A Vet's Guide To Pet Insurance
Compare PetPlan Pet Insurance
Comparison Fact SheetTo get the most from these sheets, please read the Guide to Pet Insurance first.
| Company Info | |
| Company Name | PetPlan USA |
| Also Known As | |
| Address | 3805 West Chester Pike, Suite 240 Newtown Square, PA 19073 |
| Phone | 1-866-467-3875 |
| Website | www.gopetplan.com |
| Plans That Provide Both Accident and Illness Coverage |
New Plan Accident & Illness Plan Old Plans Bronze Plan; Silver Plan; Gold Plan |
| States Covered |
New Plan PetPlan is in the process of getting approval in all 50 states, including DC. To see if this plan has gone live in your state, call PetPlan. Old Plans All 50 states, including DC |
| Underwriter and AM Best Financial Strength Rating |
New Plan Policies are underwritten by XL Specialty Insurance Company (XL Catlin) and AGCS Marine Insurance Company. XL Specialty Insurance Company has an AM Best Financial Strength Rating of "A+" and an Outlook of "Stable" as of 1/1/19. AGCS Marine Insurance Company has an AM Best Financial Strength Rating of "A+" and an outlook of "Stable" as of 1/1/19. Old Plans Policies are underwritten by AGCS Marine Insurance Company (a member of the Allianz Group). AGCS Marine Insurance Company has an AM Best Financial Strength Rating of "A+" and an outlook of "Stable" as of 1/1/19. For the most recent ratings go to: AM Best and enter the name of the underwriter in the box labeled 'Text'. |
| Year Company Started | 2003 in the USA |
| Policy Basics | |
| 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. There is no upper age limit. |
| Cancellation Policy | Ask for a current copy of their insurance policy so that you may review their cancellation policy |
| Waiting Period |
New Plan 5 days after the policy effective date for injuries. 15 days after the policy effective date for illness. There is a (6) month exclusion on cruciates and patellas. "Coverage will be afforded if your pet is examined by a veterinarian within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees, subject to the waiting period." Waiting periods and exclusionary periods may vary depending on state. Old Plans 24 hours after the policy effective date for accidents. 14 days after the policy effective date for illness. |
| Waiting Period for Cruciate Injury |
New Plan There is a (6) month exclusion on cruciates and patellas. "Coverage will be afforded if your pet is examined by a veterinarian within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees, subject to the waiting period." Waiting periods and exclusionary periods may vary depending on state. Old Plans 6 months for cruciate injuries and patella defects. They will waive this exclusion if your pet is examined by a vet within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees. |
| 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. The premium may also increase due to inflation or other reasons.
Contact the company for more information on when and how your premium may increase. |
| 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 there is no lapse in coverage. (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 in the US. |
| 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? |
New Plan No Old Plans A 20% copay applies in the following situations: (Does not apply to life-saving emergency conditions)
|
| 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 online |
| What's Covered | |
| 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 |
New Plan [INCLUDED] PetPlan will pay for veterinary consultations provided by a licensed vet accredited in behavioral therapy. The consultation must be to diagnose and treat behavioral problems where an underlying medical condition is the cause of your pet's behavioral issues. Coverage does not apply to obedience training. Ask PetPlan if there are any additional monetary limits to behavioral therapy as there have been in the past. Old Plans [INCLUDED] Behavioral Therapy is included and covers consultations with a licensed veterinarian to diagnose and treat behavioral problems where an underlying medical condition is the cause of your pet's behavioral issues. There are annual monetary limits depending on the plan you select. This amount is part of, and not in addition to, your policy's maximum annual limit for vet fees. The monetary limits for behavior coverage are as follows: Gold Plan - $1,000 annually Silver Plan - $500 annually Bronze - $250 annually The veterinarian no longer needs to be accredited in behavioral therapy to be covered. (Note: A licensed vet who is accredited in behavioral therapy is considered a specialist. If you see a behavior specialist, the specialist copay may apply here.) Coverage does not apply to obedience training. **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 |
New Plan "...a pre-existing condition as a medical condition which first occurred or showed clinical sign(s) or symptoms before the effective date of your policy or which occurred or showed clinical sign(s) or symptoms during the policy waiting period." If your pet has experienced a curable condition previous to enrolling in a Petplan pet insurance policy, the condition, while pre-existing, MAY be eligible for coverage after an exclusionary period. Old Plans Pre-existing conditions are not covered. According to Petplan's terms and conditions policy, a pre-existing condition is "...a medical condition which first occurred or showed clinical sign(s) or symptoms before the effective date of this policy or which occurred or showed clinical sign(s) or symptoms during the policy waiting period." 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 |
New Plan [INCLUDED] Prescription drugs are covered as long as they are prescribed by a veterinarian for a covered condition. Old Plans [INCLUDED] Prescription drugs are covered provided they have been prescribed by the treating veterinarian as treatment for a covered illness or accident. Petplan does provide coverage for vitamins and nutritional supplements prescribed by a licensed vet as part of the course of treatment for a coverable condition. All prescription drugs must be FDA approved for pets, subject to policy provisions. **See actual policy or call Petplan for any additional limitations on Prescription Drug Coverage |
| Pregnancy Coverage |
