| Policy Term |
12 months |
| Effective Date |
The Effective Date will be listed on the Declarations
Page of your policy after you apply and are accepted. |
| Enrollment Age |
Pet must be at least 6 weeks of age.
Oldest age of enrollment depends on the state you live in. For some there isn't a maximum age, for others it is others it is 8 years for dogs and 10 years for cats.
If the dog is one of PetPlan's Select Breeds the age limit is up to 5 years.
|
| Cancellation Policy |
Ask for a current copy of their insurance policy so that you may review their cancellation policy |
| Waiting Period |
24 hours after the policy effective date for
accidents.
14 days after the policy effective date for illness. |
| Waiting Period for Cruciate Injury |
Cruciate injuries are subject to the 24 hour accident/injury waiting period.
|
| Coverage When Travel Out of State or
Country? |
Out of State Coverage - You WILL be covered while traveling to other states with your pet.
Out of Country Coverage - You WILL be covered when traveling to Canada |
| Can the Price of the Policy Increase as my Pet
Ages? |
Yes, the policy premium can increase as your pet ages.
Contact the company for more information on these increases. |
| Does Coverage Stop Due to Age? |
No |
| What Happens when the Policy Renews? |
Chronic conditions will continue to be covered
each year as long as you do not go over your Annual Maximum Payout
for that year. (See 'Max Payout Annually' section below) |
| Can the Price of the Policy Increase
if a Claim is Filed? |
No |
| Choice of Vet? |
You can choose any licensed veterinarian in
the US and Canada, but you must live in the US permanently to purchase
a policy |
| Money Back Guarantee? |
If you change your mind within 30 days they
will refund your money in full as long as you have not filed a claim.
|
| Surcharge for Visiting a Specialist or Emergency
Clinic? |
Co-pay is increased to 30% in the following
situations:
- Your veterinarian refers you to a specialized referral veterinary facility
- You see a veterinary specialist either by referral or on your own without a referral
- You take your pet to an emergency care facility (Does not apply to life-saving emergency conditions)
- You take your pet to an after hours veterinary facility (Does not apply to life-saving emergency conditions)
- You take your pet to an accredited school of veterinary medicine
|
| Referral needed to Visit a Specialist? |
No |
| Pre-certification Required? |
No |
| Additional Requirements |
**See actual policy or call PetPlan for a complete
list of the requirements you are expected to adhere to in order to
maintain coverage. |
| Pet Insurance Policy Available for Pre-Purchase
Review? |
Sample
policy available by request |
| Species Covered |
Dogs and Cats |
Accident/Injury - Baseline Coverage |
Covers examinations, diagnostics and lab tests, surgery, treatments, hospitalization, prescription medication.
|
Illness - Baseline Coverage |
Covers examinations, diagnostics and lab tests, surgery, treatments, hospitalization, prescription medication.
|
| Behavioral Therapy Coverage |
[OPTIONAL] Behavioral Therapy is included as
part of the Gold Plan up to the limit of $250. Behavioral Therapy
must be used in relation to a covered injury or illness. Behavioral
Therapy must be performed by a licensed veterinarian.
**See actual policy or call PetPlan for any additional limitations
on Behavioral Therapy Coverage |
| Alternative Therapy Coverage |
[INCLUDED] Alternative Therapy is covered as long as the treatment is recommended and performed by a licensed veterinarian.
**See actual policy or call PetPlan for any additional limitations
on Alternative Therapy Coverage. |
| Pre-existing Conditions Policy |
Pre-existing conditions are not covered.
According to PetPlan's website, a pre-existing condition "...is any condition which first occurred or showed clinical signs before the pet's coverage
started or which occurred during the policy waiting period...This would include conditions that have not yet
been clearly diagnosed, are currently in remission, are seasonal or being controlled via prescription medications."
These conditions may be covered in the future if cured, however, this is at the discretion of PetPlan
**See actual policy or call PetPlan for complete description of pre-existing
conditions. |
| Hereditary & Congenital Conditions Coverage |
[INCLUDED] Hereditary and congenital conditions
are covered as long as your pet is not showing signs and the disease
has not been diagnosed or suspected prior to enrollment or during
the waiting period.
**See actual policy or call PetPlan for complete description of their
Hereditary & Congenital Conditions Policy. |
| Continual Coverage for Chronic Conditions
|
[INCLUDED] Continual coverage for chronic conditions
is included with the policy.
Chronic conditions are covered up to the annual maximum payout per
policy year. (See 'Max Payout Annually' section below) |
| Chronic Conditions Policy |
Chronic conditions are covered up to the annual
maximum payout per policy year. (See 'Max Payout Annually' section
below)
They do not cover chronic conditions that are pre-existing or that
occur during the waiting period.
