How does pet insurance work for surgeries?
Pet insurance plans may cover medically necessary surgeries, including emergency surgeries and some preventative procedures. Optional or elective surgeries are usually not covered, and some surgeries may be excluded if they're related to a pre-existing condition.
What kind of pet insurance covers surgery?
There are two main types of pet insurance, and they cover surgeries in different scenarios:
- Accident-only pet insurance covers medical costs if your pet is injured due to an accident. For example, if your pet is hit by a car or eats something it's not supposed to, your accident-only pet insurance will help cover the cost of surgery.
- Comprehensive accident and illness pet insurance plans cover accidents as well as diseases and chronic illnesses. For example, if your pet suffers from hip dysplasia and isn't genetically predisposed, then your comprehensive pet plan may cover corrective surgery.
Which surgeries are covered by pet insurance?
Medically necessary surgeries tend to be covered if they're required to save your pet's life, such as an obstruction in the intestines or a bladder stone. Accidental injuries that require surgery, such as a broken leg, are typically covered as well.
Which surgeries aren't covered?
Pet insurance typically won't cover surgeries for pre-existing conditions, as defined by your insurer. For pre-existing conditions, you may be able to set up a financing option with your veterinarian if you can't afford the cost of procedures out of pocket.
Many pet insurance policies also won't cover elective surgeries such as spaying and neutering, though they may be covered under some routine care or wellness plans. Because spaying and neutering are relatively common veterinary surgical procedures, they tend to be less expensive. Some preventative surgeries may also be excluded from coverage if they aren't deemed life-saving or medically necessary.
Example:Prophylactic procedures are common preventative pet surgeries that reduce the risk of complications from other disorders. In some high-risk dog breeds, for example, gastropexy surgery may be recommended to eliminate the risk of gastric dilatation. In many cases, prophylactic procedures won't be covered by pet insurance plans, even if a vet recommends them for your pet.
How does pet insurance cover surgery costs?
Pet insurance works on a reimbursement basis, which is different than human health insurance. Rather than paying the veterinarian directly, your pet insurance policy will reimburse you a specific percentage of your dog or cat's surgery costs based on your policy's reimbursement level and annual deductible.
Example:If a surgery costs $3,000 and your pet insurance reimburses you 80%, you'd pay the surgical costs, then file a claim with your insurance company. Once your claim is processed, you'd receive a $2,400 reimbursement if you've already met your annual deductible.
What are the most common pet surgeries?
As a pet owner, you may encounter one of these common pet surgeries:
- CCL/ACL surgery: Active dog breeds frequently tear their cranial cruciate ligament (CCL), the canine equivalent of the anterior cruciate ligament (ACL) in humans. The only fix for this injury is a CCL repair surgery, which can cost $2,000 to $4,000 on average, according to CareCredit. Pet insurance plans may cover CCL surgery because it's usually caused by an accident and medically necessary for your pet.
- Eye surgery: All animals, but particularly cats, can suffer eye injuries that result in the need to remove the eye — a surgical procedure known as enucleation that typically costs $600 to $1,000, according to Wag!. Pet insurance plans may cover eye surgeries if they're deemed medically necessary and not caused by a pre-existing condition.
- Hip surgery: Some dog breeds are prone to hip dysplasia, which may require total hip replacement surgery. This procedure can cost between $3,500 to $7,000 per hip, according to Northeast Veterinary Referral Hospital. Pet insurance plans may not cover this surgery if it's due to a genetic disposition in some breeds, as it may be considered a pre-existing condition.
- Tumor removal surgery: Surgery to remove a cancerous tumor can cost between $180 to $2,000 or more, depending on the complexity and location of the tumor. A comprehensive pet insurance plan may cover surgery to remove cancerous tumors if the cancer developed while on the plan. If the cancer existed before coverage started, it may not be covered as a pre-existing condition.
- Limb amputation: If a pet's limb is too injured or the cost of repairing it is too high, a veterinarian may recommend amputation. For dogs, this procedure can range in cost from $700 to $1,000, according to Wag!. Pet insurance plans may cover a limb amputation because it's usually deemed medically necessary and not caused by a pre-existing condition.
- Foreign object removal: The cost of removing a foreign object from a dog's intestinal tract can range from $800 to more than $3,500 depending on the method used, according to Wag!. This surgery may be covered by pet insurance as it's usually caused by accident and deemed medically necessary.
- Spaying and neutering: Spaying and neutering any animal is a standard procedure. While neutering can cost up to $250 and spaying can cost as much as $500, many state-sponsored programs subsidize the cost. Spaying and neutering are typically not covered by pet insurance because they're considered elective surgeries. It may be covered by a wellness plan for routine care though, such as the Progressive by Pets Best BestWellness plan (which can be added to a BestBenefit Accident and Illness Plan).
- Joint surgery: Some animals, particularly dogs, are prone to joint problems that require surgery. Depending on the complexity, this procedure can range from $100 to $3,000 for dogs. Pet insurance may cover joint surgery costs if they are deemed medically necessary and not caused by a pre-existing condition. If the joint issues are due to a genetic disposition in certain breeds, surgery may not be covered as it could be considered a pre-existing condition.
How to get pet insurance
Get a quote from Progressive Pet Insurance by Pets Best.
Call a rep
Call 1-877-298-0639 and speak with a representative from Progressive Pet Insurance by Pets Best.