A Vet's Review of ASPCA Pet Insurance

by Frances Wilkerson, DVM

This review discusses coverage and payout structure

To get the most from this review, please read the Guide to Pet Insurance first.
For a detailed look at ASPCA, see ASPCA's Comparison Sheet.



Overview

ASPCA / Hartville / PetsHealth Pet Insurance brands are all under one company, Hartville Group, Inc.

Hartville Group, Inc has offered pet insurance since 1997.

This review refers to the following plans: Level 2, Level 3, and Level 4.



Coverage Overview

In general, ASPCA / Hartville / PetsHealth Pet Insurance covers examinations, diagnostics and lab tests, surgery, treatments, hospitalization, and prescription medications for accidents/injuries and illnesses as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.

Non-routine dental coverage is limited.



Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

ASPCA / Hartville / PetsHealth Pet Insurance offers coverage for chronic diseases, but if your pet develops a chronic disease that is hereditary/congenital in nature, you will only be covered if you purchased the Level 3 or Level 4 Plan.

ASPCA / Hartville / PetsHealth offers continual coverage for chronic diseases in its Level 2, Level 3, and Level 4 plans, however...

The monetary payout for the condition after the first year has limits. In addition, the copay increases to 20%.

Because ASPCA / Hartville / PetsHealth has monetary payout limits, their continual coverage for chronic conditions is low to moderate.

It is not clear at this time whether the per incident limit for continual coverage is reset each policy year. If it is not reset each policy year, the coverage is low. If it is reset every year, the coverage is moderate.


Hereditary & Congenital Coverage

Coverage for hereditary and congenital conditions is available in Level 3 and Level 4 plans, however...

The monetary payout for these types of conditions has limits. These limits are very low.



Cancer Coverage

ASPCA / Hartville / PetsHealth Pet Insurance offers cancer coverage, however...
  1. Cancers that are considered to be hereditary or genetic may not be covered in plans that do not cover Hereditary/Congenital conditions.
  2. To get Continuing Care coverage for cancer you must purchase the Level 2, 3, or 4 plan.
  3. The Continuing Care coverage has its own deductible, copay, and monetary payout limits. (See 'Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases above')


Coverage For Breed Specific Conditions

Breed specific medical conditions often occur as hereditary/congenital issues. ASPCA / Hartville / PetsHealth Pet Insurance covers hereditary/congenital conditions, however, the monetary payout for these types of conditions has limits and these limits are very low.



Maximum Payout Structure

ASPCA / Hartville / PetsHealth Pet Insurance has a per-incident maximum payout structure. This per-incident maximum payout may work for people whose calculated "Worst Case Scenario Costs" are on the moderate to low end...but if your calculated "Worst Case Scenario Costs" are high, this payout structure may not meet your needs. (See: Picking the Right Maximum Payout)


In addition, Hereditary/Congenital conditions and Continual Care for Chronic Conditions have monetary limits lower than the per-incident maximums stated above. These are two of the most costly situations in veterinary medicine. ASPCA / Hartville / PetsHealth's monetary coverage for these situations may not meet those with moderate to high "Worst Case Scenario Costs".



Summary of Coverage and Payout Structure

Gotchas

  • Low monetary coverage for Hereditary/Congenital conditions
  • The per-incident payout structure may not be enough for those with high "Worst Case Scenario Costs"
  • There are monetary payout limits for chronic conditions after the first year they occur. In addition, the copay increases to 20%.
  • If a cancer is shown to be hereditary or genetic, it may not be covered if you do not buy a plan with Hereditary/Congenital coverage
  • Non-routine dental coverage is limited



Good Points

  • Strong underwriter
  • Coverage when travel out of state or to Canada



Additional Comments Regarding All Pet Insurance Companies:

  • Make sure you understand what the waiting periods are.
  • Make sure you understand their bilateral conditions policy.
  • Make sure you understand any requirements that you must adhere to to maintain coverage.
  • Make sure you read the terms and conditions to get a thorough understanding of all exclusions.
  • Make sure you understand how and when your premium can increase.
  • If you change plan levels, there is a possibility that all medical conditions present under the old plan will be considered pre-existing in the new plan. Make sure you ask the company if this is the case.
  • For some companies, pre-existing conditions can be based on symptoms alone, a diagnosis is not needed. For example, if your pet had a cough before you applied for pet insurance and this cough was discussed and written in the pet's medical record, there is the possibility that all future cough conditions, no matter what the cause, would be considered pre-existing - even if there was no treatment given. Make sure you ask the company if this is the case.
  • Pet insurance companies are businesses. The top priority of any business is to make a profit for their stakeholders. Pet insurance companies can and may change your rates and terms to meet that top priority. A change of business ownership or underwriters can also be a catalyst for changes in your rates and terms.

    When you purchase pet insurance make sure you have a realistic understanding of this and how it can affect you.


Additional Reviews:

AKC | ASPCA | Embrace | Healthy Paws | PetFirst | PetPlan | Pets Best | Purina | Trupanion | VPI | 24 Pet Watch


**Disclaimer:This review is meant to supplement not replace your own due diligence. Please read all terms and conditions of the pet insurance plan before you buy.

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