A Vet's Review of Figo Pet Insurance
2024

by Frances Wilkerson, DVM

This review discusses the 5 important pieces of coverage and payout structure

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



Overview

Figo has offered pet insurance since 2015 in the USA.



Coverage Overview

In general, Figo Pet Insurance covers diagnostics and lab tests, surgery, treatments, hospitalization and prescription medications for accidents/injuries and illnesses.

Coverage for examinations for accidents and illness is not included in the base policy, but it can be purchased as an addon.

Dental coverage for accidents and illnesses is limited.


Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

Figo Pet Insurance offers chronic diseases coverage and continual coverage for chronic conditions as part of the base policy, as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Hereditary & Congenital Coverage

Figo covers hereditary and congenital conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Cancer Coverage

Figo covers cancer conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.

Osteosarcoma (bone cancer) falls under the 6 month waiting period for orthopedic conditions. Based on their website, this waiting period for orthopedic conditions may apply only to dogs. (Contact Figo to confirm)

According to their sample policy: "...If a Pet had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, unrelated conditions may be covered..."

Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.


Coverage For Breed Specific Conditions

Figo covers breed specific conditions medical conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Maximum Payout Structure

Figo has an annual maximum payout structure. They offer plans with a maximum annual payout of $5,000, $10,000, or Unlimited. These maximum payout structure options are varied enough to meet everyone's calculated "Worst Case Scenario Costs". (See: Picking the Right Maximum Payout)



Summary of Coverage and Payout Structure

Limitations

  • To get exam fee coverage, you must remember to purchase the add on
  • Figo's Bilateral conditions exclusion policy is not clear at the time of this writing
  • According to their sample policy: "If a Pet had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, unrelated conditions may be covered"

    Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.
  • 6 months waiting period for orthopedic conditions. According their sample policy, this waiting period for orthopedic conditions may apply only to dogs. (Contact Figo to confirm) (May vary by state)

    While the orthopedic waiting period can be waived with a healthy orthopedic exam completed within the first 30 days of policy period, please note that a Vet may want additional diagnostics (e.g. x-rays, ultrasound, etc) before they will feel comfortable certifying this. The cost of this will be out of your own pocket.
  • Dental coverage for accidents and illness is limited


Good Points

  • Strong underwriter
  • Has an unlimited maximum annual payout option
  • You may visit any licensed veterinarian in the world.
  • Provides comprehensive coverage in the 5 important areas as part of the base plan:
    1. Chronic disease
    2. Continual coverage for chronic disease
    3. Hereditary/congenital conditions
    4. Cancer
    5. Breed specific conditions


Concerns

  • According to their sample policy: "If a Pet had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, unrelated conditions may be covered"

    Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive

    Masses are very common in veterinary medicine. If a potential buyer misses this information and/or can't afford to get a diagnosis, they may end up with a policy that doesn't cover any malignant or non-malignant masses (tumors) after the waiting period.
  • While they define what Bilateral Conditions are, it is not clear if any body systems will become pre-existing Bilateral Condition exclusions. T
  • Based on their pre-existing conditions policy, signs and symptoms can be used to denote something as pre-existing. As with all pet insurance companies that use this wording, I have concerns that this can be used to deny claims even when these previous signs/symptoms are not directly related to the disease or condition currently in question.
  • Reimbursements are calculated by applying your reimbursement percentage first, then your deductible. This can lead to being reimbursed less than companies that subtract the deductible BEFORE applying the reimbursement percentage.
  • You can request a medical review to get an idea of what your pet's pre-existing exclusions will be, but it is only available with policies that have been active for at least 30 days. It appears to only be available after the money back guarantee has expired.


Additional Comments Regarding All Pet Insurance Companies:

  • Make sure you research what customers are saying about the company. A company may have the 5 components that should be part of a pet insurance plan, but the company may not be a hit with customers. Sites to check include but are not limited to BBB.org, Yelp.com and PetInsuranceReview.com. Things to look for include but are not limited to: How fast are payments paid?, What are customers saying about the pre-existing conditions policy?, How often are claims denied and for what reason?, What is the customer service experience like?, Are there issues with premium increases?
  • Check with your state's Department of Insurance to see if any complaints have been filed for the company you are interested in.
  • 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 when and by how much 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 signs and 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:

24PetProtect | AKC | ASPCA | Bivvy | Companion Protect | Doggo | Embrace | Fetch | Figo | Hartville | Healthy Paws | Lemonade | ManyPets | MetLife | Nationwide | Odie | Petco | Pet Partners | Pets Best | Physicians Mutual | Prudent Pet | Pumpkin | Spot | Toto | Trupanion | Wagmo


**Disclaimer: This review is meant to supplement, not replace your own due diligence. Terms and conditions can vary from state to state. Before buying a pet insurance plan, confirm all information by contacting the company or reading the most current policy for your state. We will not be held liable for errors or omissions. If you see something that is incorrect or needs clarifying, please let me know.

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