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3 Ways Pet Insurance Is Different From Human Health Insurance

The Ascent logo The Ascent 7/2/2022 Christy Bieber
Woman with dog in kitchen foreground, while man looks on. © Getty Images Woman with dog in kitchen foreground, while man looks on.

Most people know it is important to have human health insurance in order to provide care for themselves and their loved ones. Pet owners also know that buying pet insurance coverage is crucial as well since pets are part of the family and also deserve advanced medical care if they need it -- even if it comes at a high price.

But what many pet owners do not realize is there are very important differences between human health insurance and pet insurance. Here are three big discrepancies to be aware of that could affect the coverage available. 

1. Pet insurance can exclude pre-existing conditions but human insurance cannot

One of the biggest differences between pet insurance and human health insurance relates to pre-existing conditions.

The Patient Protection and Affordable Care Act (better known as ObamaCare) prohibited human insurance companies from denying health coverage for people due to pre-existing conditions. It also prohibited insurers from charging them higher premiums as a result of existing medical problems. 

Because these protections are in place under ObamaCare, insurers won't be able to penalize people who got sick before getting covered by a human health insurance plan. Even people with serious medical problems can sign up for insurance during open enrollment season that happens once annually. Once signed up, they can pay the same price as everyone else of the same age in the same location, and can get their medical care for the condition covered by insurance. 

This is not the case for pet insurance. Every pet insurer has rules regarding pre-existing conditions. Typically, if an animal had a medical problem before getting covered, any treatment that might relate to that existing issue will not be covered by the insurer going forward. This means if a pet owner does not buy insurance for their animal before the pet gets sick, the owner is on his own to pay for all of the necessary care. 

Some pet insurers have a slightly more relaxed rule on pre-existing conditions than others. For example, if the condition is an acute one rather than a chronic one and an animal has recovered from it for a period of time, the insurer may begin offering coverage again for a similar issue after a suitable time has passed.  

But, in every case, if a pet does have an existing medical problem, there is no guarantee a pet insurer must offer coverage for it if the pet owner wants it. 

2. Pet insurance typically does not cover preventative care while human insurance does

Most human insurance plans pay for preventative care as a matter of course. In fact, even high deductible health plans usually offer pretty comprehensive coverage for preventative services even before the deductible is met. 

Most pet insurance plans, on the other hand, are intended only to pay for care needed after an accident or when a pet is sick. The standard plans, in other words, do not cover routine vet care or wellness care such as visits to get vaccines. 

Now, there are some pet insurers that have add-on wellness plans that will offer this coverage. But not all do and it comes as an additional expense, which isn't the case for human health coverage. 

3. Many pet insurance policies have lifetime coverage limits while human insurance policies can't 

Finally, it is common for pet insurers to limit the amount of coverage a pet can receive per year or per condition. Human health insurers, on the other hand, cannot impose lifetime limits on coverage. 

For all of these reasons, human insurance is more comprehensive than pet insurance. Pet owners need to know the differences and make sure they understand the coverage they are buying and have money saved to pay for anything their policy won't. 

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