How Pet Insurance Companies Calculate Your Reimbursement

Some owners shopping for pet insurance policies and others that have policies want to know how their pet insurance reimbursement is calculated.

In North America, of the thirteen companies that offer pet insurance, one company offers a benefit schedule for reimbursement and the other twelve reimburse based on a co-pay and deductible format. We will define those terms how each of these pet insurance reimbursements work.

Benefit Schedule:

The company that reimburses pet owners based on the benefits schedule is Veterinary Pet Insurance (VPI). What does a benefit schedule mean? Let’s define that.

  • Benefit Schedule – One pet insurance company reimburses pet owners based on a benefit schedule (VPI). Benefit schedules set limits or payment amounts on how much they will reimburse for a given problem. For example – if your dog has an intestinal upset – VPI’s will reimburse based on their benefit schedule and your plan. The VPI comprehensive plan will pay up to $630 for that diagnosis and the economical plan will pay up to $315. For more information on their benefits schedule – go to: What is covered.  

Co-pay and Deductible Format

Most pet insurance companies reimburse based on the deductible and coinsurance levels you select. When choosing insurance, you generally have the ability to select how much coverage you want and need.

What does this mean and how does it affect your reimbursement?

First, let’s define the words “Deductible” and “Co-insurance”:

  • Deductible – the amount that is not insured and needs to be paid out of pocket before the health insurer pays their share. For example, an annual deductible of $100 is the amount the insurance company will require off the top of the bill. Most pet insurance deductibles are annual but some are also per incident. This can be a very important distinction.
  • Co-insurance – also referred to as co-pay, this is the amount that the insurance company will pay versus what you will be required to pay. This is a common variable that you will need to choose when picking a pet insurance policy. Common co-insurance percentages are 70%, 80% and 90%. If the pet insurance pays 90%, then you will be required to pay 10%.

Here is an example of a reimbursement with a deductible and co-insurance:

If you choose a policy that has a $100 deductible and 90% reimbursement, the reimbursement on a $2000 vet bill would be: $1,710.00.

If you choose a policy with a $500 deductible and 70% reimbursement – the reimbursement on a $2000 vet bill would be: $1,050.00.

I hope this article gives you the information you needed on How Pet Insurance Companies Calculate Your Reimbursement.

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