Sample Pet Insurance Policies

Pets have accidents and are diagnosed with illnesses just like the humans that love them. With the accident and illness plans from Prudent Pet, we help keep your promise to your pet. We want you to know exactly what is covered and what is not so that you can provide your pet with the best care possible.

Your policy includes:

  • 5-day waiting period for accidents
  • 14-day waiting period for illnesses
  • 30-day money-back guarantee
  • Unlimited 24/7 Vet Chat
  • Optional wellness coverage for routine care
  • Multi-pet discounts

Pre-Existing Conditions

When understanding your pet insurance policy benefits, it’s important to know that pre-existing conditions are excluded. It’s also important to know how we define a pre-existing condition. Prudent Pet defines a pre-existing condition as a medical condition which first occurred or showed clinical sign(s) before the effective date of your policy or which occurred or showed clinical sign(s) during the policy waiting period.

Sample Policies

Sample plans are samples only and may not include state specific variations

Illness Benefits

Your policy reimburses actual costs for covered expenses related to the diagnosis and treatment of illnesses, up to the applicable policy limits, exclusions and limitations. Remember that pre-existing conditions are not covered. Eligible illness expenses are:

  • Veterinary treatment for a covered illness (an illness that is not considered pre-existing)
  • Expenses listed under accident benefits when applicable to an illness
  • Diagnostic and laboratory testing including CT’s, MRI’s and other imaging
  • Cancer treatments (including but not limited to chemotherapy and radiation treatment)
  • Treatment for behavioral issues subject to a sublimit of your policy and administered through a veterinarian.
  • Treatment for hereditary and congenital conditions
  • Surgery and specialized care
  • Emergencies and hospitalization
  • Prescription food to treat bladder stones and crystals for a limited period of time.
  • Prescription medications
  • Medical supplies
  • Alternative therapies recommended and overseen by a licensed veterinarian

Examples of covered illnesses include but are not limited to cancer and growths, dental and gum disease when a history of proper dental care has been followed, digestive illnesses, eye, ear and skin conditions, hereditary and congenital conditions, hip dysplasia, urinary infections, etc.

Accident Benefits

We will pay, up to the maximum annual benefit as shown on the Declarations Page, for the actual cost(s) of any medically necessary treatment your pet receives during the policy period for a covered injury. This benefit is subject to the reimbursement percentage and deductible as shown on the Declarations Page of your policy. Eligible accident expenses are:

  • Alternative therapy if prescribed by a licensed veterinarian
  • Intravenous (IV) fluids and medications
  • Medical supplies
  • Diagnostics including MRI, CT scans and/or x-rays
  • Poison control consultation fees (must be enrolled in Exam Fee Coverage)
  • Prescription medications prescribed by a veterinarian
  • Stem cell therapy
  • Tooth extractions
  • Veterinary treatment, consultations and laboratory and diagnostic tests

Examples of covered accidents include but are not limited to bite wounds, broken bones, swallowed objects, etc. Like all pet insurance, we do not cover pre-existing conditions.

WHAT IS NOT COVERED

EXCLUSIONS

We will not pay for costs associated with or resulting from the following:

