What Does Pet Insurance Cover?

In this article, we’ll break down exactly what pet insurance does and doesn’t cover; from emergency surgeries to everyday wellness care. During my years reviewing insurance policies, I’ve seen far too many pet owners blindsided by unexpected costs.

Vet bills can skyrocket fast. A broken leg or sudden illness can cost thousands, and without insurance, that burden falls entirely on you. Worse, skipping coverage can sometimes mean choosing between your savings and your pet’s life.

Most plans don’t include routine or preventive care, like vaccines or checkups, unless you add a wellness plan. Coverage varies by provider, so always check the fine print before you buy.

Comparison of pet insurance plans coverage

There are three main types of pet insurance plans — accident-only, accident & illness, and wellness. Each type covers different needs and comes with its own price range.

Whether you have a cat or a dog, the right plan depends on your pet’s age, breed, health condition, and how much coverage you want.

In general, pet insurance covers medical costs associated with accidents or illnesses. The type of plan you have will determine exactly what coverage is available to you and your pet.

Accidents & illnesses

Most pet insurance policies provide coverage for accidents and injuries. Accidents and injuries include things such as:

• Bite wounds
• Broken bones
• Lacerations
• ACL ruptures

Chronic illnesses

Chronic illnesses are long-term conditions that require ongoing care. These are typically covered under an accident and illness policy, and may include:

• Allergies
• Seizures
• Digestive disorders
• Skin conditions

Hereditary conditions

Some breeds are prone to inherited health issues. A good policy may cover:

• Eye disorders
• Hip or elbow dysplasia
• Blood disorders

Testing and diagnostics

Covered tests often include:

• Bloodwork
• Ultrasounds
• X-rays
• MRIs
• CT scans

For example, if your vet suspects a tumor during a wellness visit and orders blood tests or X-rays, those costs may be covered under your illness policy — as long as it’s not a pre-existing condition.

Procedures

Diagnostic results often lead to treatments like:

• Surgery
• Hospitalization
• Nursing care
• Endoscopies
• Chemotherapy

Holistic and alternative procedures

General pet insurance policies will often cover holistic and alternative procedures as these can be qualifying forms of treatment for accidents or illnesses. Some examples include:

• Acupuncture
• Laser therapy
• Chiropractic adjustments

Wellness procedures

These are only covered under wellness plans or riders:

• Annual exams
• Vaccinations
• Flea/tick and heartworm prevention

Behavioral therapy

Covers treatment for anxiety, aggression, or other behavioral issues. May include:

• Medication
• Professional behavioral sessions

Additional care

This category overlaps with wellness but may also include:

• Spaying or neutering
• Dental cleanings (under wellness plans)
• Microchipping

Prescriptions

Some pet policies include the cost of prescriptions assuming they are prescribed for a qualifying accident or illness. If your policy does not include coverage for prescription medications, you might be able to add a rider for prescriptions.

Pre-existing Conditions

Any medical issue diagnosed before you purchased your pet insurance is typically excluded from coverage. Some providers offer limited coverage for “curable” conditions after a waiting period, but premiums are often higher.

Cosmetic Procedures

These are elective treatments done for appearance, not health. They include:

• Ear cropping
• Tail docking
• Testicular implants (e.g. post-neuter prosthetics)

Most plans will not cover these.

Breeding Costs

Insurance policies don’t cover expenses related to breeding, even if your pet is purebred. This includes:

• Genetic and health testing
• Fertility treatments
• Stud fees and shipping
• Implantation costs

Grooming

Routine grooming isn’t covered. This includes:

• Baths
• Hair trimming or styling
• Nail clipping

These are considered personal care, not medical needs.

Supplements

Non-prescription products like joint chews, multivitamins, or CBD oils are usually excluded unless explicitly prescribed as part of treatment for a covered condition.

Experimental Treatments

Any procedure not recognized by the state veterinary board or lacking peer-reviewed research may be excluded. Always check if your provider considers a treatment “approved” before proceeding.

Types of Pet Insurance Plans & What They Cover

There are three main types of pet insurance policies:

• Accident-only coverage – The most basic and affordable option, covering only accidents like injuries from falls or bites.
• Accident and illness coverage – A more comprehensive policy that also covers conditions like cancer, allergies, and infections.
• Wellness coverage – An optional add-on to accident and illness policies that covers preventative care, like checkups and vaccines.

According to 2022 data from NAPHIA, 24 companies offer pet insurance in the U.S., giving you plenty of choice for both base plans and custom add-ons.

Accident-Only Coverage

This budget-friendly plan covers only unexpected accidents. For example, if your dog is injured in a fight, the following would be covered:

• Diagnostic tests
• Hospitalization
• Surgery
• Medications

But if that same dog is later diagnosed with cancer or a chronic skin condition, treatment would not be covered — those are considered illnesses.

