What is an annual incident limit?
Annual Incident Limit – The total amount you can be reimbursed over one 12-month plan period for treatments relating to a single condition.
Level | Annual Incident Limit |
---|---|
Level 1 | $2,500 |
Level 2 | $3,000 |
Level 3 | $5,000 |
Level 4 | $7,000 |
Conditions that need treatment over multiple plan periods are considered to be ongoing conditions and are subject to a separate deductible and separate limits. Click "Plan Details" for more information.
What is a lifetime incident limit?
Lifetime Incident Limit – The total amount you can be reimbursed over the course of your pet’s life for treatments relating to a single condition.
What is a lifetime coverage limit?
Lifetime Coverage Limit – The total amount you can be reimbursed over the course of your pet's life for treatments relating to a specific type of coverage, such as ongoing conditions coverage or hereditary and congenital conditions coverage.
What is an annual coverage limit?
Annual Coverage Limit – The total amount you can be reimbursed over one 12-month plan period for treatments relating to a specific type of coverage, such as alternative therapies and behavioral care coverage.
Wellness Coverage
When you add wellness coverage to your plan, you’ll be reimbursed up to a set amount for a list of wellness services. You do not have to satisfy your deductible before you can be reimbursed for these services, and there is no waiting period, so you can start using your wellness coverage as soon as your plan is effective.
See the wellness services that are eligible for reimbursement below.
Routine |
Advanced |
|
---|---|---|
Reimbursements Up To: | ||
Wellness Exam | $40 | $50 |
Heartworm Test or FELV Screen | $15 | $15 |
Fecal Screen | $15 | $15 |
Spay/Neuter and/or Wellness Blood Screening | $80 | $100 |
DOGS: Rabies Vaccine/Titer and/or Lyme Vaccine/Titer | $15 | $15 |
CATS: Rabies Vaccine/Titer and/or FIP Vaccine/Titer | $15 | $15 |
Canine DHLPP Vaccine/Titer | $15 | $15 |
Feline FVRCP Vaccine/Titer | $15 | $15 |
Microchip and/or Urinalysis | $20 | $20 |
CATS: Feline FELV Vaccine/Titer | — | $15 |
DOGS: Canine Bordetella Vaccine/Titer | — | $15 |
Dental Cleaning | — | $100 |
Heartworm/ Flea Prevention | — | $55 |
Total Annual Benefit | $200 | $400 |
$10 per month | $25 per month |
What is a waiting period?
Waiting Period – The amount of time that must pass before coverage can start. Waiting periods only apply in the first 12-month plan period.
Conditions that show symptoms before the plan's effective date or during a waiting period are considered pre-existing and ineligible for coverage. However, an injury or illness that is cured and free of treatment and symptoms for 180 days will no longer be regarded as pre-existing. See all of our waiting periods below.
Accidents & Injuries Excluding ligament and knee injuries |
No waiting period |
Wellness | No waiting period |
Illnesses | 30-day waiting period |
Hereditary and congenital conditions | 180-day waiting period |
Ligament and knee injuries | 12-month waiting period |
Download Sample Pet Insurance Plans
Sample plans are samples only and may not include state specific variations.
Level 1
Level 1 (includes Continuing Care Endorsement)
Routine Wellness Care (optional)
Advanced Wellness Care (optional)
Level 2
Continuing Care Endorsement (if eligible)
Routine Wellness Care (optional)
Advanced Wellness Care (optional)
Level 3
Level 3 (includes Congenital & Hereditary Care endorsement)
Continuing Care Endorsement (if eligible)
Routine Wellness Care (optional)
Advanced Wellness Care (optional)
Level 4
Level 4 (includes Congenital & Hereditary Care Endorsement)
Continuing Care Endorsement (if eligible)
Routine Wellness Care (optional)
Advanced Wellness Care (optional)
Download Sample Pet Insurance Plans
Sample plans are samples only and may not include state specific variations.
What are usual and customary costs?
Usual and Customary Costs - The typical costs of veterinary services within areas similar to the area of your veterinary clinic.
