Questions to Consider When Buying Pet Insurance: Our Complete Shopping Guide

When buying pet insurance, consider asking these 10 essential questions: What does the policy cover? Are pre-existing conditions excluded? What are the deductible and reimbursement options? Are there breed or age restrictions? Can I use any veterinarian? Does it cover chronic and hereditary conditions? What are the annual and per-incident limits? What’s the waiting period? Are exam fees included? How does the claims process work? Understanding these coverage details can help you choose the right policy for your pet’s needs and your budget.

With 94 million U.S. households³ owning pets according to the American Pet Products Association’s 2025 report, choosing the right pet insurance policy can be an important decision for millions of families. Despite pet ownership reaching all-time highs, NAPHIA’s 2025 State of the Industry Report² shows only 5.46% of dogs and 2.04% of cats in the U.S. were insured by the end of 2024. This guide walks you through some critical questions to ask before purchasing coverage, helping you make an informed decision that can protect both your pet and your wallet.

Why Asking the Right Questions Matters

Pet insurance policies can vary significantly in coverage scope, exclusions, and costs. What one insurer covers, another might exclude. Veterinary costs vary widely depending on the procedure. CareCredit reports that routine vet visits range from $70-$174 for dogs and $53-$124 for cats, while emergency exams average $125 for dogs and $121 for cats. Major procedures like cancer therapy can cost $5,351 for dogs and $3,980 for cats.¹

Without the right coverage, unexpected veterinary expenses can add up and potentially create financial hardship. Asking detailed questions upfront helps you understand exactly what you’re purchasing, compare policies effectively, and avoid surprises when you need to file a claim. Spot Pet Insurance recommends evaluating multiple factors—not just premium cost—to find the best protection for your pet’s unique needs.

Question 1: What Does Pet Insurance Actually Cover?

Pet insurance typically helps cover eligible veterinary expenses related to unexpected accidents and illnesses. Understanding how pet insurance works helps you evaluate coverage options effectively. Spot Pet Insurance offers two base plan options: an Accident & Illness plan that helps cover both unexpected emergencies and medical conditions, or an Accident-Only plan for pets who need coverage for unexpected injuries.

Accident Coverage

Accident coverage includes injuries from unexpected events such as broken bones, lacerations, foreign object ingestion, toxic substance exposure, and bite wounds. According to CareCredit, treatment for accidents can range from $465 for dog spay surgery to $3,681 for stomach blockage surgery.¹

Illness Coverage

Illness coverage addresses unexpected medical conditions which can include infections, digestive issues, cancer, diabetes, and organ diseases. Chronic conditions like diabetes are important considerations when evaluating pet insurance. One study showed 23.6 cases of diabetes per 10,000 dogs and 67.6 cases per 10,000 cats, with most dogs diagnosed between 7-10 years of age.⁴

Wellness and Preventive Care Options

Base accident and illness plans typically don’t include coverage for routine wellness care. Spot Pet Insurance offers optional preventive care add-ons that can help cover the eligible costs of routine exams, vaccinations, dental cleanings, and other preventive services. These add-ons have no waiting period—coverage begins the next day after enrollment.

Question 2: Are Pre-Existing Conditions Covered?

Pre-existing conditions are any injuries, illnesses, or health issues diagnosed or showing signs and symptoms before your pet’s coverage starts, including during any waiting periods. These conditions are typically excluded from pet insurance coverage. Learn more about what counts as a pre-existing condition in pet insurance.

Spot Pet Insurance distinguishes between curable and incurable pre-existing conditions. If your pet’s pre-existing condition is curable and has been cured and free from treatment and symptoms for 180 days, it may be covered as a new occurrence. This does not apply to ligament and knee conditions. Chronic conditions requiring ongoing management—such as diabetes, allergies, or heart disease—are typically considered incurable and remain excluded.

This policy underscores why enrolling your pet early matters. Any health issues that develop during a waiting period can be classified as pre-existing and excluded from future coverage. The younger and healthier your pet is when you enroll, the more your plan can help cover throughout their life.

