Pet Insurance Dictionary: Understanding Insurance Lingo

Kara Bednarik

pet insurance terminology

Insurance terminology can be confusing. It may feel like a completely different language. But once you know what insurance terms mean, you’ll be prepared to select the best pet insurance policy for your pet.

Reading the terms and conditions can seem like a chore, but they are a treasure trove of information that you should know about your insurance policy. Some of the highlights of it include definitions of the terms that insurance companies commonly use. Check out a few of the most common ones below.

Alternative Therapy: These are less traditional approaches to veterinary care, including hydrotherapy, acupuncture, reiki, chiropractic, and more. Not all pet insurance plans cover alternative therapies and some offer them only as an additional rider to your pet’s policy. Embrace covers alternative therapies on every policy, for every covered condition.

Annual Limit or Annual Maximum: The maximum amount the pet insurance company will reimburse you per pet in a period of insurance. The annual maximum does not include the deductible and copay amounts you pay.

Benefit Schedule: The reimbursement limit that certain pet insurance companies put on treatments and procedures. This is a very limiting practice as it does not usually cover what you pay. Embrace does not use a benefit schedule, we work directly off of the vet bill’s actual charges.

Bilateral Condition: A condition or disease that affects both sides of the body. Embrace does not exclude coverage for bilateral conditions as long as the initial condition is not a pre-existing condition.

Breed-Specific Condition: A condition that presents itself in certain breeds more than others. Many companies will not cover these, or limit the coverage, if you have a pure breed dog or cat. Embrace does not exclude coverage for them.

Copay: The percentage of the covered allowable charge for which you are responsible per pet. This is not reimbursable under your policy. See also: reimbursement percentage

Deductible: The amount you pay per pet for treatments covered by the policy before the pet insurance company begins to reimburse you. Embrace has an annual deductible, meaning you only have to pay it once per policy year. Many companies have a per-incident deductible, meaning you have to pay it for each incident or condition.

Explanation of Benefits: An itemized description of covered and not-covered charges of a veterinary bill. This is available for each claim that is processed.

Lifetime Limit: The maximum amount your insurance will reimburse you over the lifetime of your pet. Embrace does not have a lifetime limit.

Medical History Review: This is a free service that Embrace offers to policyholders. At the end of the 14-day illness waiting period, we will request the records from any vets used in the last 12 months and review them to let you know what, if anything, would be considered pre-existing, and for how long.

Per-incident Limit: The maximum amount your policy will reimburse for each accident or illness. Embrace does not have per-incident limits. This means that you have your full annual maximum available for one condition if you need it.

Policy Year/Policy Term: The period in which your policy is active. Embrace goes by “policy year” which is the anniversary of when you begin your coverage. For example: If you start your policy on June 10, 2017, your policy year will end on June 9, 2018 and renew on June 10, 2018. See also: renewal

Pre-Certification: An optional process of submitting an estimate for a procedure before moving forward with it to confirm that it will be covered. Embrace never requires a pre-certification for coverage.

Pre-Existing Condition: A condition that presented itself, or began to show symptoms, either before your policy start or prior to the end of the of the waiting periods. Sadly, no pet insurance covers pre-existing conditions at this time. Embrace handles them a little differently though. See how.

Premium: This is the price that you pay for your policy. Factors such as your pet’s breed, your location, and the deductible, annual maximum, and reimbursement percentage you choose can play a role in this payment amount.

Reimbursement Percentage: The percentage of the covered allowable charge that Embrace is responsible per pet. AKA, what you’ll get back from your claim after your deductible is met. At Embrace, this amount is figured after your deductible. This means your copay is less.

Renewal: At the end of your policy year your policy will renew automatically. When your policy renews, your deductible and annual maximum reset. Embrace does not reset any waiting periods at renewal.

Waiting Period: The time period in which the policy’s coverage is restricted. If something happens, or begins to show symptoms, before the waiting period ends, it would not be covered.

Copyright © 2005-2018 

Pet health insurance is administered by Embrace Pet Insurance Agency, LLC and underwritten by one of the licensed insurers of American Modern Insurance Group, Inc., including American Modern Home Insurance Company d/b/a in CA as American Modern Insurance Company (Lic. No 2222-8), and American Southern Home Insurance Company. Coverage is subject to policy terms, conditions, limitations, exclusions, underwriting review, and approval, and may not be available for all risks or in all states. Rates and discounts vary, are determined by many factors, and are subject to change. Wellness Rewards is offered as a supplementary, non-insurance benefit administered by Embrace Pet Insurance Agency in the United States. © 2016 American Modern Insurance Group, Inc.