How does pet insurance work?

Dogs and cats bring us plenty of joy and laughter, but they’re also a big responsibility. While you can plan ahead and budget for your pet’s routine veterinary care, the costs of unexpected accidents and illnesses can quickly add up. If you’re concerned about providing medical care for your pet without depleting your savings account, pet insurance can be a great option. But how does pet insurance work?

Researching the differences between pet health insurance providers can feel like a daunting task, but your local State Farm® agent can help you explore coverage options to help meet your needs. Read on to learn more about how pet insurance works and how a policy might fit into your pet care plans.

What is pet insurance, and should I consider it? 

Pet health insurance can help pet owners manage the high costs of unexpected vet bills by paying for a percentage of eligible veterinary treatments after meeting a deductible. Many pet insurance providers offer coverage for cats and dogs — other pets are considered exotic animals, and only a few providers offer specialized plans for these types of pets.

While many pet insurance plans may cover the treatment of unexpected illnesses and injuries for cats and dogs, you may find in your research that payout percentages, deductible choices and payout limits vary depending on the provider you choose. Selecting quality coverage from a reputable provider while your pet is young and healthy or shortly after you bring your dog or cat home may help you avoid unexpected denials for pre-existing conditions or high co-pays when it’s time to file a pet insurance claim.

State Farm chose to team up with Trupanion because some pet insurance providers have strict age or even breed limitations. Fortunately, any cat or dog under the age of 14 can sign up, and there are no breed restrictions or breed-specific exclusions in the Trupanion policy.

How does pet insurance work?

With many pet insurance companies, once you have enrolled in your new pet medical insurance plan, you should receive important information on your coverage and monthly premium. If you choose to enroll with Trupanion, you can expect to receive a series of communications that walk you through how to set up your online account, where you can manage claims and update your personal information.

The date your coverage becomes effective will usually not be the same day you sign up — many pet insurance providers have waiting periods before your coverage starts because pet health insurance cannot cover any accidents or illnesses that started before you signed up. Waiting periods vary from provider to provider, or even state to state. You may even find that some providers have longer waiting periods for specific conditions. For example, some pet insurance providers have a 6-month waiting period before you will be covered for a CCL tear or an orthopedic condition. If you would like to learn more about Trupanion’s waiting periods in your state, contact your local State Farm agent to learn more.  

What does pet insurance generally cover?

This will vary based on the coverage you choose. Some pet insurance plans are accident-only, while others (like Trupanion) offer robust coverage for all new, unexpected health conditions as well as accidents. Given that 83% of claims submitted to Trupanion in 2024 were for treatments for illnesses, an accident-only plan will generally not provide you with coverage for the most commonly-claimed situations.^{footnote 1}

Some providers offer wellness plans that can be added to your accident and illness coverage for an added cost, which can reimburse you for routine and preventative veterinary care. Sometimes insurance providers will charge you more for a wellness plan than you can reasonably claim over the course of a year. Many veterinarians offer wellness plans that operate more like a loyalty discount, which can actually help you save money on these routine expenses. Asking your veterinarian for their advice on how to budget for your pet’s wellness care while taking the time to review the fine print could help you avoid overpaying for your pet’s routine care.

As far as what pet medical insurance does not cover, exclusions may vary between providers, so it can be helpful to review the fine print. In general, pet insurance companies do not cover pre-existing conditions. Some pet insurance providers exclude coverage for hereditary conditions, which are the conditions most likely to happen to purebred pets. Other pet insurance providers may have exclusions for specific veterinary treatments, or require you to purchase an add-on to receive full coverage. Coverage for dental care varies from provider to provider, so that can be a helpful question to ask as you are shopping around for pet insurance. Trupanion’s main exclusions are: pre-existing conditions, routine and preventative care (like vaccines and dental cleanings) and veterinary examination fees.

Filing a pet insurance claim

The pet insurance claims process at many pet insurance companies requires you to pay your veterinary bill up front and submit a claim for reimbursement. Trupanion is the only pet insurance provider who can pay participating veterinarians at the time of checkout, eliminating the need to file an insurance claim in the first place (you can read more about how this works below).