Question 3: What Are My Deductible and Reimbursement Options?

Understanding deductibles and reimbursement rates is essential for predicting your reimbursement payment when filing claims.

Annual Deductibles

Spot Pet Insurance plans have an annual deductible. Choosing the right deductible depends on your budget and risk tolerance. Annual deductibles typically range from $100 to $1,000, with common options at $100-$250, $500, and $1,000. Once you meet your annual deductible, your plan reimburses eligible expenses for the rest of your policy year according to your chosen reimbursement rate—with no limit on reimbursement payments if you select an unlimited annual limit option.

Lower deductibles may mean higher monthly premiums, but less to satisfy before reimbursement kicks in. Higher deductibles help reduce your monthly premium but require more vet visits before reimbursement can begin.

Reimbursement Percentages

Spot Pet Insurance offers three reimbursement rate options:

For example, if your dog requires $1,000 in eligible veterinary care and you’ve met your annual deductible: a 70% reimbursement rate pays you back $700 (amount after reimbursement $300), an 80% rate pays back $800 (amount after reimbursement $200), and a 90% rate pays back $900 (amount after reimbursement $100).

Question 4: Are There Breed or Age Restrictions?

Some insurers impose breed-specific exclusions or age limits that can affect eligibility and coverage.

Breed-Specific Considerations

Certain breeds are predisposed to specific health conditions. Research published in the Journal of the American Veterinary Medical Association⁵ identifies hip dysplasia and cruciate ligament deficiency as among the most common orthopedic problems in dogs, with allergies and hip/elbow dysplasia being the most common hereditary conditions. Some insurers may exclude coverage for breed-specific conditions, while others may charge higher premiums for breeds prone to certain health issues.

Ask whether your pet’s breed faces any coverage limitations or premium adjustments. Spot Pet Insurance does not exclude specific breeds from coverage, though premiums may vary based on breed-related risk factors.

Age Enrollment Limits

Many insurers set minimum and maximum age requirements for new enrollments. Some policies won’t accept senior pets, while others may accept older pets but with limited coverage or higher premiums. Ask about age restrictions and whether there are differences in coverage based on your pet’s life stage.

Enrolling your pet while they’re young and healthy can help ensure broader coverage eligibility.

Question 5: Can I Use My Preferred Veterinarian?

Many pet insurance policies, including Spot Pet Insurance plans, allow you to visit any licensed veterinarian in the United States and Canada. This means you can continue seeing your current vet, specialists, go to emergency animal hospitals, and seek care while traveling—without network restrictions.

Some policies may have network limitations or require pre-approval for specialist visits. Ask whether the policy restricts where you can receive care, whether specialist consultations are covered, and if there are any out-of-network penalties. The flexibility to choose any licensed vet helps ensure your pet can receive the best available care with less coverage concerns.

Question 6: Does It Cover Chronic and Hereditary Conditions?

Chronic conditions require ongoing management throughout your pet’s life, while hereditary conditions are passed down genetically. Coverage for these conditions varies significantly between insurers.

Chronic Condition Coverage

Chronic conditions include diabetes, allergies, heart disease, kidney disease, and arthritis. Ask whether the policy covers treatment for chronic conditions diagnosed after enrollment and whether there are limits on how long or how much they’ll pay for ongoing management.

Spot Pet Insurance plans help cover eligible chronic conditions diagnosed after your waiting period ends and not classified as pre-existing. This means if your pet develops diabetes, arthritis, or another chronic condition after coverage begins, eligible treatments are covered according to your policy terms.

Hereditary and Congenital Conditions

Hereditary conditions like hip dysplasia, heart defects, and eye disorders can require expensive long-term treatment. Ask whether hereditary conditions are covered and if there are waiting periods specific to certain conditions.

Spot Pet Insurance plans help cover eligible hereditary conditions, though illness coverage is subject to a 14-day waiting period on all policies.

Question 7: What Are the Coverage Limits?