Accident and Illness Coverage

This is the most popular and well-rounded policy type. It covers:

• Accidents (like torn ligaments or broken bones)
• Illnesses (such as infections, cancer, and allergies)
• Hereditary and chronic conditions

Example: Your boxer tears his ACL. Your policy would cover the surgery and recovery. Months later, he develops allergies and ear infections — these would also be covered under the same plan.

Wellness Coverage

This optional add-on extends coverage to routine care and preventive treatment. It typically includes:

• Annual vet exams
• Vaccinations
• Flea, tick, and heartworm meds
• Routine dental cleanings

Let’s say your cat goes in for a checkup and needs vaccines. Your accident and illness policy won’t help — but your wellness plan will.

According to APPA, the average annual cost of a surgical vet visit is $458 for a dog and $201 for a cat. A wellness plan can help cover some of those out-of-pocket costs with routine care.

Does pet insurance cover spaying or neutering?

Generally, no. Spaying and neutering are considered elective procedures and not covered under standard plans. However, some wellness plans or add-ons may cover them as part of routine preventive care.

Does pet insurance cover dental care?

Most accident and illness plans don’t cover routine dental care unless it’s related to a covered condition. Some wellness or comprehensive plans may include dental cleanings or procedures.

Does pet insurance cover vaccines?

Usually, no—unless you have a wellness rider. Vaccinations and routine preventive care are typically only included with a wellness plan or optional add-on.

Does pet insurance cover pre-existing conditions?

Standard policies do not cover pre-existing conditions. However, some providers may cover curable pre-existing conditions after a waiting period, or offer specialized plans at a higher cost.

Does pet insurance cover surgery?

Yes—if the surgery is for a covered accident or illness. You’ll still need to pay your deductible and co-insurance, depending on your reimbursement level.

Does pet insurance cover medication?

Often yes, but only if the medication is prescribed by a licensed vet and treats a condition covered under your policy. Some providers require a prescription rider for this.

Does pet health insurance cover cancer treatments?

Yes, most comprehensive policies cover cancer treatments unless it’s a pre-existing condition. Riders may be available if it’s excluded from base coverage.

Does pet health insurance cover diagnostics?

Yes, diagnostic tests like blood work or x-rays are covered if they’re related to a covered accident or illness.

Does pet health insurance cover physical therapy?

Sometimes. Physical therapy must be recommended by a vet and related to a covered condition. Not all providers include this by default.

How Does Pet Insurance Work?

Pet insurance is a reimbursement model. Here’s how it works:

1. Visit any licensed vet — no network restrictions.
2. Pay for treatment upfront.
3. Submit your receipt to the insurer and get reimbursed (usually within 2–4 weeks).

Your reimbursement amount depends on your deductible and coverage percentage (e.g., 80%, 90%, etc.). The simpler your policy, the faster claims are typically processed.

How much does pet insurance cost?

To understand how pet insurance pricing works, it’s important to know three core terms:

• Annual Reimbursement Limit – The maximum amount your insurer will pay out per year.
• Annual Deductible – The amount you must pay before coverage kicks in.
• Reimbursement Percentage – The percentage of eligible costs the insurer reimburses after you meet your deductible.

These three variables can be adjusted to suit your budget. However, changing one will impact your monthly premium.

According to NAPHIA’s 2023 industry report, the average pet insurance premium is $32 per month.

Cost Example: 13-Year-Old Domestic Longhair Cat in New York

As seen above, higher deductibles (like $1,000) can significantly reduce your monthly cost. Meanwhile, increasing your reimbursement limit from $10,000 to $15,000 makes only a small difference.

Below is the same example but based on a 5-year-old male Puggle dog:

Dogs are the most commonly insured pets in the U.S., and pricing reflects their slightly higher risk profile.

Real-World Example: Cat with Kidney Disease

Without insurance:

• Diagnostics & bloodwork (recurring): $900/year
• X-rays for cancer screening: $170/year
• Prescription food: $900/year

Total: $2,635/year

With pet insurance (80% reimbursement, $500 deductible):

• Out-of-pocket: $500 deductible + $427 coinsurance

Total: $927/year

That’s a savings of over $1,700 – especially important for aging pets who may develop multiple health conditions.

Regional Pricing Variations

Insurance costs vary by location due to differences in veterinary care pricing.

• Indiana, Colorado, Ohio (cat): ~$27.56/month
• Michigan (cat): $15–$33/month
• Most-insured states: California, New York, Florida (source: NAPHIA)

Optional Add-On Coverage

You can customize your policy with additional benefits:

• Exam Fees
  • Covers vet exam costs related to accidents/illnesses.
  • Estimated cost: +$4/month
• Prescription Drug Coverage
  • Covers prescribed medications for eligible conditions.
  • Estimated cost: +$4.28/month