Pet insurance is a ripoff

How poor little Fido and Fluffy are being denied healthcare because of ‘preexisting conditions.’

Gina Papini honestly isn’t sure whether she got taken for a ride on pet insurance, but it’s pretty clear she didn’t get much bang for her buck.

Papini and her husband decided to add coverage for their two dogs and their cat when it was offered in 2021 as a bundle with their home-insurance plan. It seemed like a simple way to protect their pets’ health. But the whole endeavor wound up being a headache. The pets’ combined premiums cost hundreds of dollars a month, she says, and the coverage proved far less comprehensive than they anticipated. The couple never really needed to use the insurance for their two younger animals, and for their older dog, Kato, the process was a mess. Whenever Kato wound up at the vet, usually with stomach issues, they’d pay the bill and then submit it to the insurance company, which would then balk at reimbursing them.

“We thought it would save us money in the long run if we got it, but then they would refute claims and say, ‘Well, this could have been a preexisting condition,’ and preexisting conditions aren’t covered,” Papini said. “You need extra vet paperwork to back up that it wasn’t. And so then you just get to a point where you’re jumping through so many hoops.”

Papini and her husband got tired of dealing with all the rigamarole and axed their insurance plan after a year. Despite paying thousands of dollars in premiums, they never saw a single reimbursement.

People love their pets, and they’re willing to do a lot for them, financially and otherwise. The American Pet Products Association has estimated that Americans spent $147 billion on their animals in 2023, including $38 billion on their healthcare. This level of attachment has helped turn the pet insurance industry into a lucrative and rapidly expanding market. The North American Pet Health Insurance Association found that pet owners in the US paid $3.9 billion in premiums in 2023, a 22% increase from the year before. Some 6.25 million pets in the US were insured as of the end of 2023, per NAPHIA. That’s still a small fraction of all the pets in the country, given that there are over 80 million pet dogs and 60 million pet cats, according to the American Veterinary Medical Association. But it’s growing.

As pet insurance becomes more prevalent, so too do the questions about it. While some people swear by it, others think it’s a scam. One thing is for sure: As the industry grows, pet insurance is becoming as confusing and messy as health insurance is for humans. It’s barely regulated, and deciphering what it does and doesn’t encompass can be super confusing. Just like regular health insurance, coverage for pets often winds up being riddled with loopholes and fine print that allows insurers to deny claims, declining to pay for the very care that motivated consumers to buy the policy in the first place. Because consumers pay up front, they often don’t realize they won’t be reimbursed until it’s too late. Pet insurance gets pricier over time, meaning many people can no longer afford to keep their coverage just when they might start to need it.

In short, pet insurance isn’t a grift — some people do end up using their benefits. But for many people, insuring their furry friends ends up being a money suck.

Pet insurance isn’t technically even health insurance; it falls in the property-and-casualty category. It’s generally regulated pretty lightly by states. There are no broad federal regulations around it, and only a handful of states have laws and standards around it specifically. How it usually works is people pay a monthly premium, and after they’ve paid a vet bill, they submit it to the insurer to try to get their money back. Just as with human health insurance, there are also deductibles and copays and annual limits on how much the policy will pay out.

The big problem with pet insurance is it’s just an expensive product
There are three categories of pet insurance: accident only; accident and illness; and accident, illness, and wellness. Adding more coverage makes the policy more expensive. Accident and accident-illness policies cover costs only if something goes awry — Rover gets into a rough fight at the dog park or develops arthritis. Fancier, more-comprehensive policies also cover wellness visits and preventive care, like dental care and vaccines. No matter the policy you choose, insurance can get expensive fast. Premiums generally go up each year as a pet gets older. And as with many insurance products, pet-insurance premiums across the board are on the rise because of inflation and the increasing cost of care.

“The big problem with pet insurance is it’s just an expensive product,” said Kevin Brasler, the executive editor of Consumers’ Checkbook, a consumer watchdog group. “If you’re going to be one of these plans, buy it when your pet’s young, but just know your costs are likely going to skyrocket as time goes on.”

Even if a pet owner can find an affordable policy, they may have trouble deciphering what’s covered. Pet insurance almost never covers preexisting conditions, and what qualifies as preexisting can be quite broad and hard to parse. (It’s wild that we used to do this for people, by the way.) If you get a policy for your puppy before it has a chance to develop any problems, it might be a good deal. But if you have a 10-year-old dog with diabetes, that’s a different story. I got some quotes from the website Pawlicy Advisor for my fictional dog, a mixed breed named Dan. When I changed the inputs to make Dan a six-month-old in optimal health, the platform recommended a policy starting at $28 a month. When Dan was 10 and had some issues, the first policy it suggested was $125, and some plans were about $350.