Hereditary & Congenital Conditions
Muscular/Skeletal Problems
- Elbow Dysplasia (Fragmented Medial Coronoid Process/FCP, Incongruent Elbow, Premature Closure of the Distal Ulnar/Radial Physis, Ununited Anconeal Process/UAP)
- Hemivertebra
- Hip Dysplasia
- Intervertebral Disc Disease (IVDD) Type I 1
- Legg-Calve Perthes Disease (Spontaneous Aseptic Necrosis of the Femoral Head)
- Medial Patellar Luxation 2
- Osteochondritis Dissecans (OCD), Osteochondrosis
- Osteochondrodysplasia
- Vertebral Stenosis
- Wobbler’s Syndrome (Cervical Vertebral Instability)
Disorders Affecting the Eyes
- Cherry Eye
- Cataracts (occurring in dogs 6 years and under)
- Collie Eye Anomaly (CEA)
- Corneal Dystrophy
- Distichiasis/Trichiasis/ Ectopic Cilia
- Ectropion/Entropion
- Keratoconjunctivitis Sicca (KCS)
- Pannus
- Progressive Retinal Atrophy
- Retinal Dysplasia
Cardiovascular Disorders
- Atrial Septal Defect
- Dilated Cardiomyopathy (DCM)
- Hypertrophic Cardiomyopathy (HCM) 3
- Mitral Valvular Disease (Endocardiosis)
- Patent Ductus Arteriosus (PDA)
- Pulmonic Stenosis
- Tricuspid Valve Dysplasia
- Subaortic Stenosis (SAS)
- Ventricular Septal Defect (VSD)
Medical Disorders
- Bleeding Disorders (Hemophilia, Factor II, Factor VII, Factor VIII, Factor IX, Factor X, Factor XI, Factor XII, Von Willebrand’s Disease)
- Brachycephalic Syndrome (Caudally Displaced Maxillae, Elongated Soft Palate, Everted Laryngeal Saccules, Hypoplastic Trachea, Stenotic Nares, Tortuous Turbinates)
- Congenital Renal Disease (Polycystic Renal Disease, Renal Agenesis, Renal Dysplasia)
- Copper Hepatopathy
- Corkscrew Tail
- Cryptorchidism
- Demodicosis (occurring in animals age 2 years and under)
- Ectopic Ureters
- Epilepsy 4
- Exocrine Pancreatic Insufficiency
- Fold Dermatitis 5
- Hepatoportal Microvascular Dysplasia
- Hydrocephalus
- Megaesophagus
- Myasthenia Gravis (MG)
- Portosystemic Shunt
- Protein Losing Nephropathy (PLN) 6
- Sebaceous Adenitis
- Shaker Syndrome
- Tracheal Collapse
- Umbilical Hernia 7
Age Limits
Dogs over the age of 12 and cats over the age of 14 before enrollment are only eligible for Level 1 coverage.
Transaction Fee
There is a $0.00 transaction fee for each monthly, quarterly, or semi-annual payment. The fee will be waived if you choose to pay annually.
Policy Terms
For your convenience, we’ll automatically issue you a new plan every 12 months unless you contact us to cancel. We’ll use your current payment method and notify you in advance of any changes to your plan or premium.
Pre-existing conditions are not covered.
Conditions that show symptoms before the plan’s effective date or during a waiting period will be considered pre-existing and ineligible for coverage, even if they haven’t been formally diagnosed or treated by a veterinarian. However, an injury or illness that is cured and free of treatment and symptoms for 180 days will no longer be regarded as pre-existing. Conditions that occur in one plan period and need care after your plan is re-issued are only eligible if the endorsement covering ongoing conditions is in effect (subject to eligibility).
The information provided must be accurate. Coverage may be cancelled if important information about a pet is intentionally not disclosed or is misrepresented.
Pet parents must be 18 or older to purchase this insurance.
Waiting periods apply in the first plan period.
Illness coverage, if applicable, begins 30 days after the plan’s effective date. Hereditary and congenital conditions coverage, if applicable, begins 180 days after the plan’s effective date. Coverage for ligament and knee injuries begins in the second 12-month plan period. Conditions that show symptoms before the plan’s effective date or during a waiting period will be considered pre-existing and ineligible for coverage, even if they haven’t been formally diagnosed or treated by a veterinarian. However, an injury or illness that is cured and free of treatment and symptoms for 180 days will no longer be regarded as pre-existing.
Rules apply for group priority codes
If a group priority code is used, we must be informed of any change in group employment or membership status.
Enrollments are subject to review.
Pets that are enrolled in an ASPCA Pet Health Insurance plan are subject to review by underwriting. Veterinary records may be requested on occasion for clarity about health problems.
What if my pet's condition isn't listed?
We only need to know if your pet has one of the conditions on this list. Other conditions won't affect plan eligibility. If this is the case, please select 'None of these'
Billing Address
We need to complete your enrollment over the phone. Please call us at (855) 786-1084 and an agent will be able to access the plan(s) you have selected and complete your enrollment.
How we use your email address:
We'll send you an email with a link to your saved quote. You can opt out of receiving our communications at any time.
INSURER DISCLOSURE OF IMPORTANT POLICY PROVISIONS
Please read below for important information to help you understand our coverage. Keep in mind, we will not reduce coverage or increase premium due to claims history.
We use certain terms in our policy documents and want to make sure you understand how they are used. Following are some common DEFINITIONS:
Congenital anomaly or disorder – means a Condition that is present from birth, whether inherited or caused by the environment, which may cause or otherwise contribute to Illness or disease.
