A Vet's Review of Lemonade Pet Insurance
2024

• There is a 6 month waiting period for cruciate ligament events. May vary by state
• To get exam fee coverage, you must remember to purchase the add on
• To get dental illness coverage, you must remember to purchase the add on. Dental Accident coverage is included in the base policy
• Coverage not available for some breeds after a certain age.

• Appears to have comprehensive dental illness coverage that is obtainable via an addon. The monetary limit is $1000 per year. Without this addon, only Dental accidents are covered. (See 'Concerns' section below).
• Offers various maximum payout options that will work for most people's "Worst Case Scenario" Costs
• Lemonade is a Public Benefit Corporation (PBC). PBC's are a type of for-profit corporate entity structure that must also provide a positive impact on society. Lemonade does this by donating any remaining money to meaningful non-profit organizations.
• Some pre-existing conditions may be deemed curable (and therefore will be covered) if there has been no symptoms or treatments for 1 year. This does not apply to knee conditions.
• Provides 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

• According to their FAQ section, your premium may be affected by your claims history.
  
  My question would be: Does this mean that if you have other types of Policies with Lemonade and you file claims with them they can increase your pet insurance premium over time?
• I would like to see more clarity on when and by how much premiums can increase.
• Based on their pre-existing conditions policy, signs or 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.
• While the addon for dental illness is comprehensive, it is not clear what they will consider to be a pre-existing condition in this case. For example, is previous noted tartar a case for denial of claims in this case?
• 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.
• If a bilateral condition happens on one side before they policy starts or during the waiting period, that condition will not be covered if it happens on the other side. Even if it happens after the waiting period.
  
  The way it is written in their sample policy, it appears this applies to all bilateral conditions.
  
  There are so many body systems that inhabit both sides of the body (e.g. eyes, ears, knees, hips, front paws, elbows, toenails, kidneys, lungs, femur, etc). Not clearly defining which systems they are referring to leaves a big door open that could allow them to deem something as a bilateral exclusion whenever they see fit.
  
  Letting customers know what specific conditions and/or systems fall under this exclusion would be much more transparent. Even if they want the definition to include all body systems that inhabit both sides of the body, it is important to clearly let the customer to know this.
• Lemonade Pet Insurance is a newer company. Based on what I've seen since 2008, it can take time for a company to settle in on consistent premium pricing and policy terms.

• 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.

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