Michael San Filippo, a spokesperson for the American Veterinary Medical Association, said in an email that the group endorsed the “concept” of pet health insurance, which can help keep vet costs down and save animals’ lives, but he acknowledged that when the rubber hits the road, it can get hard to figure out.

“It’s important that pet owners understand the scope of what their pet insurance does and does not cover, so they’re not caught off guard by unexpected payments,” he said.

Even getting good advice on which pet-insurance policy is right for you can be a challenge. There are endless listicles recommending various policies, as well as websites dedicated to comparing insurers. The sheer volume of information can be hard to parse. It’s also difficult to differentiate what is genuine advice and what’s paid for. Many comparison tools get commissions for sales made through their platforms, so what they’re recommending may not actually be the best option — it’s just the one they’ll make money off of. (This is true for all sorts of platforms that compare and recommend financial products, from credit cards to travel insurance.)

This new structure has been a detriment to the industry with profit as the primary motive versus what is in the best interest of the consumer
The spread of these lists also points to another problem with the industry: the corporatization of pet insurance. Doug Kenney, a retired veterinarian who writes about the pet-insurance industry, said in an email that a decade ago, most pet-insurance companies were considered small businesses and were led by a founder/CEO with a vision for the company. Over time, these companies took on larger corporate structures, and some founders were pushed out by their boards. Nowadays, there are many large pet-insurance companies, some of which specialize only in pets, others of which are larger insurers that offer pet insurance, and many of which are publicly traded, meaning they ultimately answer to shareholders.

“This new structure has been a detriment to the industry with profit as the primary motive versus what is in the best interest of the consumer,” Kenney said. “I used to say that pet insurance was a win, win, win proposition with the insurance company, veterinarians, and the policyholders and their pets all benefiting. I don’t think that’s the case anymore.”

Reporting this story, I fully expected to come down on one side or the other on whether pet insurance is good or bad. But I really didn’t come up with an answer. I heard about a wide array of experiences with pet insurance, from awesome to mediocre to awful. One woman saved $4,000 on vet bills thanks to her insurance after her cat ate a pom-pom toy and the doctor had to fish it out. One man looked into getting coverage for his two cats after learning that both had extra teeth, but the minute they were documented, those overcrowded mouths became a preexisting condition. Another woman adopted a dog from Mexico with a “pretty wonky leg” that’s “very noticeable.” At her first vet appointment with the animal, the doctor told her to apply for pet insurance. She said she wouldn’t note the leg on the dog’s chart so the application would be approved — everyone agreeing to do a light amount of insurance fraud.

It’s not likely to save you money down the road, and if it does, you’re an outlier.
In a purely financial or economic sense, pet insurance seems pretty worthless for many consumers. There are too many exceptions, too many hoops to jump through, and little regulatory recourse if you think you got taken for a ride. Unless something goes really awry, people pay more into their policies than they get out of them. Brasler was pretty blunt in his assessment of the overall product.

“You really need to think carefully about ‘What kind of pet owner am I?’ No judgments,” he said. “This is a really expensive product. It’s not likely to save you money down the road, and if it does, you’re an outlier.”

Ultimately, a lot of the value of this sort of insurance is emotional. It’s possible to do some back-of-the-envelope calculations to figure out the lifetime cost of a policy, but the personal side of the equation is considering how much you’re willing to spend on your furry friend. Maybe you feel like spending $10,000 over the course of your pet’s life on insurance is worth it for the peace of mind. Or maybe you forgo insurance, figuring that if your companion has a serious health problem, you’ll make the decision then to spend the money on them — or not. (Again, no judgments!)

As for Papini, she’s not getting back on the pet-insurance train. It was just too hard to deal with, and her husband is still cranky about the ordeal. She knows they’re fortunate to be able to pay out of pocket for their animals’ needs, which remain expensive. Kato now has cancer, and the treatments cost thousands of dollars. Would the insurance be worth it now? It’s hard to know.

“Who’s to say they wouldn’t have been like, ‘Well, he had diarrhea in 2017, so therefore it’s a preexisting condition,'” she said. “Then we would’ve spent thousands of dollars for the insurance, never been able to use it, and still had to pay out of pocket on top of it.”