Pet Insurance Terms: A Full Glossary of Everything You Should Know

Whether comparing plans, filing a claim, or simply wanting to understand your coverage, this glossary will help you navigate the sometimes confusing language of pet insurance. Here, we provide clear, concise definitions of common terms you’ll find in pet insurance policies.

A

Accident and illness coverage

Accident and illness coverage helps pay for vet bills if your pet gets hurt in an accident or gets an unexpected illness. It often covers things like emergency exams, medicine, surgeries, and hospital stays when your pet has an injury or different kinds of sicknesses.^[1]

Accident coverage/Accident-only coverage

Accident coverage (aka accident-only coverage) is insurance that covers expenses only related to accidents and injuries, such as broken bones, cuts, swallowed objects, or poisoning. Covered expenses can include diagnostics, hospitalization, treatment, and medications.

Age limits

Age limits are the youngest or oldest age a pet can be when you sign them up for a new insurance plan. Some companies don’t let pets older than a certain age — like 12 or 14 years — get new insurance. After that age, pets might only be able to get insurance that covers accidents, not illnesses.^[2] But some pet insurance companies have no upper age limits.

Age restrictions

Age restrictions are rules that pet insurance companies make about how old your pet can be to get coverage. These rules state the youngest age your pet can be to sign up (like 8 weeks old) and the oldest age for new insurance. These rules can affect what kind of coverage older pets can get and how soon you can get coverage for your puppy or kitten.^[3]

Alternative therapies

Alternative therapies — also called complementary treatments — are special kinds of care that help keep your pet healthy or help them get better. Some examples are chiropractic care, water therapy, laser therapy, and acupuncture. These are different from regular vet treatments.

Some pet insurance companies include coverage for alternative therapies as part of their standard accident and illness plans. Others offer it as an add-on for an additional cost, and some don’t cover alternative therapies at all.

Annual deductible

An annual deductible is the amount of money you must pay for your pet’s vet bills each year before your pet insurance kicks in. After you pay this amount in one year, the insurance company will help cover the rest of the costs, up to the limit of your plan.

Annual limit

This is the most money your pet insurance will pay you back for vet bills in one year, after you’ve paid your deductible. If your vet bills go over this amount in the same year, you’ll have to pay the rest yourself until your insurance renews.

B

Behavioral coverage

Some pet insurance policies reimburse you for the diagnosis and treatment of behavioral problems like anxiety, aggression, or compulsive behaviors — but only when a veterinarian or veterinary behaviorist recommends it. Behavioral coverage usually pays for treatments such as therapy, medication, or consultations that your vet prescribes.

But it won’t pay for basic obedience training or training classes meant to teach commands like “sit” and “stay.” Coverage details, limits, and exclusions — such as pre-existing behavioral issues — vary by provider, so it’s important to review your policy.

Benefit schedule

A benefit schedule is a list that comes with some pet insurance plans. It shows the most money the insurance will pay for each type of illness, injury, or treatment. If your vet bill is higher than the amount on the list, you’ll have to pay the extra yourself. This method isn’t as common as plans that pay a percentage of your vet bill.

Benefits

Benefits are the different kinds of vet care, treatments, and services that your pet insurance will help pay for. What your policy covers depends on your plan.

Benefits can include things like care for accidents and sickness, help with behavioral problems, prescription medicines, and more. Each insurance company has rules about how much their insurance policies will pay, what you have to pay first (your deductible), and what it won’t cover.

Benefit limit

A benefit limit is the most money your pet insurance will pay for vet bills that your plan covers. This limit can be set for each year, for each accident or illness, for each type of problem, or for your pet’s whole life.

If your vet bills go over this limit, you’ll have to pay the rest yourself.

Bilateral condition

A bilateral condition is a medical issue that can affect both sides of your pet’s body, like hip dysplasia or cruciate ligament disease. If your pet has a problem on one side before you buy insurance, most pet insurance companies will consider the other side as part of the same condition and won’t cover it later.

Some companies make exceptions for curable conditions, but most keep these rules for chronic or genetic issues like hip dysplasia.^[4]

Boarding fees

Boarding fees coverage helps pay for the cost of keeping your pet at a licensed boarding facility if you have to stay in the hospital for a certain number of days — typically four or more. Some pet insurance plans include this benefit to make sure your pet has a safe place to stay while you recover.

Brachycephalic condition

A brachycephalic condition refers to health problems that affect dogs with flat faces and short noses, like pugs, French bulldogs, English bulldogs, Boston terriers, and shih tzus.

