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Is pet insurance worth the cost?

Like health coverage for people, pet policies can be complicated. Here's what we found when we analyzed the coverage and premiums from four pet health insurers.

Published: September 2010

Before he died in 2008, Gremlin the Cat racked up nearly $10,000 in veterinary bills to treat salivary cancer, a rare disorder. The 13-year-old gray tabby was treated twice in a New York City veterinary hospital to shrink a tumor and died a few months later.

Gremlin's owner, Carol Sherwin of South Salem, N.Y., says she doesn't regret spending the money on Gremlin's care. But just to make sure her new kittens, Isabelli and Fang, don't take a similar bite out of her wallet, she plans to buy pet insurance. "They are my furry children," she says, "and I want them to be healthy and happy for as long as possible."

The high cost of vet care

Some people will do anything for their pets. But a majority of owners draw the line after spending $500 for veterinary care, according to a recent survey by the Associated Press and Petside, a website. As costs move closer to $1,000, fewer pet owners are likely to pay for care.

That's where pet insurers say they can help. For monthly premiums of less than $10 to more than $90, they promise to pay a portion of your pet's bills for medical and surgical care, and, depending on the policy, some other types of care. What you pay depends on where you live, your pet's breed and age, the deductible, and the coverage. Pet insurance, says Dennis Drent, CEO of Veterinary Pet Insurance (VPI), the largest insurer, is intended to help owners avoid having to choose "economic euthanasia"—letting a beloved animal go because they can't afford the vet costs.

Pet insurance is not widely owned. At most, 3 percent of dogs and 1 percent of cats are insured, by some recent estimates. By focusing on the potentially high cost of care, insurers are hoping to change that. You'll find the coverage promoted on TV, online, in supermarkets, in retail stores like Petco, and in veterinary offices.

But do you need it? More specifically, is it worth the money? We shopped online and analyzed coverage by three brands—VPI, ASPCA Pet Health Insurance, and 24PetWatch QuickCare—whose parent companies together control an estimated 87 percent of the market. We also examined a relative newcomer, Trupanion, which offers a simpler approach than the others. Counting variations in coverage and deductibles, we looked at nine plans.

To compare them, we used as a model Roxy, a purebred beagle, age 10, in Westchester County, N.Y. Her vet calls her a "basically healthy" dog. Over the years she's had a few health issues. She was treated twice in an animal emergency room after downing potentially poisonous chocolate. She was also treated for a puncture wound after a fight with another dog. She's had two costly dental cleanings under anesthesia, suffered a few ear and eye infections, and as a pup had gastrointestinal distress.

We adjusted Roxy's total vet bills into present-day costs to create a model to judge how her lifetime expenses would have been covered under the nine policies. We also looked at how the value of the coverage changed if we added potentially costly elements to her medical history: chronic arthritis; incontinence as a result of spaying; hypothyroidism; the removal of a benign tumor; and euthanasia. Here's what we found:

Coverage limitations

Like human health insurers have traditionally done, pet insurers exclude pre-existing conditions from coverage. An insurer also might exclude a pet's condition from coverage at renewal. To address this, ASPCA Pet Health Insurance offers a "continuing care" option to new customers, which added 36 percent to Roxy's estimated premiums.

Cost-sharing

You'll face either a deductible, a co-pay, or both with most insurers. They might impose a maximum limit on treatment for individual illnesses, or on the yearly or lifetime reimbursement.

Exclusions

Carriers often exclude hip dysplasia, a chronic malady. QuickCare Gold won't cover any illness claims for Chinese shar-peis or their crossbreeds, though it will cover accidents. VPI has its own long list of excluded conditions.

Extra fees

They include a one-time fee of $25 for Trupanion and $2 a month for VPI and QuickCare customers who pay their premiums monthly rather than annually.

