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



Overview

Prudent Pet started in 2018.

This review refers to their plans: Essential and Ultimate



Coverage Overview

In general, Prudent Pet 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.

Exam Fees are not covered unless you purchase the exam fee addon.

Dental coverage for accidents and illnesses is limited.



Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

Prudent Pet provides 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

Prudent Pet 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

Prudent Pet provides cancer coverage 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.


Coverage For Breed Specific Conditions

Prudent Pet 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 maximum payout limit.



Maximum Payout Structure

Prudent Pet has an annual maximum payout structure. They offer plans with a maximum annual payout of $10,000 or Unlimited. These choices of maximum payout will meet the needs of those whose "Worst Case Scenario Costs" are medium or high. (See: Picking the Right Maximum Payout)


Summary of Coverage and Payout Structure

Limitations

  • 6 month waiting period for damage or rupture of cruciate ligaments, luxation of the patellas or other soft tissue disorders of the knee. May vary by state.

    While this waiting period can be waived if your vet certifies that your pet does not have pre-existing knee conditions, 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.
  • If a cruciate or soft tissue injury to the knee 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.
  • Dental coverage for accidents and illnesses is limited.


Good Points

  • Strong underwriters
  • Coverage when travel out of state including the US, Puerto Rico, and Canada.
  • 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


Concerns

  • Based on their pre-existing conditions policy, signs 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 are not directly related to the disease or condition currently in question.
  • In their sample policy it states that the following is an exclusion: "... any illness that is the same as, or has the same diagnosis or clinical sign(s) as any illness your pet had before the effective date of this policy or during the first fourteen (14) days beginning on the effective date of this policy." It is not clear whether or not this includes any conditions that can happen on both sides of the body.
  • It is not clear whether reimbursements are calculated by taking the deductible first or the reimbursement percentage first.



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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