What does pet insurance typically cover?

Health treatment for pets is not subsidised by the government, so it’s usually much more expensive than care for people. In New Zealand, pet insurance typically reimburses you for all or some of your vet bills if your dog or cat has an unexpected injury or illness. Ideally you’ll never have to use it, but chances are you will to some degree.

How much an insurer will contribute, and what illnesses and injuries are eligible, varies from one policy to another. That’s why it pays to shop around and read the details of any policy carefully, before you sign up.

To help you get started, this article provides a summary of the cover most pet insurance policies provide. It also explains the options you often have to create a policy that better suits your needs and budget. Let’s begin with a quick review of how pet insurance works.

How does pet insurance work?

Like other forms of insurance, you pay a fortnightly, monthly or annual fee (premium) in return for knowing you’ll be reimbursed for a percentage of any eligible vet bills you have to pay. The agreed ‘co-payment’ percentage and eligible injuries or illnesses are detailed in your policy. Some policies also have an excess, which is the amount you agree to contribute to any claim. The insurer simply deducts this from their agreed pay-out. With most insurers you can increase or decrease the premium by adjusting the co-payment percentage, excess and types of cover included.

What does pet insurance normally include?

Typical cat and dog insurance policies provide agreed levels of cover for vet charges arising from an accident or illness. Some policies only provide accident cover. An accident-only policy may be suitable if you can’t afford full cover or your pet is too old to qualify for illness cover.

If your cat or dog is accidently injured or becomes ill, standard policies will usually include some level of cover for:

  • Initial vet consultations
  • Surgical procedures
  • Emergency treatment
  • Hospital care
  • Associated medication
  • Emergency boarding, if you (the owner) are hospitalised for example
  • Euthanasia (being put down) when it’s recommended by your vet

What are the common options for pet insurance?

With many pet insurance policies, there are options to alter the amount of cover provided and add extra benefits. Here are a few examples:

  • Co-payments – this is the percentage of any qualifying vet charge that you agree to pay. It’s usually between 10% and 20%, but you can often reduce it to 0% by paying a higher premium. To reduce your premium, you can set the co-payment as high as 40%.
  • Benefit limits – pet insurance policies set limits for how much they will pay out. There may be maximum limits for each year and sub-limits for specified procedures. Many policies let you choose an annual cover limit, which could be anything from $2,500 to $15,000. A higher limit will come with a higher premium; a lower limit will mean a lower premium.
  • Routine care – this refers to everyday vet care treatments, as specified in each policy. They often include scheduled check-ups, vaccinations, micro-chipping, de-sexing and flea control. Routine care is usually offered as an optional add-on to a standard policy or included in a comprehensive policy.
  • Dental care – the treatments specified for this benefit often include treatment for abscesses and gingivitis (a gum disease), teeth cleaning and tooth removal due to certain conditions. Again, this can be offered as an optional add-on or as part of a comprehensive policy.

What does pet insurance not cover in most cases?

Every policy will have a long list of conditions and injuries that aren’t covered, because having a defined list helps to avoid any misunderstandings. Known as exclusions, these things can vary from one policy to another, so be sure to read them carefully when making comparisons.

In general, standard illness and accident policies tend to exclude:

  • Pre-existing conditions – insurance is designed to cover unexpected events, not pay the vet bills for a condition you already know your pet has. A pre-existing condition is usually defined as something like an injury or illness you knew about or should reasonably have known about when your cover started. Some temporary conditions that are pre-existing can often be added to your cover if they haven’t occurred for an agreed period, such as 18 months.
  • Illness during a wait period – when you take out a policy with illness cover, there’s normally a wait period before that cover begins. It’s usually around two or three weeks. It’s designed to stop people getting pet insurance because their cat or dog might already be ill.
  • Congenital conditions – these are anomalies or defects your cat or dog was born with. Some policies won’t cover them at all; others will cover some specified conditions if there’s no pre-existing evidence of them being present.
    Psychological or behavioural conditions – these are things like phobias, anxiety and conditions caused by a chemical imbalance, such as depression.
  • Elective treatments – these are treatments that are not prescribed or considered essential by your vet, but you choose to get anyway. Cosmetic surgery, debarking, tail docking and voluntary euthanasia are common examples.
  • Routine and dental care – as we mentioned above, everyday vet visits and dental care are usually excluded from standard policies, but might be offered as add-ons or included in a comprehensive policy.
  • If you don’t take reasonable care – pet insurance policies usually require you to take reasonable care of your pet to minimise the need for vet charges in the first place. It usually excludes cover for treatments arising from things like hunting activities, maltreatment, neglect or gross negligence.

Next steps

It’s important to shop around to find the right policy for you and your pet. Talk to vets, breeders and friends or family who’ve owned pets. Ask about their experience with pet insurance, as well as the common treatments required for your breed of cat or dog.

You’ll also find more detail in our complete guide to pet insurance.

DISCLAIMER: The information contained in this article is general in nature. While facts have been checked, the article does not constitute an insurance advice service. It is only intended to provide education about the New Zealand insurances sector. Nothing in this article constitutes a recommendation that any type of insurance cover is suitable for any specific person. We cannot assess anything about your personal circumstances, all of which are unique to you. Before making insurance decisions, we recommend you seek assistance from an insurance adviser or expert.

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