**See actual policy or call PetPlan for complete description of their
Chronic Conditions Policy. |
| Cancer Coverage |
[INCLUDED] Cancer conditions are covered as
long as they are not pre-existing and have not occurred during the
waiting period.
(See 'Chronic Conditions Policy' section above) |
| Cancer Coverage Limits |
Cancer conditions are covered as long as you
have not gone over your annual maximum payout per policy year. (See
'Max Payout Annually' section below) |
| Hip Dysplasia |
[INCLUDED] Hip dysplasia is covered as long
as your pet is not showing signs and the disease has not been diagnosed
or suspected prior to enrollment or during the waiting period.
(See 'Hereditary & Congenital Conditions Coverage' section above). |
| Prescription Drug Coverage |
[INCLUDED] Prescription drugs are covered. Does not cover nutritional supplements and vitamins. All prescription drugs must be FDA approved for pet which is subject to policy provisions. The prescription drugs must be prescribed by the veterinarian treating the pet for an accident or illness.
**See actual policy or call PetPlan for any additional limitations
on Prescription Drug Coverage |
| Pregnancy Coverage |
[LIMITED COVERAGE] Only emergency C-sections
are covered
**See actual policy or call PetPlan for full list of inclusions
and exclusions
|
| Routine/Wellness Coverage |
[NO] - Routine Care is not covered or offered as an addon |
| Vaccinations |
[NO] - Routine Care is not covered or offered as an addon |
| Spay/Neuter |
[NO] - Routine Care is not covered or offered as an addon |
| Dental Care (Routine) |
[NO] - Routine Dental Care is not covered or offered as an addon
|
| Dental Care (Illness/Accident) |
[LIMITED] Dental coverage for illness and
accidents is included if your pet has had its teeth checked by a veterinarian
in the twelve months before the effective date of your policy. If
this is not done, dental treatments are not covered.
**See actual policy or call PetPlan for full list of inclusions and exclusions.
|
| Bilateral Conditions Policy |
? |
Coverage - Overview (please
read policy for full coverage details) |
Diagnostics and treatments due to illness and accidents
[Included] Hereditary & Congenital Disorders, Alternative Therapy,
Continual Chronic Conditions Coverage, Cancer Coverage, Hip Dysplasia,
Prescription Medications, Dental Illness/Accident. (Refer to each
category's section for limitations)
[Optional] Behavioral Therapy
**See actual policy or call PetPlan for full list of inclusions, exclusions, limitations and conditions.
|
What's not Covered - Overview
(partial listing, please read policy
for full details) |
- Pre-existing conditions
- Conditions that occur during the waiting period
- Routine dental treatments (eg. routine teeth cleaning)
- Routine Care (spay/neuter, vaccinations, etc)
- Elective Procedures
...See policy for a complete listing |
| Co-pay |
You can choose from 0%, 10% or 20%
Co-pay is 30% for visits to a specialist
(See 'Surcharge for Visiting a Specialist or Emergency Clinic' above) |
| Deductible |
You
can choose $50, $100 or $200 deductible per Medical Condition
According to PetPlan's sample policy a Medical Condition refers to
"...All clinical signs and symptoms resulting from the same diagnostic
classification or disease process, regardless of the number of incidents
or areas of the body affected." |
| Flat Deductible vs % Deductible |
Flat |
| Deductible Per Incident vs Annual Deductible |
The deductible will be applied separately to
each Medical Condition. According to PetPlan's sample policy a Medical
Condition refers to "...All clinical signs and symptoms resulting
from the same diagnostic classification or disease process, regardless
of the number of incidents or areas of the body affected." |
| How is Reimbursement Determined |
CUSTOMER REP: If they feel the fees are high
compared to what is defined by the AAHA Fee Reference Guide, they
will use UCR. Otherwise reimbursement is based on the actual veterinary
bill.
IN POLICY: UCR
|
| Max Payout Annually |
Bronze Plan - Annual maximum payout $8,000
Silver Plan - Annual maximum payout $12,000
Gold Plan - Annual maximum payout $20,000 |
| Max Lifetime Payout |
PetPlan does not have a maximum lifetime payout |
| Max Payout per Incident |
PetPlan does not have a maximum payout per incident |
| Max Payout Based on Body System |
PetPlan does not have a maximum payout based on body system |
| Client Reimbursed or Vet Paid Directly |
You pay the veterinarian and then you are reimbursed
after you file the claim. |