A Vet's Review of PetPartners 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 PetPartners Pet Insurance, see PetPartners' Comparison Sheet.



Overview

Partnered with AKC in 2003 to create AKC Pet Insurance.

Currently owned by JAB Holding (a German private equity firm)

This review refers to their Accident and Illness Plan



Coverage Overview

In general, PetPartners Pet Insurance covers 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 limits.

PetPartners does not cover exam fees unless you purchase the ExamCare addon.

Dental coverage for injury and illness is limited.



Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

If your pet develops a chronic disease that is hereditary or congenital in nature you will not be covered unless you purchase their HereditaryPlus addon.

Also, PetPartners does not cover some very common chronic diseases unless you purchase their HereditaryPlus addon. These include but are not limited to: Arthritis and Diabetes. Coverage for these types of chronic diseases should be apart of any pet insurance plan you purchase as these are common ailments seen in older pets. (See: 5 Points of Coverage Your Pet Insurance Plan Must Have).

Diseases in this list can be hereditary/congenital in origin but there can be other causes of origin as well. For example: arthritis can also be caused by infection of the joint or trauma to the joint.

The HereditaryPlus addon may have additional waiting periods.

Pets must be under 2 years of age to purchase The HereditaryPlus addon.



Hereditary & Congenital Coverage

PetPartners does not cover hereditary and congenital conditions including hip dysplasia unless you purchase their HereditaryPlus addon.

The HereditaryPlus addon may have additional waiting periods.

Pets must be under 2 years of age to purchase The HereditaryPlus addon.


Hereditary / congenital coverage is one of the important pieces of coverage that must be part of any pet insurance plan. (See: 5 Points of Coverage Your Pet Insurance Plan Must Have).



Cancer Coverage

PetPartners offers cancer coverage but... if the cancer is shown to be due to hereditary or genetic reasons, it may not be covered unless you purchase their HereditaryPlus addon which has additional waiting periods.

Pets must be under 2 years of age to purchase The HereditaryPlus addon.



Coverage For Breed Specific Conditions

Breed Specific Medical Conditions can occur as hereditary and congenital issues and as chronic medical diseases. PetPartners does not cover hereditary or congenital conditions unless you purchase their HereditaryPlus addon which has additional waiting periods.

Pets must be under 2 years of age to purchase The HereditaryPlus addon.



Maximum Payout Structure

For its customized plans, PetPartners has an annual maximum payout structure. You can choose an annual maximum payout from $2,500 to Unlimited (in some states). To know if the maximum payout will cover your "Worst Case Scenario Costs", you will need to check the annual maximum payout options for your state.

For its basic plans, PetPartners has a per-incident maximum payout structure combined with an unlimited annual maximum payout structure. The maximum payout per-incident is $500. This means $500 will be the maximum amount they will reimburse your for an individual injury or illness over the life of the pet. For chronic diseases conditions or serious acute emergencies this is extremely low, even for those whose calculated "Worst Case Scenario Costs" are low.

(See: Picking the Right Maximum Payout)



Summary of Coverage and Payout Structure

Limitations

  • No hereditary or congenital coverage (including hip dysplasia) unless you purchase the HereditaryPlus addon which has it's own waiting period before conditions are covered.
  • The HereditaryPlus addon is only available to pet who are enrolled before the age of two (2).
  • Some very common chronic medical conditions are not covered unless you purchase the HereditaryPlus addon.
  • If a cancer is shown to be hereditary or genetic, it may not be covered unless you purchase the HereditaryPlus addon
  • The per-incident payout structure (available through the basic plan) is only $500 per incident for the life of the pet. This is low, even for those with low "Worst Case Scenario Costs".
  • To get exam fee coverage, you must remember to purchase the ExamCare addon.
  • 180 day waiting period for Cruciate Ligament related conditions and Intervertebral Disc Disease. May vary by state.
  • Dental coverage for injury and illness is limited.
  • Behavioral Therapy Coverage has an annual maximum benefit of $1,000.


Good Points

  • Strong underwriter
  • Coverage when travel out of state, to US territories and possessions and to Canada
  • Some pre-existing conditions may be covered after a 365 day waiting period. May vary by state


Concerns

  • 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. Their Bilateral Conditions policy doesn't clearly list the medical conditions that fall under this exclusion.

    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 that they clearly let the customer know this.
  • It is also not clear if bilateral conditions are treated as one condition when it comes to the Per-Incident Maximum Payout structure under their Basic Plan.
  • Based on their pre-existing conditions policy, 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 symptoms are not directly related to the disease or condition currently in question.
  • It is not clear whether reimbursements are calculated by taking the deductible first or the reimbursement percentage first.
  • No hereditary or congenital coverage (including hip dysplasia) unless you purchase the HereditaryPlus addon. It is only available to pets under the age of 2. If you buy this plan for a pet 2 years of age or older, you will not covered for one of the 5 important pieces of coverage.
  • Some very common chronic medical conditions are not covered unless you purchase the HereditaryPlus addon. Based on information from their website, these conditions include but are not limited to: diabetes and arthritis. Diseases in this list can be hereditary/congenital in origin but there can be other causes of origin as well. For example: arthritis can also be caused by infection of the joint or trauma to the joint.



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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