Understanding how pet insurance companies calculate reimbursements can help you be more knowledgeable about your pet’s insurance coverage. Managing routine or unexpected vet visits can be easier with pet insurance. In this article, we’ll break down the most common reimbursement methods, helping you know how they work and what they mean for your out-of-pocket costs. Spot Pet Insurance explains pet insurance reimbursement below to help you better understand how pet insurance can impact your finances.
How Pet Insurers Calculate Claim Reimbursement
There are three general methods that pet insurance companies use to process claims and reimbursements for vet bills:
Benefit schedule
Subtracting a deductible then copay from the charged amount
Subtracting copay then deductible from the charged amount
What is a Benefit Schedule Reimbursement Method?
A benefit schedule is a list of treatments with the maximum amount that a pet insurance coverage plan will pay if your pet requires treatment for a diagnosis.
What is a Deductible in Pet Insurance?
In insurance language, a deductible is the amount that you are responsible for paying out of pocket toward your pet’s covered veterinary expenses before the insurance policy reimburses you. Spot Pet Insurance uses an annual deductible. You can learn more about pet insurance deductibles here.
Claim Example
To illustrate how all of the different parts of a pet insurance policy work, we have set up this example of a pet insurance claim:
Eligible Veterinary Bill: $1,000
Annual Deductible: $250
Remaining after deductible: $750
The amount reimbursed by Insurance: $675*
How Does Spot Pet Insurance Calculate Reimbursement?
The amount that Spot Pet Insurance reimburses pet owners has to do with the annual limit, reimbursement rate, and annual deductible that you choose at the time of getting a policy.
What is an Annual Limit?
An annual limit in pet insurance is the amount that you can be reimbursed over one 12-month policy period.
What is a Reimbursement Rate?
The “reimbursement rate” is the percentage amount of covered expenses that Spot Pet Insurance plan reimburses.
What is an Annual Deductible?
Spot plans operate under an annual deductible. This means that you must pay your deductible once per 12-month policy period.
*Actual reimbursement amounts may vary depending on plan type and options, including annual limit, co-insurance, and annual deductible, as well as the specifics of the claim and your policy terms.
With 10 years of experience as a pet parent, I aim to empower pet owners with insights into pet insurance and maintaining their pet's well-being. I aspire to be a trusted source, combining knowledge with a commitment to the welfare of our beloved pets.
Audrey Halfen: Beta fish whisperer - whopping 9 months and counting! Once had a dog named Max, who I assertively claim is the cutest dog ever. Ready to throw down in a cute-off, if necessary.