Hereditary disorder – means an abnormality that is genetically transmitted from parent to offspring and may cause Illness or disease.
Pet insurance – means an individual or group insurance policy that provides coverage for Veterinary expenses.
Pre-existing condition – means any Condition for which a Veterinarian provided medical advice, the Pet received Treatment for, or the Pet displayed signs or Symptoms consistent with the stated Condition prior to the Effective Date of a Pet insurance policy or during any waiting period.
Usual and Customary Costs – Typical fees that Veterinarians in the same territory charge based on proprietary data and available industry information as determined by the process outlined under What Is Covered.
Veterinarian – means an individual who holds a valid license to practice Veterinary medicine from the Veterinary Medical Board pursuant to Chapter 11 (commencing with Section 4800) of Division 2 of the Business and Professions Code or other appropriate licensing entity in the jurisdiction in which he or she practices.
Waiting Period – means the period of time specified in a Pet Insurance Policy that is required to transpire before some or all of the coverage in the policy can begin.
Coverage for the following conditions may be EXCLUDED depending upon the plan chosen.
Pre-existing condition: Pre-existing conditions are not covered by our plans. However, a condition will no longer be considered preexisting if 180 days have passed since the pet’s condition was cured and free from treatment and symptoms.
Hereditary disorder and Congenital anomaly or disorder: Hereditary disorders and Congenital anomalies or disorders are excluded from coverage on the Level 1 and Level 2 plans. A list of these conditions is available here and is included with the policy documents. These disorders are covered by our Level 3 and Level 4 plans up to the applicable incident and lifetime limits.
Chronic conditions and ongoing conditions: Chronic conditions are those that can be treated or managed, but not cured. An ongoing condition is any condition that requires treatment in multiple policy periods. Our base plans provide coverage for chronic and ongoing conditions during the plan year in which the symptoms first appear. If eligible, the Continuing Care Endorsement provides coverage for conditions that span to another plan year. The Continuing Care Endorsement has separate deductible and incident/lifetime limits.
Other exclusions may apply. Please refer to the exclusions section of the policy (What Is Not Covered) for more information. Please continue reading for information on Waiting Periods, Claims, Deductibles, Co-insurance and Other Policy Limits.
Waiting Period
There are WAITING PERIODS that apply before certain coverages are effective. On Levels 2, 3, and 4, a 30-day illness waiting period applies to the first policy period. On Levels 3 and 4, conditions that appear on the Hereditary, Genetic, or Congenital List are subject to a 180 day waiting period. Diagnosis and treatment for ligament and knee conditions are subject to a 12 month waiting period on all policies. Conditions that occur during a waiting period are considered pre-existing.
Determination of Claim Payments
Our accident and illness coverage provides reimbursement for Usual and Customary costs for expenses incurred during the Policy Period that are eligible for coverage under Your policy, referred to as Covered Expenses. After subtracting the deductible amount shown on the declarations page from Covered Expenses and applying Your Co-insurance listed on the declarations page, We will pay Our portion of the Covered Expenses up to any applicable maximums. There are maximum amounts specified on the declarations page for the Incident Limit that applies to each eligible Incident. Please refer to the declarations page for other applicable coverage.
Usual and Customary Basis: Usual and Customary costs are determined by using proprietary and industry data. We use proprietary data to group zip codes into territories based on the veterinary fees charged there. Excluding outliers, the mean of the charges falling with the third quartile are deemed Usual and Customary for each territory. Publicly available industry data is used to validate the results of Our calculations.
Wellness benefits are paid according to the schedule of benefits provided with the policy, if applicable.
Deductible
We offer a choice of annual deductible options. The annual deductible applies to each policy period. We subtract that deductible amount from the covered expenses before calculating your co-insurance.
Co-Insurance
We offer a choice of co-insurance options. After the deductible is met, you are responsible for your portion of the covered expenses in addition to any amounts not covered by the policy. We then pay our portion of the covered expenses subject to any applicable plan limits.