New Plan [LIMITED COVERAGE] It is not entirely clear whether there is pregnancy coverage. Policy states: Costs arising out of or related to Pregnancy are not covered. It also states: Costs related to complications from pregnancy will be covered if the date of breeding falls after the waiting period of the effective date of your policy. [See Policy - General Exclusions - Section n] Old Plans [LIMITED COVERAGE] Costs related to complications from pregnancy (e.g. c-section) may be covered. The treatment must be deemed medically necessary, must not be a scheduled event, and the pregnancy must have started within the policy period. [See Sample Gold Policy - General Exclusions - Section 5p] **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) |
New Plan [LIMITED] Petplan will cover non-routine dental treatments such as broken teeth or periodontal disease provided your pet has had its teeth checked by a vet in the 12 months prior to the effective date of coverage and any treatment recommended as a result of a veterinary check-up was carried out. It is not clear if other dental illnesses or treatments are covered. Old Plans [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, and any treatment that was recommended as a result of a veterinary check was carried out. If this is not done, dental treatments are not covered. Coverage does not extend to dental disease where clinical signs were noted prior to the policy or during the 14-day illness waiting period. **See actual policy or call PetPlan for full list of inclusions and exclusions. |
| Bilateral Conditions Policy |
New Plan "If your pet has received treatment for a cruciate or soft tissue injury to one knee during the first six (6) months of the policy (where no certification of knee health has been provided) then the other knee is automatically excluded from coverage for a period of twelve (12) months from the date of last treatment to the affected knee." "If your pet has received treatment for a cruciate or soft tissue injury to one knee prior to policy inception then the other knee is automatically excluded." "If your pet has shown clinical signs of a cruciate or soft tissue injury to one knee prior to the effective date of this policy or during the first six (6) months of the policy (where no certification of knee health has been provided), then the other knee is automatically excluded from coverage." It is not clear whether or not other conditions fall under their bilateral conditions policy. Old Plans The bilateral conditions policy only applies to knee injuries. If your pet has a torn cruciate or soft tissue injury of the knee prior to policy or during the 6-month exclusionary period without an examination by a veterinarian within the first 30 days then the other leg is automatically excluded from coverage for a period of twelve months from the date of treatment. |
| 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 (limited), Behavioral Therapy (It is unclear if there are additional monetary limits for behavior therapy). (Refer to each category's section for limitations) **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) |
|
| How The Policy Works | |
| Co-pay |
New Plan You can choose from 10%, 20% or 30% Old Plans You can choose from 0%, 10% or 20% Co-pay is 20% for visits to a specialist. (See 'Surcharge for Visiting a Specialist or Emergency Clinic' above) |
| Deductible |
New Plan You can choose from $250 to $1000 in $50 or $100 increments. You can choose to apply the deductible annually or per condition per policy period (i.e. each year). [Call Petplan for the per condition per policy period option] Old Plans You can choose $50, $100 or $200 deductible per illness/injury per policy period. |
| Flat Deductible vs % Deductible | Flat |
| Deductible Per Incident vs Annual Deductible |
New Plan You can choose to apply the deductible annually or per condition per policy period (i.e. each year). [Call Petplan for the per condition per policy period option] Old Plans Per illness/injury per policy period |
| How is Reimbursement Determined | Actual Vet Bill as defined by the fees regularly charged and incurred for a given treatment or procedure by the treating veterinary facility. |
| Max Payout Annually |
New Plan Choose a maximum annual payout from $2500 to Unlimited. Old Plans Bronze Plan - Annual maximum payout $10,000 (may be $8,000 in some states) Silver Plan - Annual maximum payout $14,000 (may be $12,000 in some states) Gold Plan - Annual maximum payout $22,000 (may be $20,000 in some states) |
| 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. |
| Pricing | |
| Approximate Monthly Costs | Approximately $7.80 - $64.00 depending on the deductible, co-pay annual max, age of pet, your location, etc. |
| Additional Info | |
| My Review | PetPlan Review |
| What are Customers Saying? | PetInsuranceReview.com and Yelp.com |
| Better Business Bureau | bbb.org |
| Additional Info |
New Plan If your pet has not been examined by a veterinarian within sixty (60) days prior to the effective date of the policy, you must arrange to have your pet examined at your own expense within thirty (30) days of the effective date of this policy. Any medical condition(s) or clinical sign(s) observed or recorded during the first exam, and all costs associated therewith, are automatically excluded from coverage. Old Plans If your pet has not been examined by a primary care veterinarian within the twelve (12) months prior to the effective date of the policy, you must have your pet examined within the first 30 days. This examination will be used as the basis for determining any pre-existing conditions. |
**Disclaimer: These charts are created based on my research. While I do my best to stay current, information can change quickly. Also, terms and conditions can vary from state to state. Before buying a pet insurance plan, confirm all information by calling the company or reading the most current policy. We will not be held liable for errors or omissions. If you see something that is incorrect or needs clarifying, please let me know.
**Copyright: You are more than welcome to link to this website, in fact, it is greatly appreciated. However, a lot of time, energy and effort went into the production of this material so please do not copy and paste the contents of this chart/website into your website or written material.
If you use data from this website as a research point for your own website or written material, you must cite Pet-Insurance-University.com as the source.
All names, logos and trademarks in this site are the property of their respective owner(s).
↑ Top
Classroom
Research Library
Copyright © Pet-Insurance-University.com. All Rights Reserved
2008 - 2023.
No part of this website can be reproduced in any form without the
express permission of the author.