Coverage limits determine the maximum amount your insurer will reimburse over a specific period.

Annual Maximum Limits

Annual limits cap how much the insurer pays per policy year. Spot Pet Insurance offers annual limit options ranging from $2,500 to unlimited coverage. With unlimited annual limits, there’s no cap on reimbursement once you’ve met your deductible.

For pets with serious illnesses or injuries requiring extensive treatment, unlimited coverage offers the most financial protection. Pets with lower-risk profiles might find adequate protection with more moderate annual limits at lower premiums.

Per-Incident vs. Lifetime Limits

Some insurers impose per-incident limits (capping reimbursement for each individual condition) or lifetime limits (capping total reimbursement over the pet’s life). These limitations can significantly impact coverage for chronic conditions or recurring health issues.

Spot Pet Insurance uses annual limits that reset each policy year rather than per-incident or lifetime caps. This structure helps ensure your pet has coverage renewed annually regardless of how many different conditions they’ve claimed.

Question 8: What’s the Waiting Period Before Coverage Starts?

Waiting periods are the time between enrolling and when coverage begins. These exist to help prevent fraud and ensure policies aren’t purchased only after illness or injury occurs.

Spot Pet Insurance plans have a 14-day waiting period for both accidents and illnesses in most states. Coverage for Accident-Only and Accident & Illness base plans generally begins after this 14-day waiting period. However, next-day accident coverage is available in select states—residents of California, Delaware, Hawaii, Louisiana, Maine, Missouri, Montana, Nebraska, New Hampshire, Ohio, Pennsylvania, Vermont, and Washington are eligible for next-day accident coverage.

Diagnosis and treatment for ligament and knee conditions are also subject to a 14-day waiting period. Any illness or injury occurring during the waiting period typically won’t be covered and may be classified as pre-existing for the life of the policy.

For preventive care add-ons, Spot Pet Insurance plans have no waiting period—coverage begins the next day after enrollment. This allows immediate access to wellness benefits like routine exams and vaccinations.

Question 9: Are Exam Fees and Diagnostic Tests Included?

Exam fees and diagnostic tests can add significant costs to veterinary care. Ask whether your policy covers these expenses or if they’re excluded.

Exam Fee Coverage

Spot Pet Insurance plans help cover eligible exam fees for covered conditions, including both specialist and emergency exams. This means if your pet requires emergency veterinary care, the emergency exam fee can be covered as part of the eligible treatment expenses. However, wellness or routine annual exam fees are not covered by base plans unless you purchase an optional preventive care add-on.

Diagnostic Testing

When your pet needs diagnostic testing to identify a health problem, those tests are typically covered under Accident & Illness plans. Spot Pet Insurance plans help cover diagnostic services like MRIs, CT scans, X-rays, and lab tests when related to covered accidents or illnesses. According to CareCredit, blood tests average $188 for dogs and $113 for cats, while more advanced imaging can cost significantly more.¹

Coverage for diagnostics helps ensure you can pursue care without financial barriers, allowing your vet to identify health issues quickly and accurately.

Question 10: How Does the Claims and Reimbursement Process Work?

Understanding the claims process helps you know what to expect when seeking reimbursement.

Filing Claims

Spot Pet Insurance helps make filing claims simple through the Member Center or mobile app. The process takes approximately 30 seconds—you log in, select your pet, upload your itemized invoice, and submit. You have 270 days from the treatment date to file a claim, though filing promptly can help with faster reimbursement and reduces the chance of you losing documentation.

Reimbursement Timeline

Spot Pet Insurance processes standard claims in 5-7 business days, while preventive care claims can take just 2 business days. Most claims are processed within three days after all required documents have been submitted.

Payment Methods

Reimbursement is sent via your preferred method—direct deposit or check. Direct deposit is typically faster, getting funds to you more quickly. Medical records, while not required for all types of claims, can help speed up processing for complex claims.

Creating Your Pet Insurance Shopping Checklist

Use these steps to help evaluate and compare pet insurance policies effectively: