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Pet insurance allows people with animal companions to make sure their animals get the very best care. But how can policyholders make a pet insurance claim? Here's what pet owners need to know about how the claims process works for this type of coverage.
To make a pet insurance claim, you'll typically need to pay for veterinary care out of your own pocket first. That's because pet insurance operates on a reimbursement model. There are some limited exceptions where the insurer pays the vet directly. However, only a few pet insurers offer this, and not all veterinarians allow this.
In most cases, pet owners need to know that they'll typically pay for medical services, then request the insurer reimburse them by making a pet insurance claim.
If the veterinary care is covered, the insurer will send the owner the funds after the claim is approved. The insurer will subtract the amount of the pet insurance deductible, which is the amount you have to pay before insurance kicks in. If there is a copay, then the copay amount will also be deducted from the reimbursed amount when you make a pet insurance claim.
To make a pet insurance claim, certain documentation is usually required. Typically, pet owners will need to submit the following to request reimbursement for covered veterinary care:
Owners may be eager for reimbursement when making a pet insurance claim. The specific amount of time a claim takes varies depending on many factors. Different insurers promise different reimbursement times. And delays could occur if an insurer needs to investigate whether a pet insurance claim is covered.
In general, however, a claim will usually be paid in around two weeks or less.
Sometimes, problems will arise when you make a pet health insurance claim. But there are some steps you can take to avoid issues with reimbursement for covered veterinary services.
Owners make pet insurance claims for many different kinds of medical issues. Common claims include treatment for the following health problems:
Owners also make claims for many more serious health issues, including cancers and heart disease.
The specific deadline for submitting a pet insurance claim varies by insurance provider. Time deadlines typically range from around 90 days to 180 days after a pet receives covered veterinary care.
It is not possible to purchase retroactive pet insurance coverage. Policies become active only after a pet owner signs up. In many cases, there is a waiting period after getting insurance before the policy kicks in and begins paying claims.
When a pet owner makes a pet insurance claim, the pet insurance company will provide full or partial reimbursement for covered veterinary care. The specific amount of reimbursement depends on the policy terms.
Typically, pet owners must first pay a deductible before the insurer covers any costs. Then, there may also be coinsurance costs. That means the owner would have to pay a percentage of the costs of treatment. For example, the pet insurance company may cover 80% of the costs of care and the pet owner would cover the remaining 20%.
Since coinsurance costs and deductibles vary by insurer and policy, it's important for pet owners to know the details of their coverage before making a pet insurance claim.
Some pet insurers promise they won't raise premiums just because a pet owner makes a claim. But in most cases, when a claim is made, this raises red flags for the insurer. It suggests the pet has a health issue that may require further treatment. Since there's an increased risk to the insurer of having to pay out a claim, the insurer may raise rates when the policy renews.
Pet owners should be aware of the potential for cost increases. This doesn't mean you shouldn't make a pet insurance claim since you purchase coverage in order to use it. But it is important to prepare for the potential for rising premiums when submitting a request for reimbursement for veterinary services.
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