Insurance Terminology – Understanding Pet Insurance Made Easy

Unless you’ve got an insurance license, when you first get a policy or start comparing different policies that are applicable to your needs, you’re going to end up getting confused about what exactly is being said.

There is a ton of lingo that’s thrown around in policies, and in the reviews on our blog that can turn people off, leaving them not wanting to properly insure their pet because they think the process is too difficult.

That’s why we’re breaking down the specific terms you’re going to be seeing as you’re going through the policies and while you’re talking to the agents on the phone.

  • Chemotherapy and Radiation Treatment Allowance: When you encounter these in a policy, they’re generally going to be split up into two separate categories. One for the maximum reimbursement limits on chemotherapy and another for the maximum reimbursement limits on radiation treatment. Allowances for radiation treatment are, generally, higher than the limits for chemotherapy.
  • Code: Code, as it’s listed on your policies, is the code that is used by the insurance companies to identify the type of procedure or diagnosis that’s being given to your pet.
  • Co-Payment: Your co-payment is the amount of money you’re going to have to come out of pocket per incident, after your deductible is covered. This is usually listed as a percentage, such as 75%/25%, which means that the insurance company will cover 75% of the balance after your deductible is paid, while you’re paying the additional 25%.
  • Deductible: Your deductible is how much money must be paid by yourself to the vet before you are able to receive a reimbursement payment from the insurance company. Most companies will offer a per incident reimbursement, so make sure that you understand the differences between a policy that offers per-incident, and one that has annual deductibles.
  • Endorsements: Endorsements are considered add-ons to your policy, and usually come in the form of commonly known problems, or issues that can occur as your dog grows in age. The most common endorsements are for cancer, and extend the amount of coverage you’re able to get should your pet incur the specific illnesses listed in the endorsements.
  • Exclusions: Exclusions are going to be issues or illnesses that are not going to be covered by your policy, such as pre-existing conditions, disorders, and intentional injuries that are caused by you. When you’re going over the quotes and policies that you receive, make sure to spend time looking at the various exclusions to ensure you understand what you’re buying.
  • General Anesthesia Allowance: If your pet has to have surgery, most policies are going to state a maximum allowance for general anesthesia.
  • Pre-Existing Conditions: If your dog currently has a condition or illness, most companies are going to group it into a “pre-existing” condition and have specific terms about how much will be covered, in terms of vet visits that pertain specifically to the pre-existing condition. That means, if your dog is already diagnosed with cancer, any visits to your vet that are cancer related will not be covered.
  • Incidents: The incident is going to be the specific reason that you are visiting the vet. For some policies, chronic conditions that require multiple visits to the vet for the same reason are going to be grouped as a single incident, even if you have to pay per visit.
  • Primary Diagnosis Or Condition: This is going to cover the limits that your insurance company is going to place for a diagnosis or condition that includes multiple areas, such as injections, exams, treatment, and surgery or hospitalization.
  • Primary Diagnostic Testing Maximums: Most companies will apply cost limits to any testing required by your vet during a visit for an incident. In most policies, the primary diagnostic testing maximums are not going to include specialized tests, which you will be required to pay 100% out of pocket for.
  • Schedule Of Benefits: Your schedule of benefits outlines the various different allowances, limits, and conditions that are covered by your policy, generally on a per diagnosis basis.
  • Secondary Diagnosis or Condition: When your pet is diagnosed with a secondary condition that is a result of the primary diagnosis, it will typically get covered underneath the secondary diagnosis or condition label. Most policies will reimburse you additionally for any secondary conditions.

Still Need Help?

If you need a deeper explanation about anything we’ve discussed here, or get confused while you are reading through the policies you’re considering, either leave a comment below or reach out to us and we’ll be glad to help you.

Last Updated on June 12, 2016 by

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