Claims quirks

With these plans, you foot the bill yourself and wait for reimbursement. ASPCA limits coverage to "reasonable costs" based on veterinary pricing in the area in which the fee was incurred. VPI posts a long schedule on its website outlining the maximum payouts for each illness or injury. We wager most people won't slog through those details until after a claim is paid. They probably should. While consumer complaints to the national Better Business Bureau about all four insurers are few, they focus heavily on disputes over contract language. (The BBB rates newcomer Trupanion A-, and gives the others A+, its top rating.)

Costly or unnecessary add-ons

Some carriers let you add "wellness care" coverage to their accident and illness policies. We found it's generally not worth the cost. ASPCA's Level 3 coverage adds spaying or neutering, an annual physical, three common vaccines, and fecal and heartworm tests to its Level 2 accident and illness coverage. The coverage also promises higher maximum benefits. But for Roxy, it added $2,766 to the insurance cost over 10 years and paid out just $1,159 in benefits. VPI offers a "CareGuard Core" rider that costs $12 per month—$144 a year—but it never paid out that much in any year.

Playing the odds

Overall, we found that the pet policies we analyzed were not worth the cost for a generally healthy animal. In healthy Roxy's case, we found that none of the nine policies would have paid out more than the projected premiums over a 10-year period.

If you're unlucky enough to have a pet with a costly chronic condition or illness, or a young animal in need of major care, we found you could get a positive payout from pet insurance—if your pet develops the condition while covered. For our dog with chronic problems and our very sick kitties, the Trupanion plans provided the highest net benefits. (VPI sent us several examples of when its estimated payouts were higher.) Trupanion doesn't pay for wellness care or exams, and it imposes other limitations. But after a per-incident deductible, it promises to pay 90 percent of the bill, with no lifetime ceiling.

While it's impossible to predict your pet's odds of contracting a costly illness, you can take a number of steps to keep him or her healthy and minimize veterinary costs.

Save in advance for vet bills

Dog owners spent an average of $225 last year on routine vet visits and $532 on surgical visits; for cats, the averages were $203 and $278, according to the American Pet Products Association. Our preferred alternative to pet insurance is to add a couple hundred dollars each year to an emergency savings fund for pet care.

Spay or neuter your pet

Among other advantages, neutered animals are less likely to get into fights. And spaying reduces the risk of breast cancer.

Get annual checkups

Make sure vaccinations are kept current.

Shop with your eyes open

If you're considering pet insurance, download a sample policy and its terms and conditions from the insurer's website and read them thoroughly for limitations, exceptions, and co-payments. (If the site doesn't include a sample contract, call the company to ask for one.) We prefer coverage with simple, percentage-based payouts, and no reliance on judgments of what's "reasonable." Avoid riders for wellness care. If you plan to use the insurance for catastrophic coverage—say, $1,000 and up—go for the highest deductible you can comfortably afford.

Putting pet policies to the test

We projected the net benefit of pet health coverage under nine policies for Roxy, a healthy 10-year-old beagle. Over the years, her vet bills have totaled $6,616 (in current dollars). With few major problems to date, coverage for her would not have been worthwhile. But when we added treatment for more serious issues, which increased vet bills to $11,944, coverage by some policies would have paid off.

A tale of two kitties

Pet insurance can be useful in extreme situations, as illustrated by these stories based on two cats with rare conditions—one older, one very young.

Fuffles was adopted around age 6.

At 10, the cat was diagnosed with liver cancer. Her owner opted for removal of the tumor and chemotherapy as a palliative measure. "We knew she was going to die," the owner said. "We just wanted to make her comfortable." The 2008 surgery and follow-up treatments cost $9,647 (in 2010 dollars).

Ozzy was 6 months old in 2008 when he had surgery for a heart condition.

The cost was $7,106 (2010 dollars). Ozzy is now 2 and doing fine, his owner says.

All nine of the policies we studied would have saved money. The Trupanion coverage paid the most for both cats, at both the $100 and $500 deductible levels.

But in the four years before Fuffles' surgery, when she needed more-routine care—checkups, dental cleanings, the removal of infected teeth, an overnight hospitalization—only the Trupanion coverage with a $100 deductible would have paid off.

This article appeared in Consumer Reports Money Adviser.

   

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