Does pet insurance cover hospitalization?

Will pet insurance cover a hospital stay?

According to the American Animal Hospital Association (AAHA), most pet insurance policies will cover a hospital stay if it’s related to an unexpected illness or accident. For instance, pet insurance typically covers a hospital stay when your pet is attacked by another animal and requires overnight observation. However, if you decide to hospitalize your pet overnight before or after a routine procedure (such as a spay or neuter), pet insurance may deny your claim unless the stay is deemed medically necessary.

Note that coverage may depend on what type of policy you have — accident-only or comprehensive (accident and illness). Some plans may not cover complications from routine procedures, such as a vaccine reaction, unless you have a wellness add-on that covers routine care. Keep in mind that coverage varies by provider, so it’s important to read policy details carefully and ask questions.

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How to file a pet insurance claim for hospitalization

Generally, pet insurance works on a reimbursement model — you pay the bill upfront, file a claim and wait for repayment. The repayment amount depends on your reimbursement rate, usually between 70% and 90%. If your policy has a deductible (the amount you must pay before insurance kicks in), it will be subtracted from your reimbursement.

While the claims process may vary slightly between providers, general steps remain the same:

1. Take your pet to the vet and pay the bill in full upfront.
2. Gather necessary documents such as an itemized invoice, the veterinarian’s notes and a receipt of payment.
3. Start a claim through your provider’s website or mobile app. Some providers may also accept claims via mail, email or fax. Check with your provider for the preferred submission method.
4. Wait for approval and reimbursement. AAHA states reimbursements may be issued via check or direct deposit, depending on the provider’s payment process.

How long does it take to get reimbursed with pet insurance?

Turnaround times for reimbursement differ by provider. For example, AKC Pet Insurance states its claims processing can take anywhere from one to 30 business days, depending on the complexity of the claim. Simple claims with all required documents are typically processed within one to two business days, while those requiring additional vet records may take up to 30 days. Most pet insurance companies offer some kind of online portal that you can check for updates.

» MORE: What pet insurance pays the vet directly?

How much does hospitalization coverage cost?

Since hospitalization is typically included in standard pet insurance plans, you don’t have to pay extra for it. That means the average monthly cost of pet insurance — around $56 for dogs and $32 for cats, according to the North American Pet Health Insurance Association (NAPHIA) — already includes hospitalization coverage. Prices vary by provider, plan type and coverage level.

Average pet insurance costs

According to NAPHIA, the average annual cost of pet insurance in 2023 ranged from $116.11 to $675.61, depending on the type of policy and whether the pet was a dog or a cat.

Sample pet insurance quote: Embrace Pet Insurance for a German shepherd

The following table outlines the cost of a policy from Embrace Pet Insurance for a 1-year-old female German shepherd in San Diego, California. Notice that premium costs fluctuate based on factors like annual coverage limits, deductibles and reimbursement rates.

What affects the cost of pet insurance?

Several elements determine how much you'll pay for pet insurance, including:

• Pet’s age and breed: Older pets often have higher premiums due to an increased risk of illness, while certain breeds prone to health conditions may also cost more to insure.
• Coverage type: Accident-only plans tend to be more affordable but provide limited coverage. More comprehensive plans, especially those with wellness add-ons, come at a higher cost.
• Deductibles and coverage limits: Choosing a higher deductible generally lowers monthly premiums, while lower deductibles and higher payout limits increase costs.
• Location: Veterinary costs vary by region, meaning pet owners in urban areas or high-cost regions may see higher premiums.
• Preexisting conditions: Insurance providers may charge more for pets with preexisting conditions or exclude them from coverage altogether.

While these are some of the most common factors influencing pet insurance rates, each provider calculates premiums differently.

What exclusions apply to hospitalization coverage?

Pet insurance policies come with exclusions, meaning some hospitalizations may not be covered. While exclusions vary by provider, most policies don’t cover:

• Preexisting conditions: If your pet is hospitalized due to a condition that showed signs or was diagnosed before your policy started, insurance will likely deny the claim.
• Routine and preventive care: Hospital stays related to routine exams, vaccinations, dental cleanings or wellness visits are generally not covered unless you have a wellness plan add-on.
• Elective or cosmetic procedures: Hospitalization for procedures that aren’t medically necessary — such as tail docking, ear cropping or declawing — is typically excluded. Some policies also exclude spaying and neutering unless covered by an add-on.
• Breeding-related expenses: Whelping (labor and delivery), pregnancy and complications related to breeding aren’t usually covered. This includes hospitalization for procedures like cesarean sections and artificial insemination.

Always check your policy details to understand what’s covered and what’s not. Don’t be afraid to ask your provider if you’re unsure about specific exclusions.

Is pet insurance worth it for hospitalization coverage?

Pet insurance can be worth it if your pet needs hospitalization for a covered illness or injury. Most comprehensive plans include hospital stays for unexpected emergencies, and those costs can range from several hundred to several thousand dollars. With such high expenses, pet insurance can make a big difference by reducing the financial strain.