Because these dogs have smaller airways, narrowed nostrils, and extra tissue in their throats, they’re more prone to develop conditions like brachycephalic obstructive airway syndrome (BOAS).^[5]

Breed restrictions

These are rules in some pet insurance plans that limit or change coverage based on your pet’s breed. Some insurance companies may not cover certain breeds, may charge you more for those breeds, or may not pay for health problems that those breeds often get.^[6]

For example, if your dog’s breed is more prone to hip problems, insurance might not cover its hip treatments.

Breed-specific condition

A breed-specific condition is a health problem that certain dog breeds are more likely to get because of their genetics. For example, large breeds like German shepherds and Labrador retrievers often develop hip dysplasia, while flat-faced breeds such as bulldogs, pugs, and French bulldogs frequently have breathing problems.

Some pet insurance policies may not cover these breed-specific conditions or may limit how much they’ll pay for them.

C

Chronic conditions

These are health problems that last a long time or keep coming back. Examples include diabetes, arthritis, and allergies.

Pets with chronic conditions often need regular vet visits, medicine, and ongoing care throughout their lives. Some pet insurance plans cover chronic conditions for as long as you keep your policy active, but only if your pet didn’t have the condition before you bought the insurance.

Some plans set yearly limits on how much they’ll pay for chronic conditions, and others may have special rules or exclusions.^[7]

Claims

These are requests you send to your pet insurance company to get money back for vet bills that your plan covers. To make a claim, you usually need to provide detailed bills and medical records from your vet that show the care your pet received. Many pet insurance companies allow you to file claims online.

Claim denial

For various reasons, your pet insurance company may decline to repay you for a claim you submitted. Common reasons include if your plan doesn’t cover a particular treatment or illness, if the cost goes over your policy limits, if you didn’t send all the needed papers, or if the health problem started before you bought the insurance.

Clinical signs

Clinical signs are the visible symptoms or changes in your pet’s behavior or body that show they might be sick or hurt, like vomiting, limping, or not wanting to eat. Pet insurance companies often look at when these clinical signs first appear to decide if a condition counts as pre-existing.

If your pet shows signs of an illness before you buy insurance or during the waiting period, the insurer may consider that condition pre-existing and exclude it from coverage.

Co-insurance

Co-insurance is the part of your pet’s vet bills that you have to pay yourself after you’ve paid your deductible. For example, if your insurance pays back 80% of the covered costs, you pay the remaining 20% as your co-insurance. So, if your vet bill is $100 and you’ve already met your deductible, your insurance pays $80 and you pay $20.

Complementary therapies

Complementary therapies are non-traditional treatments that work alongside regular veterinary medicine to help your pet feel better or recover from illness or injury. Examples include acupuncture, chiropractic care, hydrotherapy (water therapy), laser therapy, massage, and physical therapy.

Some pet insurance companies cover complementary therapies in their main plans, while others offer coverage as optional add-ons.^[8]

Congenital condition

A congenital condition is a health problem that a pet has at birth because of the way it developed before being born. These problems can happen because of genetics or issues during development. Common examples include heart defects, cleft palate, or hernias. Sometimes, congenital conditions don’t show symptoms right away and may only appear later in life or after an accident or illness.

Some pet insurance companies cover congenital conditions as long as your pet didn’t show any signs or get diagnosed before you started your insurance policy. Other insurance plans may not cover these conditions at all or might require you to pay extra for this kind of coverage.

Continuous coverage

Continuous coverage means keeping your pet insurance active all the time with the same insurer, without any breaks or gaps. If your coverage stops for a while and you get a new policy later, the insurance company might treat health problems your pet had before as pre-existing and not cover them.

Copay

A copay is the set amount you pay for certain treatments after you’ve paid your deductible. Your pet insurance company pays the rest, based on your plan’s reimbursement rate.

For example, you may have a $25 copayment for routine exams.

Coverage

Coverage defines what your pet insurance policy protects your pet against. It outlines which illnesses, injuries, treatments, and services your plan will pay for. It also refers to any conditions or expenses your policy won’t cover or limits on how much it’ll pay.

Covered expenses

Covered expenses are the vet costs and services your pet insurance policy agrees to pay for. These can include things like diagnostic tests, surgeries, prescription medications, and other treatments listed in your policy.

Curable condition

A curable condition is a health issue your pet can fully recover from with treatment, such as an ear infection, urinary tract infection, vomiting, diarrhea (not related to a chronic illness), respiratory infections, or kennel cough.

Many pet insurance companies make a distinction between curable and incurable pre-existing conditions. While most insurers don’t cover incurable pre-existing conditions, some will cover curable ones if your pet has been symptom-free and treatment-free for a set period.