Policy Limits
Base Policy | Continuing Care Endorsement
(covers chronic and ongoing conditions) |
Congenital and Hereditary Care Endorsement
(covers Hereditary disorders and Congenital anomaly or disorders included on the Hereditary, Genetic, and Congenital List) |
|||
---|---|---|---|---|---|
Annual Incident Limits | Incident Limit | Lifetime Limit | Incident Limit | Lifetime Limit | |
Level 1 | $2,500 | $500 | $1,500 | $0 | $0 |
Level 2 | $3,000 | $1,000 | $2,500 | $0 | $0 |
Level 3 | $5,000 | $1,500 | $3,500 | $500 | $1,250 |
Behavior Therapy | $150 | Base Policy Limits apply | Not applicable | ||
Alternative Therapy | $150 | Base Policy Limits apply | Base Policy Limits apply | ||
Level 4 | $7,000 | $2,500 | $6,000 | $1,000 | $2,500 |
Behavior Therapy | $300 | Base Policy Limits apply | Not applicable | ||
Alternative Therapy | $300 | Base Policy Limits apply | Base Policy Limits apply |
Wellness Care Endorsement
Reimbursements are up to the lower of the amount listed or charged |
Routine |
Advanced |
---|---|---|
Wellness Exam | $40 | $50 |
Heartworm Test or FELV Screen | $15 | $15 |
Fecal Screen | $15 | $15 |
Spay/Neuter and/or Wellness Blood Screening | $80 | $100 |
DOGS: Rabies Vaccine/Titer or Lyme Vaccine/Titer | $15 | $15 |
CATS: Rabies Vaccine/Titer or FIP Vaccine/Titer | $15 | $15 |
Canine DHLPP Vaccine/Titer or Feline FVRCP Vaccine/Titer | $15 | $15 |
Microchip and/or Urinalysis | $20 | $20 |
Canine Bordetella Vaccine/ Titer or Feline FELV Vaccine/ Titer | — | $15 |
Dental Cleaning | — | $100 |
Heartworm/ Flea Prevention | — | $55 |
Complete Coverage℠ and Accident only
Please read below for important information to help you understand our coverage. Keep in mind, we will not reduce coverage or increase premium due to claims history.
We use certain terms in our policy documents and want to make sure you understand how they are used. Following are some common DEFINITIONS:
Pet insurance- means an individual or group insurance policy that provides coverage for Veterinary expenses.
Pre-existing condition- means any condition for which a veterinarian provided medical advice, the pet received treatment for, or the pet displayed signs or symptoms consistent with the stated condition prior to the effective date of a pet insurance policy or during any waiting period.
Reimbursement percentage – means co-insurance.
Veterinarian- means an individual who holds a valid license to practice veterinary medicine from the Veterinary Medical Board pursuant to Chapter 11 (commencing with Section 4800) of Division 2 of the Business and Professions Code or other appropriate licensing entity in the jurisdiction in which he or she practices.
Waiting Period- means the period of time specified in a pet insurance policy that is required to transpire before some or all of the coverage in the policy can begin.
Coverage for the following conditions will be EXCLUDED.
Pre-existing condition: Pre-existing conditions are not covered by our plans. However, a condition will no longer be considered preexisting if 180 days have passed since the pet’s condition was cured and free from treatment and symptoms.
Other exclusions apply. Please refer to the exclusions section of the policy (What Is Not Covered) for more information.
Waiting Periods
There are WAITING PERIODS that apply before certain coverages are effective. On Complete Coveragesm, a 14 day illness waiting period applies to the first policy period. Diagnosis and treatment for ligament and knee conditions are subject to a 14 day waiting period on all policies. Conditions that occur during a waiting period are considered pre-existing.
Policy Limits
Reimbursement of covered expenses is subject to the annual policy limit you select at enrollment and is listed on your declarations page.
Please continue reading for information on Claims, Deductibles, Reimbursement Percentage and Deductible.
We offer a choice of annual deductible options. The annual deductible applies to each policy period. We subtract that deductible amount from the covered expenses before calculating your reimbursement percentage.
Reimbursement Percentage
We offer a choice of reimbursement percentage options. After the deductible is met, you are responsible for your portion of the covered expenses in addition to any amounts not covered by the policy. We then pay our portion of the covered expenses subject to the annual limits.
Determination of Claim Payouts
Our coverage provides reimbursement up to the applicable annual limit for the actual costs for covered expenses that you incur during the policy period, after subtracting your deductible and applying the reimbursement percentage, listed on the declaration page.
Preventive benefits are paid according to the schedule of benefits provided with the policy, if applicable, and are not subject to a deductible or reimbursement percentage. See below for a list of available benefits.
Preventive Care optional endorsement
Reimbursements are up to the lower of the amount listed or charged. Some benefits are specifies specific as noted.
Benefit | Basic | Prime |
---|---|---|
Dental Cleaning | $100 | $0 |
Dental Cleaning OR Spay/ Neuter | $0 | $175 |
Wellness Exam | $50 | $50 |
FVRCP Vaccine/ Titer (cats), DHLPP Vaccine/ Titer (dogs) | $20 | $25 |
Rabies Vaccine/ Titer OR FIP Vaccine/ Titer (cats), Lyme Vaccine/ Titer (dogs) | $20 | $25 |
Fecal Test | $20 | $25 |
FELV Test (cats), Heartworm Test (dogs) | $20 | $25 |
Health Certificate | $0 | $25 |
Flea/ Heartworm Prevention | $0 | $50 |
FELV Vaccine/ Titer (cats), Bordetella Vaccine/ Titer (dogs) | $0 | $25 |
Blood Test | $0 | $25 |
Urinalysis | $0 | $25 |
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