A Vet's Review of Nationwide Pet Insurance (formally known as VPI)

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 Nationwide (fka VPI), see VPI's Comparison Sheet.



Overview

Nationwide (fka VPI) has offered pet insurance since 1982. This review refers to the following dog and cat plans: Whole Pet and Major Medical.


Coverage Overview

In general, the Whole Pet and Major Medical plans cover 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 comprehensive for the Whole Pet Plan and limited for the Major Medical Plan.


Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

Whole Pet Plan
The Whole Pet Plan 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 and has not occurred during the waiting period.

Major Medical Plan
For the Major Medical Plan, chronic diseases listed in the benefit schedule are covered, as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not gone over the maximum benefit allowance for the diagnosis/treatment for the year.

Unfortunately, the benefit schedule structure makes it too difficult to determine how comprehensive the chronic disease coverage will be. It would take too much time to check the benefit schedule against every known chronic disease. It would be much easier for the consumer if Nationwide (fka VPI) stated which medical conditions are not covered.

The Major Medical Plan offers continual coverage for chronic diseases. Coverage for chronic conditions in subsequent years is available up to the benefit allowance for the diagnosis/treatment. Benefit schedule allowances are reset every policy year.



Hereditary & Congenital Coverage

Whole Pet Plan
The Whole Pet Plan covers hereditary and congenital conditions as long as the condition is not pre-existing and has not occurred during the waiting period.

Major Medical Plan
Monetary and medical coverage for hereditary and congenital conditions is low for the Major Medical Plan

The Major Medical Plan does not cover congenital conditions and has limited coverage for hereditary conditions.

With the Major Medical Plan, coverage for a certain number of specified hereditary conditions becomes available after you've had the plan for one year. The monetary limits on this coverage are $275 per policy period toward diagnosis or medical treatment and $550 per policy period for surgical treatment. Hip dysplasia is one of these covered conditions.

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



Cancer Coverage

Whole Pet Plan
The Whole Pet Plan covers cancer conditions as long as the condition is not pre-existing and has not occurred during the waiting period.

Major Medical Plan
Cancers listed in the benefit schedule are covered, as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not gone over the maximum benefit allowance for the diagnosis/treatment for the year.

Again, the benefit schedule structure makes it too difficult to determine how comprehensive the cancer coverage will be. It would be much easier for the consumer if Nationwide (fka VPI) stated which cancer conditions are not covered.

If a cancer is shown to be due to hereditary/genetic reasons, there is a possibility that it will not be covered.



Coverage For Breed Specific Conditions

Whole Pet Plan
The Whole Pet Plan covers breed specific medical conditions as long as the condition is not pre-existing and has not occurred during the waiting period.

Major Medical Plan
Breed specific medical conditions often occur as hereditary/congenital issues. The Major Medical Plan does not cover congenital conditions and has limited coverage for hereditary conditions, therefore coverage for breed specific conditions is low.



Maximum Payout Structure

Whole Pet Plan
The Whole Pet Plan has an unlimited annual maximum payout structure. This maximum payout structure will meet everyone's calculated "Worst Case Scenario Costs". (See: Picking the Right Maximum Payout)

Major Medical Plan
The Major Medical Plan has a benefit allowance structure. This means there is a benefit allowance that will limit what you will receive for the medical condition's diagnosis and treatment each year. The benefit allowance may be too low for those with high calculated "Worst Case Scenario Costs". (See: Picking the Right Maximum Payout)



Summary of Coverage and Payout Structure

Gotchas

Major Medical Plan
  • No congenital coverage
  • Limited hereditary coverage
  • Hip dysplasia coverage with the Major Medical Plan is available only after the first year.
  • If a cancer condition is shown to be hereditary or genetic, there is a possibility it will not be covered
  • The payout structure for the Major Medical Plan may be to low for those with high calculated "Worst Case Scenario Costs".
  • Calculating the amount you will be reimbursed using the benefit schedule can be confusing
  • Non-routine dental coverage is limited



Good Points

Whole Pet Plan
  • Generous unlimited annual maximum payout structure
  • 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 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, 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?
  • 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 | Figo | Healthy Paws | PetFirst | PetPlan | Pets Best | 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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