D

Declarations page

This is the part of your pet insurance policy that summarizes the most important details at a glance. It typically lists your information, the pets it covers, coverage limits, deductibles, co-insurance rates, how much your premium costs, and the policy’s start and end dates.

Deductible

Your deductible is the amount you pay yourself for covered vet bills before your pet insurance starts paying you back. Depending on your policy, you might have to meet this deductible each year, for each new incident, or for each specific condition.

Dental illness coverage

Dental illness coverage reimburses you for the diagnosis and treatment of dental diseases in your pet, such as periodontal disease, gingivitis, and tooth infections.

Most comprehensive pet insurance plans include dental illness coverage, but what they cover and how much you get back varies by insurer.

Diagnosis

This is the process by which your veterinarian identifies a disease or condition in your pet. They may rely on clinical examination, medical history, and diagnostic tests to help reach a diagnosis.

Most pet insurance companies require a confirmed diagnosis for insurance claims related to specific illnesses or injuries.

Diagnostics

Diagnostics are the tests and procedures your vet does to help them determine the cause of your pet’s symptoms. These may include blood tests, urinalysis, X-rays, ultrasound, and other imaging or laboratory analyses. Many insurance policies cover diagnostics as part of eligible claims.

Discounts

Many pet insurance companies offer discounts to lower your premium costs. Common types of discounts include multi-pet discounts, special rates through your employer’s pet insurance program, reduced premiums for active or retired military members, and lower costs if you pay your premium once a year instead of monthly.

E

Effective date

The effective date is the day your pet insurance policy begins and your coverage becomes active. Your new policy won’t cover any illnesses or injuries that your pet had before this date.

Elective procedure

An elective procedure is a non-urgent, planned medical or surgical treatment that isn’t considered medically necessary, such as cosmetic surgery (like ear cropping or tail docking) or declawing. Most pet insurance policies won’t cover these.

Emergency vet care

Emergency care is fast help pets need when they’re very sick or badly hurt, like after an accident or if they eat something poisonous. Most pet insurance plans help pay for emergency care, including tests, surgery, hospital stays, medicine, and checkups after the emergency.

Endorsements

Endorsements — also called riders or add-ons — are optional extras you can add to your pet insurance policy to get coverage for things a standard plan would normally exclude. For example, many insurance companies offer wellness coverage or alternative therapies as policy endorsements.

Enrollment date

This is the day your pet insurance company officially accepts your application and activates your policy. Your policy’s waiting periods are based on your enrollment date. This date also establishes when your coverage limits, deductibles, and other policy terms start.

Exam fees

Exam fees are the costs you pay when your pet goes to the vet for a checkup, is sick, or gets hurt. These fees cover the vet’s time and the visit itself. Some companies include exam fee coverage in their standard policies, while others offer it as an add-on.

Exclusions

Exclusions are specific conditions, treatments, or circumstances that your pet insurance won’t pay for. For example, pre-existing conditions, elective procedures, and breeding-related costs are common exclusions.

Explanation of benefits

An explanation of benefits (EOB) is a document your pet insurance company provides to you after it handles your claim. The EOB shows what your plan covered, how much money you’ll get back, anything taken out for your deductible or co-insurance, and why they didn’t pay for something. This helps you see what your insurance paid and what you may still owe.

End-of-life expenses

End-of-life expenses are the costs you pay when your pet passes away. These can include euthanasia, cremation, or burial. Some pet insurance plans help cover these costs, either as part of the main plan or as an extra option you can add.

F

Final expenses

This refers to the costs associated with a pet’s end-of-life care, including euthanasia, cremation, or burial. Some pet insurance policies offer coverage for these expenses, either as part of their standard plan or as an optional add-on.

Formulary

A formulary is a list of prescription medicines your pet insurance plan will help pay for. This list shows which drugs your plan covers and may include rules, like needing your vet’s approval or covering only certain brands. If your pet’s medicine isn’t on the formulary, you’ll have to pay for it yourself.

G

General health maintenance

General health maintenance means regular checkups and care that help keep your pet healthy and catch problems early. This includes yearly vet visits, shots, teeth cleaning, wellness tests, heartworm medicine, flea and tick prevention, and blood tests.

Most standard pet insurance plans don’t cover these, but you can add a wellness plan for extra coverage.

Geriatric

Geriatric means your pet is in its “golden years” or old age. Big dogs might be geriatric at 6 years old, while small dogs and cats usually reach this stage around 10. Older pets often need more vet care and can have more health problems, which may make pet insurance cost more or change what it covers.

Some pet insurers will only offer accident-only policies for senior animals.

