Frequently Asked Questions
At Healthy Paws Pet Insurance, we're here to make it easier for you to care for your pet and easier on both of you if your pet has an unexpected illness or injury. We're also here to make what we do and what we offer easy to understand. Whenever you have a pet insurance question or need to talk through your options with a knowledgeable expert, please email us or call us at 1-800-453-4054.
Pet Insurance Coverage Questions
We cover the treatment of any new illness, injury or accident after your enrollment and waiting periods. Our plan also covers hereditary and congenital conditions. With unlimited lifetime benefits and no annual or per incident limits, we're ready to cover most anything unexpected that happens to your pet.
And our plan is customizable, with a choice of reimbursement level and deductible, so you can create a plan that's right for your budget and needs. Get your no-obligation pet insurance quote here.
If it's an accident or illness (and not a pre-existing condition), our plan covers the treatment. It's that simple. Use any licensed veterinarian, including emergency animal hospitals and specialists. This includes:
- Diagnostic testing such as x-rays and blood tests
- Hospitalization, including any treatments while in the hospital
- Prescription medications
Healthy Paws will provide you and your pet with unlimited lifetime coverage. You will have continuous, seamless coverage for the life of your pet, without the concern over any type of annual or per incident caps. Ever!
Hereditary and congenital conditions may not appear for years, but when they do the treatment can be expensive. Eye disorders like cataracts or knee issues requiring surgery like a patellar luxation are examples of these conditions. What matters most is that we do not put restrictions on hereditary and congenital conditions, so rest assured you're protected financially and can give your pets the quality medical care they deserve. Here's a quick explanation of these often confusing terms:
- A hereditary condition is one that is genetically predetermined - a condition that is passed down from your pet's parents. Examples of these conditions in pets are diabetes, cherry eye, hip dysplasia, and gastric torsion.
- A congenital condition is one that is not linked to genetics, but instead is related to things that occurred while your pet was still in utero. Examples of these conditions are often congenital heart and all other organ defects.
Of course, if a hereditary or congenital condition or its symptoms are noted by your veterinarian before your enrollment, they are considered pre-existing and will not be covered by your Healthy Paws pet insurance policy (just like any other illness or injury that occurred before your pet became insured by us).
As part of our effort to provide you with the best pet health insurance plan available, we include lifetime coverage for hip dysplasia when you enroll your pet before the age of six. There is a twelve-month waiting period before coverage takes effect in all states except Maryland and New Hampshire. The policy requirement for your pet to undergo a complete physical hip exam has been waived.
Of course, if signs or symptoms of hip dysplasia are noted by your veterinarian before your enrollment or during the twelve-month waiting period, hip dysplasia will be considered pre-existing and will not be covered by your Healthy Paws pet insurance policy.
At this time, we are unable to cover hip dysplasia if your pet is six years of age or older at the time of enrollment.
Our pet insurance plan does not cover pre-existing conditions, the veterinarian exam fee, spay/neuter procedures, or preventative care. We do not cover preventative care because we know that's just part of the expected cost of being a good and responsible pet parent.
The following preventative care is not covered:
- Preventive healthcare including vaccinations or titer test, flea control, heartworm medication, de-worming, nail trim, spaying/neutering and grooming.
- Parasite control including but not limited to internal and external parasites for which readily available prophylactic treatments are available.
- Dental healthcare including dental cleanings (prophylaxis); however, if injury to teeth is caused by an accident, we do cover the cost of extractions and reconstruction of damaged teeth.
- Anal gland expression.
- Feeding, housing, and exercise.
- Behavioral modification, medications for behavioral modification, training, or therapy.
Download the sample Healthy Paws Pet Insurance policy for the comprehensive explanation of coverage, terms, conditions, limitations, and exclusions.
By making the office visit (vet exam or consultation) part of the pet parent's financial responsibility, it allows us to offer a complete accident and illness plan at an affordable monthly premium. (Think about it like your copay when you see a doctor.)
The office visit is not covered whether you go to a general practice veterinarian, specialist, or emergency hospital.
Helping you care for your pets is just part of our story. Through our Homeless Pet Medical Grant Program, we help animal rescue groups and shelters provide medical treatment to the thousands of homeless pets in their care. So when you choose to insure your pet with us, you're not just protecting your pet, you're also helping a whole lot of homeless pets.
A pre-existing condition means that the condition first occurred or showed clinical signs or symptoms (there doesn't need to be a diagnosis) before your pet's coverage started (including waiting periods). Our pet insurance protects you against future conditions, and unfortunately no pet insurance company can cover pre-existing conditions.