  • Bathing your pet unless a vet certifies that bathing was medically necessary and that only a vet or a member of veterinary staff should bathe your pet.
  • Boarding fees unless deemed medically necessary.
  • Breeding, pregnancy, whelping or nursing unless complications arise from breeding, pregnancy or whelping if the date of the breeding falls after the 14-day waiting period.
  • Cloned pets or cloning procedures, whether or not deemed experimental or for research.
  • Congenital defects or abnormalities where clinical sign(s) were apparent prior to the effective date of the policy or that became apparent during the 14 day waiting period.
  • Cruciate ligaments, luxation of the patella or other knee disorders: Treatment associated with damage or rupture of cruciate ligaments, luxation of the patella or other soft tissue disorders of the knee where clinical sign(s) occur during the first six (6) months that the policy is in effect
    • All knee & ligament conditions require a 6-month waiting period; however, that can be waived to 30-days with an orthopedic consent waiver from your vet
  • Decontamination (i.e., the induction of vomiting, stomach pumping, or treatment with charcoal), medical, or surgical treatment of your pet arising from a repetitive and specific activity if the same or a similar activity has occurred two (2) times within the eighteen (18) month period prior to the initial coverage effective date.
  • Exam fees unless you have chosen to include them. Coverage for exam fees is an option you can add or remove at policy renewal.
  • Elective or specialty procedures, including but not limited to tail docking, dewclaw removal, eyelash removal, ear cropping, spaying or neutering, cosmetic dentistry; elective gastropexy; or routine anal gland expression. Note that coverage for spaying/neutering is available in the optional wellness add-on packages.
  • Experimental procedures and treatments.
  • Food, including food prescribed by a vet, to treat or prevent illness unless the food is used to dissolve existing bladder stones and crystals in urine (subject to limitations).
  • Grooming or grooming supplies.
  • House calls, unless a vet certifies them essential in an emergency; or extra costs or fees for treating your pet outside of usual surgery hours, unless the treating vet certifies that an immediate life-saving consultation is needed.
  • Housing, including cages – rented or bought.
  • Intervertebral Disc Disease (IVDD) when another disc in the same or neighboring spinal region (e.g. cervical, lumbosacral) was previously treated or showing clinical sign(s) prior to the effective date of this policy or during the 14-day waiting period.
  • Loss if you have not complied with all conditions related to coverage set forth in your policy.
  • Non-veterinary services, including but not limited to federal, state or local taxes, waste disposal, government fees and surcharges, photocopying fees, bank fees and credit card charges, biohazardous waste fees, OSHA fees and maintenance fees.
  • Obedience or training classes, including puppy classes, training, correctional devices, or wellness products; or the treatment of coprophagia or other eating disorders.
  • Organ transplants not deemed medically necessary or not first approved by us.
  • Parasites: Treatments or wellness treatments for parasites or conditions related to parasites (internal or external) unless there is no wellness medication for the parasite including but not limited to heartworms, fleas, ticks, roundworms, tapeworms, or hookworms.
  • Pre-existing conditions including any illness or injury that first showed clinical sign(s) before the effective date of this policy or during the waiting period.
  • Routine and preventive treatments, including but not limited to vaccinations, wellness medications (including those for heartworm and flea and tick prevention), or routine examinations. Coverage for routine examinations and select vaccinations are available in the optional wellness plans.
  • Regimens or therapy not administered or prescribed/referred by a vet (or under a vet’s direct supervision) including holistic, homeopathic, acupuncture, chiropractic, or physical therapy
  • Rental of a pool or hydro-therapy equipment of any type.
  • Telephone consultations, except if provided for an immediate life-saving emergency consultation. While your policy does not cover telephone consults, policyholders have access to free, unlimited 24/7 vet chat.
  • Time and travel expenses to a vet’s premises or hospital.
  • Treatment of illness or injury:
    • Arising out of racing; coursing; commercial guarding; organized fighting; or any other occupational, professional or business uses of your pet.
    • An intentional injury or condition as a result of abuse (including persistent neglect) of your pet, by you or a member of your household.
    • For which you were advised by a vet to take preventive measures and did not do so.
  • Treatment, death or humane destruction of your pet directly or indirectly caused by, happening through, arising or resulting from, or contributed to or by invasion, war, revolt, rebellion, revolution, military or usurped power, governmental seizure, quarantine, or other action related to public safety or health.
  • Treatment, death or humane destruction of your pet directly or indirectly caused by, happening through, arising or resulting from, or contributed to or by avian Influenza or any mutant variation, chemical, biological, biochemical or electromagnetic weapon, device, agent or material, whether controlled or uncontrolled, accidental or otherwise, nuclear reaction, radiation, radioactive contamination or the discharge of nuclear device, whether controlled or uncontrolled, accidental or otherwise.

Have Questions? We have answers.

While we have done our best to explain exactly what is covered and what is not covered, we understand that every pet is unique and insurance can be confusing. Many pet owners wonder how our plan applies to their pet. We encourage you to give us a call and tell us about your situation. We’re here to help.

Here’s how to contact us: