A Vet's Review of PetPlan 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 PetPlan, see PetPlan's Comparison Sheet.



Overview

PetPlan has offered pet insurance since 2003 in the USA. This review refers to the following plans: Bronze Plan; Silver Plan; Gold Plan



Coverage Overview

In general, PetPlan 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

PetPlan 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 annual maximum payout per policy year.



Hereditary & Congenital Coverage

PetPlan 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 annual maximum payout per policy year.



Cancer Coverage

PetPlan covers cancer conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and and you have not reached your annual maximum payout per policy year.



Coverage For Breed Specific Conditions

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



Maximum Payout Structure

PetPlan has an annual maximum payout structure and offers an array of annual maximum payouts that can fit the needs of those with high "Worst Case Scenario Costs" and those with low "Worst Case Scenario Costs". (See: Picking the Right Maximum Payout)

Note: A 20% copay applies in the following situations: (Does not apply to life-saving emergency conditions)
  • Treatment at a specialist or referral veterinary facility
  • Treatment by a veterinary specialist - A veterinary specialist is a veterinarian who is certified by a recognized veterinary specialty organization (e.g. American College of Veterinary Internal Medicine), or how has received certification as a result of additional training.
  • Treatment at an emergency care facility
  • Treatment at an after hours veterinary facility
  • Treatment at an accredited school of veterinary medicine


Summary of Coverage and Payout Structure

Gotchas

  • Non-routine dental coverage is limited
  • A 20% copay applies in the following situations: (Does not apply to life-saving emergency conditions)
    • Treatment at a specialist or referral veterinary facility
    • Treatment by a veterinary specialist - A veterinary specialist is a veterinarian who is certified by a recognized veterinary specialty organization (e.g. American College of Veterinary Internal Medicine), or how has received certification as a result of additional training.
    • Treatment at an emergency care facility
    • Treatment at an after hours veterinary facility
    • Treatment at an accredited school of veterinary medicine


Good Points

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



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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