How pet insurance reimbursement works
You pay the vet, then get paid back. Here is exactly how the deductible, percentage, and limit turn a bill into a check.
The three settings that decide your payout
- Deductible - what you pay before reimbursement begins. Usually annual (once per policy year), sometimes per-condition. A higher deductible lowers your premium.
- Reimbursement percentage - the share of the eligible bill the insurer pays after the deductible, commonly 70, 80, or 90 percent. The remainder is your coinsurance.
- Annual limit - the maximum the plan pays per policy year. Some plans are unlimited; a lower cap costs less but can be used up by one major illness.
A worked example
Say your dog needs 6,000 dollars of surgery and hospitalization, all eligible under the plan. With a 500 dollar annual deductible and 80 percent reimbursement:
| Step | Amount |
|---|---|
| Eligible bill | 6,000 dollars |
| Minus annual deductible | 500 dollars (you pay) |
| Remaining eligible | 5,500 dollars |
| Insurer pays 80 percent | 4,400 dollars (reimbursed to you) |
| Your total out of pocket | 1,600 dollars |
At 90 percent reimbursement the insurer would pay 4,950 dollars and your cost would drop to 1,050 dollars. Once you have met the annual deductible, later eligible claims that same year are reimbursed at your percentage without a new deductible.
How a claim actually happens
- Pay your vet at the time of service (most plans reimburse you afterward rather than paying the clinic directly)
- Submit the itemized invoice and any records the insurer requests, usually by app or online
- The insurer applies your deductible and percentage and pays you by direct deposit or check
- Track your annual deductible and limit - both reset at the start of each policy year
A few insurers can pay some clinics directly, but plan on paying up front and being reimbursed. See the plan overview on our pet insurance page, and how these settings affect price in what pet insurance costs.
Frequently asked questions
How does pet insurance reimbursement work?
You pay your veterinarian directly, then submit the invoice to your insurer. The insurer subtracts your deductible from the eligible amount, pays you back your reimbursement percentage of what remains, and counts it toward your annual limit. You receive the money by direct deposit or check.
What is a good reimbursement percentage?
Most plans offer 70, 80, or 90 percent. Higher percentages mean more back on every claim but a higher premium. Eighty percent is a common balance; ninety percent suits owners who want maximum payout and will pay more monthly for it.
Does the deductible apply to every claim?
Usually not every claim - most plans use an annual deductible you meet once per policy year, after which eligible claims are reimbursed at your percentage with no new deductible. Some plans use a per-condition deductible instead, so check which type your plan has.
Does pet insurance pay the vet directly?
Usually no - most plans reimburse you after you pay the clinic. A few insurers can pay some veterinary hospitals directly, but you should plan on paying up front and being reimbursed, so keep that in mind for large emergency bills.
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