How does pet insurance work?: choosing your insurance and your contract formula

If more and more owners of dogs, cats, and NAC decide to take out a health insurance contract for their little companion, this practice remains timid in France compared to our British and Scandinavian neighbors. It must be said that these formulas are swarming on the market and that their operating principle can often seem too vague to dare to risk it. Nevertheless, opting for this type of insurance is a way to take care of your animal at a lower cost, which is why we suggest that you take stock of this subject in order to make it clearer.

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Health insurance for cats or dogs: choosing your insurance and your contract formula

The world of pet health insurance is booming. As a result, offers to abound on the market, with variable and more or less attractive prices and guarantees. Since insurance companies are free to offer the formulas and prices of their choice, competition is fierce and it is not always easy to navigate. Nevertheless, the principle of operation of this pet insurance is global and relatively simple to understand.

The different formulas available

There are three main categories of formulas for these insurances which work much like our mutuals for humans. Choosing the plan that’s right for you is the first step.

  • Basic formulas: these low-end, so-called economical offers are the least covering. In fact, they only provide a limited panel of care reduced to illness and/or accident. Their reimbursement rate varies between 50 and 70% for a contribution amount that is between 5 and 15 euros per month.
  • Comfort formulas: these intermediate offers represent good value for money. They cover care relating to the accident, illness, additional examinations, laboratory analyses, and pharmacy up to 70 to 90% for a contribution ranging between 10 and 30 euros per month.
  • Premium formulas: these top-of-the-range services provide coverage for all the care mentioned above, but also costs related to euthanasia and the animal’s funeral. The reimbursement rate varies between 90 and 100% for a monthly contribution of around 30 to more than 50 euros.

The majority of insurance companies offer owners the option of taking out a prevention package for ten or twenty euros more per year. This must be added to the chosen care formula and allows part of the expenses related to prevention to be covered (vaccinations, antiparasitics, deworming, sterilization/castration, etc.).

Vigilance points

To be certain of choosing the right formula, it is important to compare the offers carefully and to study certain essential points:

  • The reimbursement rate: the reimbursement rate is important because it is the one that applies to the amounts of care covered by your contract. The higher the rate, the more you will be reimbursed. However, this oscillates between 50 and 100% depending on the formulas.
  • The cost of the formula: the same formula can be more or less expensive depending on the company. Compare them in detail to avoid being tricked, because just because your premium will be high doesn’t mean your pet will be better protected than with a competitor.
  • The amount of the annual reimbursement ceiling: this amount is crucial because it is the maximum amount that your insurer will agree to reimburse you each year. This generally varies between 1,000 and 3,000 euros and it rises with the formulas. Be very vigilant on this point, because even if you subscribe to the most covering formula with a reimbursement rate of 100%, once the ceiling has been reached, you will no longer be reimbursed for your veterinary expenses until the following year.
  • The deductible: this is an amount deducted from your reimbursements, but it is not systematically imposed. It can be either a predefined amount deducted from your first repayment(s) of the year or a percentage deducted from each of your repayments during the year.
  • The waiting period: this period runs from the signing of the contract to the date on which it takes effect. During this time, your animal is not yet covered. However, depending on the companies and formulas, it can last a few days or several months!
  • Reimbursement deadline: this is the deadline for obtaining payment of your reimbursement. This is important because some insurers pay your due after 48 hours, but others after several weeks! It a not always an easy situation when the advance of costs is important!
  • Exclusion conditions: be careful, because some insurers apply very arbitrary exclusion conditions. Thus, your animal may no longer be supported because of its breed, age, or illness.
  • Termination conditions: if most insurers do not hesitate to terminate a contract for a deceased animal or to accept a review in the event of subscription to a more expensive formula, many impose very specific termination conditions to limit departures of their policyholders to the competition. So be careful, because even if you have the right to terminate your contract each year when it expires, some unscrupulous companies take advantage of this to make you pay illegal fees that they justify under hazy reasons.

Health insurance for cats or dogs: being reimbursed for expenses

Once the formula has been chosen and the contract signed, the machine starts up and the process is simple.

Your insurer gives you care sheets that you must provide to the veterinarian during each consultation. The practitioner fills them out and gives you a detailed invoice for the treatments performed. As soon as possible after the consultation, you send these documents to your insurer.

Within a few days to several weeks, your insurance company pays your bank account the reimbursement to which you are entitled. The amount of this reimbursement takes into account the treatments concerned by your contract and the reimbursement rate applied to them. So make no mistake; you will not be reimbursed 50 to 100% of your bill, but 50 to 100% of the costs relating to the care mentioned in your contract depending on the formula you have taken out.

It should be noted that the amount of the excess may be deducted from your reimbursements. As we said before, it can be applied in the form of a fixed sum deducted from your first request (or from the first requests depending on the amount) or in the form of a percentage deducted from each request. However, not all insurance companies apply a deductible.

Finally, remember that your insurance plan includes an annual reimbursement limit. When this is reached, you no longer benefit from any reimbursement of your veterinary expenses. You can always consult, of course, but you will have to wait until the following year, that is to say, the date of tacit renewal of your contract, to be reimbursed again under the same conditions.

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