H

Hereditary and congenital conditions

Hereditary and congenital conditions are health problems pets get from their parents (hereditary) or are born with (congenital). Examples are hip dysplasia, heart defects, or some eye problems. Some pet insurance plans cover these, but others don’t or have limits, especially if your pet already had the problem before you got insurance.

I

Illness coverage

This is a type of pet insurance that helps pay you back for vet bills when your pet gets sick. It covers things like exams, medicine, surgery, and hospital stays for illnesses, from minor infections to serious diseases like cancer, diabetes, or arthritis.

Illness coverage doesn’t pay for injuries from accidents or routine care like checkups and vaccines.

Injury

An injury is when your pet gets hurt, like breaking a bone, getting a bite wound, a cut, or being hit by a car. Accident-only or accident and illness pet insurance plans usually help pay for the tests and treatments your pet needs to heal from these kinds of injuries.

Insurance provider

A provider is the company or organization that issues and manages your pet insurance policy, collects premiums, processes claims, and reimburses covered veterinary expenses.

Intervertebral disc disease (IVDD)

Intervertebral disc disease (IVDD) happens when the discs between the bones in your pet’s spine get damaged or slip out of place. This can cause pain, nerve problems, or even paralysis. Some breeds, like dachshunds, get IVDD more often.

Some pet insurance plans cover IVDD, but others might not, especially if your pet’s breed is at higher risk or if your pet already had back problems before you got insurance.^[9]

L

Lifetime limit

A lifetime limit in pet insurance is the most money your insurance company will pay for your pet’s care over their whole life. Some policies set a cap for all care or for each condition, while others have no lifetime limit.

Most plans use yearly limits that reset every year if you keep your policy active so your pet can keep getting care for long-term problems like diabetes or arthritis.

Ligament and knee injuries

Pet insurance usually covers ligament and knee injuries, as long as your pet didn’t have the problem before you got insurance or during the waiting period.

Some plans make you wait longer for knee injuries and might not cover both knees if one was hurt before. Coverage often pays for tests, surgery, and rehab, but always check your plan’s rules and limits.

M

Maximum limit

This is the highest amount a pet insurance policy will pay for covered veterinary expenses. Insurers may set this limit per year, per incident, per condition, or over the lifetime of the policy. Once you reach the maximum limit, your insurer will no longer reimburse claims until the limit resets or the policy renews.

Medical records

These are your pet’s health files from the vet. They show your pet’s visits, treatments, shots, test results, and any illnesses and injuries. Insurance companies use these records to check what care your pet’s had and if any problems started before you got insurance.

Medically necessary

Medically necessary means your vet says your pet needs a specific treatment or test to help them get better from an illness or injury. Pet insurance usually pays only for care that your vet says your pet needs, not for things like cosmetic surgery.

Microchip implantation

Microchip implantation is when a vet puts a tiny chip under your pet’s skin to help you find your pet if it gets lost. Some pet insurance plans will help pay for a microchip, especially if you have a wellness or preventive care add-on.

Money-back guarantee

A money-back guarantee lets you cancel your pet insurance within a certain time (like 30 days) and get your money back if you haven’t made any claims. This is sometimes called a “free look period.”

Multi-pet discount

A multi-pet discount is a price break you get when you insure more than one pet with the same company. This discount can help you save money if you have a lot of pets in your family.

O

Orthopedic condition

An orthopedic condition is any health problem with your pet’s bones, joints, muscles, or ligaments. Examples are hip dysplasia, broken bones, and knee injuries. Most pet insurance plans cover these after a waiting period, but not if your pet already had the problem before you got insurance.

Orthopedic exam

An orthopedic exam is a special checkup where the vet looks at your pet’s bones, joints, and muscles to see if it has any problems. Some insurance companies want this exam after you sign up so they know your pet’s joints are healthy before covering certain injuries.

P

Per-incident limit/Per-condition limit

These limits are the most your insurance will pay for one illness or accident. If your pet needs more care for that problem after you reach the limit, you’ll have to pay the rest yourself. Some pet insurance companies have these limits, while others apply limits on an annual basis.

Pet insurance policy

A pet insurance policy is the contract between you and the insurance company. It explains what it covers, what it doesn’t, how much you pay, and how much you’ll get back for vet bills.

Generally, companies offer two types of pet insurance policies: accident-only and accident and illness. Your insurance company may also offer add-ons that you can choose, like a wellness plan.

Pet liability coverage

This helps pay if your pet hurts someone or damages property. But it’s usually part of your home or renters insurance, not regular pet health insurance.

Policy expiration date

The policy expiration date is the last day your pet insurance is active. After this date, your coverage stops unless you renew your policy.

