-existing.

• Lifestyle: Active outdoor pets may need comprehensive accident coverage for injuries, while indoor pets might prioritize illness coverage over accident protection.

How To Evaluate Pet Insurance Coverage Details

• Annual limits: Choose between per-incident caps, annual maximum benefits, or lifetime coverage limits based on your pet's potential health risks and your financial comfort level.

• Deductibles: Compare annual versus per-incident deductible structures to understand how much you'll pay out-of-pocket before insurance coverage begins.

• Reimbursement percentage: Evaluate coverage rates from 70% to 100% to determine how much of the eligible expenses the insurance company will pay after deductibles.

• Waiting periods: Understand the time delay between enrollment and when coverage becomes active, typically ranging from 14-30 days for illnesses and shorter for accidents.

What Financial Considerations Should I Keep In Mind When Choosing Pet Insurance?

• Monthly premium costs: Balance affordable monthly payments against potential veterinary savings, considering your budget and your pet's health risks.

• Direct vet payment options: Determine whether the insurance company pays veterinarians directly or if you must pay upfront and seek reimbursement later.

• Emergency fund adequacy: Assess whether you have sufficient savings to cover deductibles, excluded treatments, and expenses during waiting periods.

• Regional veterinary costs: Research typical veterinary expenses in your area, as costs vary significantly between urban and rural locations.

Pro Tips For Maximizing Your Pet Insurance Coverage

• Pro Tip #1: Choose comprehensive coverage over accident-only plans if your pet is prone to breed-specific illnesses - the small premium difference can save thousands in treatment costs.

• Pro Tip #2: Add wellness riders if you're diligent about preventive care - the annual savings on vaccines, dental cleanings, and checkups often exceed the rider cost.

• Pro Tip #3: Opt for annual deductibles instead of per-incident deductibles if your pet has chronic conditions requiring ongoing treatment throughout the year.

"The pet insurance industry has grown significantly over the years. I've heard great success stories from established companies like Trupanion and Embrace. When evaluating plans, focus on three key questions: what they cover, what percentage they reimburse, and whether they pay veterinarians directly or require you to pay upfront and seek reimbursement later," says Wong.

Frequently Asked Questions

Are vaccinations covered by pet insurance? 

Basic pet insurance typically doesn't cover routine vaccinations, but many companies offer wellness add-ons or riders that include preventive care like vaccines, annual exams, and parasite prevention for an additional monthly fee.

What are pre-existing conditions in pet insurance? 

Pre-existing conditions are any health issues, symptoms, or injuries your pet had before your policy's effective date. These are permanently excluded from coverage. Insurers review veterinary records to identify pre-existing conditions, so it's important to enroll while your pet is healthy.

What does accident-only pet insurance coverage mean? 

Accident-only policies cover injuries from unexpected events like broken bones, cuts, poisoning, or swallowing foreign objects, but exclude illnesses, diseases, and routine care. These plans are typically less expensive but provide limited protection compared to comprehensive coverage.

Does pet insurance cover dental care? 

Most basic plans don't cover routine dental cleanings, but they typically cover dental accidents (broken teeth) and dental diseases requiring treatment. Some wellness plans include preventive dental care, while others cover dental surgery and extractions related to illness.

Is pet insurance worth it? 

"Prevention is the best medicine. Insurance plans that support and reimburse preventative medicine, procedures, and protocols are the way to go," says Dr. Wong. The value depends on your pet's health risks, your financial situation, and the specific policy terms. Consider your pet's breed, age, and your ability to handle large veterinary bills when deciding.

Conclusion

Pet insurance provides valuable financial protection for accidents, illnesses, and emergency veterinary care, but coverage varies significantly between providers and plan types. Remember that pre-existing conditions are never covered, so enrolling while your pet is healthy gives you the best coverage options.

"I always recommend starting them on insurance when they are young, since the premiums are usually the cheapest when they are young. Looking into the deductible amount in terms of how much you have to cover initially before they start to reimburse you should also be something you consider when choosing insurance plans," says Dr. Wong.

Compare top pet insurance providers to find the best fit for your pet's needs and your budget. Start by getting quotes from multiple companies and reading policy details carefully to ensure you understand exactly what's covered and what's not.

Methodology

• Cost data sources: All veterinary cost estimates in this article are based on real-world practice experience from Dr. Loke Jin Wong, Associate Veterinarian at Murraysville Veterinary Associates, who has worked in both emergency and general practice settings. Cost ranges reflect typical pricing observed in his clinical practice and may vary by geographic location and specific veterinary facility.

• Insurance coverage information: Pet insurance coverage details, exclusions, and policy features are compiled from publicly available information from major pet insurance providers' websites, policy documents, and regulatory filings. Coverage percentages and reimbursement rates represent typical industry standards as of 2025.

• Industry statistics: Pet insurance adoption rates are sourced from the North American Pet Health Insurance Association (NAPHIA), the industry's primary trade organization that tracks market data and consumer trends.

• Verification process: All claims and recommendations in this article have been reviewed by our veterinary expert for accuracy and clinical relevance. Cost estimates are presented as ranges to account for regional variations and individual case complexity.

• Transparency note: BestMoney.com is committed to providing accurate, unbiased information to help consumers make informed decisions about pet insurance.