Each insurance provider has different requirements for claims processing and reimbursement, so be sure to ask for an itemized invoice or receipt from your veterinarian that lists the services provided. You will normally need to submit this to your insurance company with a claims form that lists out your account information and details on what occurred.

Here’s what you can expect from a typical claims process:

1. You pay your vet for their services and request an itemized invoice and receipt of payment.
2. You file a claim with your pet insurance company, either through an online portal, over e-mail or in the mail, depending on what your insurance provider requests.
3. Your insurance provider will collect and review your pet’s medical history to help determine if any treatments are related to a pre-existing condition.
4. Your insurance provider will reimburse you for eligible expenses based on the coverage you’ve selected.

You can usually choose to receive your claims reimbursements mailed to you via paper check or deposited directly in your bank account through ACH. Before you select your insurance provider, it can be helpful to ask how long it takes for a claim to be processed and reimbursed — some providers can reimburse your claim in days, and others may take weeks. In 2024, nearly 72% of the claims submitted to Trupanion were closed in under 24 hours, and 82% were closed in under 3 days.^{footnote 1} The first claim you submit may take longer than usual to process if your pet insurance company has not gathered your pet’s medical records in advance. Seeing that your pet insurance company knows which veterinary hospitals to contact for medical records before you submit your first claim may help speed up the process.

Reimbursement vs. VetDirect Pay™

The pet insurance claims process typically requires you to file your pet insurance claim and wait for reimbursement, which means you must have the funds available to pay your vet at the time of service. Trupanion is different. If your veterinarian uses Trupanion’s VetDirect Pay™ software, you only need to pay your portion of the bill when it’s time to check out. Thousands of veterinarians across the country are using Trupanion’s VetDirect Pay™ solution as a part of their checkout process for Trupanion customers, which eliminates the need for filing a pet insurance claim.

How much do emergency vet visits cost?

Pet hazards could be anywhere, and even when you are taking all of the right precautions, an accident can happen at any time. So, does pet insurance cover emergency care?

Many pet insurance providers offer coverage for veterinary treatments that help your veterinarian diagnose or treat unexpected conditions like medications, surgeries, hospital stays, x-rays or surgeries, which can get quite costly. According to Violet Crown Veterinary Specialists, the cost of walking in the door for an emergency exam can average $250, while x-rays could cost $700, and emergency surgeries can cost $5,000 or more!

Trupanion conducted a survey of Veterinary Professionals in 2023 that indicated that the average pet owner would not be able to pursue treatment if their pet’s veterinary bill exceeded $1,145 without a pet insurance policy, and it isn’t uncommon for veterinary bills to exceed that amount.^{footnote 2} The largest payment Trupanion made directly to a veterinarian in 2024 was $76,974.21!^{footnote 1}

How do I get a pet insurance quote?

Many pet insurance providers will ask you for details about your cat or dog, including their breed, gender and age. You will find that each provider may present you with different options to choose from, including a payout percentage, deductible and annual limit. Occasionally, there are add-ons if you want to take advantage of different veterinary treatments, like acupuncture or physical therapy. If you notice that the initial price you are being offered by one provider is much lower than what you have been quoted by other companies, you may want to check that you aren’t signing up for an accident-only policy, or a policy with a high deductible or low payout limits by accident.

Many pet insurance providers will increase your premiums as your pet ages, but Trupanion prices your pet insurance policy based on the expected lifetime care for your pet, only adjusting rates over time to keep up with rising costs of care. This may mean that Trupanion’s rates appear more expensive than other providers when you first enroll, but their approach to pricing a policy based on the age you enroll your pet as opposed to your pet’s attained age is unique and can help you budget for your pet insurance policy well into your pet’s senior years.

Where to start with pet insurance

Now that you understand how pet insurance works, get your Trupanion pet insurance quote now or contact your local State Farm agent to see what coverage is going to be the best fit for you and your furry family member.