Policy expiry age

Policy expiry age is the oldest your pet can be to keep their insurance. Some companies stop coverage when your pet reaches a certain age, like 14 or 15 years old. Others may not offer new policies for older pets. And some may only offer accident-only coverage for senior pets.

Policy period

This is how long your pet insurance lasts — usually one year. You’ll need to renew it each year to keep your coverage going.

Policyholder

The policyholder is the person who owns the pet insurance plan. This person pays for the insurance, files claims, and gets the money back from the company.

Pre-certification

Pre-certification means you ask your insurance company if they’ll cover a treatment before your pet gets it. This helps you know if they’ll pay for it and can help prevent claim problems later.

Your insurer may require you to get an itemized estimate for treatment costs in order to pre-certify your pet’s treatment.

Pre-existing condition

A pre-existing condition is any illness or injury your pet had or showed signs of before your insurance started. Most pet insurance plans won’t pay for these problems. But some will pay for recurring curable pre-existing conditions if your pet remains symptom- and treatment-free for a certain amount of time.

Premium

This is the amount you pay to keep your pet insurance active. You can pay each month or once a year. The price depends on your pet’s age, its breed, where you live, and what coverage you pick.

Prescription food and supplements coverage

Prescription food and supplements coverage helps pay for special diets or vitamins your vet says your pet needs for certain health problems. Some insurance plans include this coverage in their standard accident and illness policies. Others may offer it as an add-on that you have to pay for, and some don’t offer this coverage at all.

Preventive care coverage

This helps pay for regular vet visits, shots, flea and tick medicine, and teeth cleaning to keep your pet healthy. It’s usually an extra you can add to your main pet insurance plan. It’s also commonly called a wellness plan.

Q

Quote

A quote is an estimate from the insurance company showing how much your pet insurance will cost and what it covers. You can use quotes to compare different plans before you buy.

R

Rehabilitation therapies

These are special treatments that help your pet recover after surgery or an injury. They can include physical therapy, water therapy, or laser therapy. Some insurance plans help pay for these if your vet says your pet needs them.

Reimbursement

This is the money you get back from your insurance company after you pay your vet and send in a claim for covered care. You can usually choose your reimbursement rate (or reimbursement percentage) when you buy your pet insurance policy.

Reimbursement percentage/Reimbursement rate

The reimbursement percentage (or reimbursement rate) is the part of your vet bill your insurance will pay after you meet your deductible. For example, if your reimbursement rate is 80%, you pay the other 20%.

Most insurers offer multiple reimbursement rate options, and you can usually choose your reimbursement percentage when you buy a pet insurance policy.

Renewal

This is when you keep your pet insurance policy going for another year after your current plan ends. Most companies renew your plan automatically if you keep paying.

S

SOAP notes

Short for “subjective, objective, assessment, and plan,” SOAP notes are your pet’s detailed medical records. They include what you noticed, what the vet found, the vet’s thoughts, and the plan for care. Insurance companies may ask for these notes when you file a claim.^[10]

Specialist care

Specialist care is when your pet sees a vet who’s had extra training in a certain area, like surgery or cancer care. Some insurance plans help pay for this if your regular vet sends you to a specialist.

Supplements

Supplements are vitamins or other products your vet recommends for your pet to help with certain health problems. Some insurance plans cover these if your vet prescribes them.

Surgery coverage

This is the part of your insurance policy that helps pay for operations your pet needs because of an accident or illness. These include exams, anesthesia, surgery, and post-operation care.

U

Underwriting

This is the process an insurance company uses to decide what your policy covers, your pet’s eligibility for coverage, and your premium. Sometimes, the underwriter is different from the company that sells your insurance.

Usual and customary fees

These fees are the normal prices vets charge in your area. Some insurance plans pay only up to these prices, so if your vet charges more, you’ll pay the extra.

V

Veterinary exam fee coverage

Exam fee coverage means your insurance will help pay for the cost of the vet’s checkup or office visit. Some plans include this, while others make you buy it as an extra.

Veterinary specialist

A veterinary specialist is a vet who’s trained even more in one area, like heart care or surgery. Your pet might need a specialist for serious or tricky health problems. Most pet insurance policies cover specialist care.

W

Waiting period

A waiting period is the time you have to wait after you buy pet insurance before your coverage starts. Most plans make you wait a few days for accidents and a few weeks for illnesses. It’s also common for insurers to have longer waiting periods for orthopedic conditions.

Wellness coverage

Wellness coverage is a common add-on plan that helps pay for regular care to keep your pet healthy, like yearly checkups, vaccines, teeth cleaning, and flea prevention. Not all pet insurers offer these plans.