At Healthy Paws, identifying a pre-existing condition is simple! If it's an accident, illness or injury and the symptoms didn't occur before enrollment, you're covered.
Here are some of examples of how pre-existing conditions work:
- Example 1: Your dog has been itchy ever since you adopted her from the
shelter. Over the past month she's been in several times to see her veterinarian for her itchy
skin, loss of fur, hot spots and ear infections. Your veterinarian is treating the symptoms,
but has not diagnosed the condition yet.
The cost of the treatment is becoming more expensive, so you decide to enroll her in pet insurance. A couple of months later your dog has another flare-up of itchy skin and you take her to see her veterinarian, who diagnoses her condition as allergies and prescribes additional medication.
Allergies would be considered pre-existing, since the clinical signs and symptoms of the condition were noted before enrollment.
- Example 2: Your cat was seen for a urinary tract infection (UTI) one
year ago. The urinalysis showed bacteria and crystals. Your veterinarian treated the condition
with antibiotics and placed him on a special diet.
Your cat is back to normal and you decide to enroll in pet insurance. During the 15-day waiting period, your cat begins showing signs of a UTI and you take him to see your veterinarian.
A UTI would be considered pre-existing because your cat was treated for the same condition one year ago, and the clinical signs and symptoms of this condition started during the 15-day waiting period.
If you are aware that your pet has a congenital condition before you enroll in pet insurance, this condition will more than likely be considered pre-existing. Unfortunately, no pet insurance company can cover pre-existing conditions.
There are many types of congenital conditions that do not become apparent until some time after birth. Healthy Paws will cover these types of congenital conditions as long as there were no clinical signs or symptoms present before enrollment or during the waiting periods.
Unlike many other pet insurance companies that exclude most bilateral conditions (a condition that can occur on both sides of the body), Healthy Paws has only one bilateral-exclusion on our policy for cruciate ligament problems.
If your pet was showing any cruciate ligament problems such as lameness, or a full/partial tear before enrollment or during the 15-day waiting period, this condition would be considered pre-existing and we would not be able to provide any coverage for your pet.
Is My Pet Eligible?
Healthy Paws Pet Insurance provides unlimited lifetime health coverage. From minor accidents that heal quickly, to chronic conditions that require treatment well into old age, we will be there with you, throughout your pets' lives, to help them get back on their paws as quickly as possible.
Any conditions occurring after enrollment and the waiting period would be covered for life. Our policy is continuous until canceled, which means that there is no "renewal" event that can change the terms of your policy. Besides, we love pets and we wouldn't be very good pet protectors if we stopped covering a condition the following year.
During the course of your normal care, your pet has probably visited your favorite veterinarian within our guidelines. Answer the two questions below to see if you need to do anything special:
- For pets younger than six years old, have you seen your veterinarian within the past 12 months? If yes, there is nothing more that you need to do.
- For pets six or older, have you seen your veterinarian within the past 30 days? If yes, there is nothing more that you need to do.
If you answered "No" to the above questions, you'll need to schedule a standard veterinary examination within 15 days for the policy to be effective.
When you file your first claim, we will need a copy of your pet's full medical history, including documentation of the enrollment exam. We can request this from your veterinarian or you can send them to us directly. If we do not receive your pet's full medical records, it may delay the processing of your claim.
You may use the rescue group's or shelter's adoption physical if you have documentation of the examination including the doctors notes. If you are unsure if the adoption physical satisfies as our policy requirement, you may fax us a copy of the records to review. We will let you know if this exam satisfies our policy requirements or if another examination is recommended.
Please note, many adoption agreements recommend that your new furry family member gets a complete physical examination from your veterinarian, typically within 72 hours. This exam would satisfy our policy requirements for a baseline or enrollment exam.
If you cannot get a copy of your pet adoption records, it may delay the processing of your claim and possibly affect your coverage.
Filing Claims and Getting Reimbursed
There is a waiting period of 15 days after your policy effective date for accidents and illnesses. Your policy is effective 12:01 a.m. of the day following the date you enroll your pet with Healthy Paws Pet Insurance.
Hip dysplasia coverage is provided at no extra cost and is subject to a 12 month waiting period for pets younger than six. At this time, we are unable to cover hip dysplasia if your pet is six years of age or older at the time of enrollment.
We know that when your pet is sick or injured, the last thing you want to worry about is how to pay for it. So we try to make this process as simple as possible. You can expect:
- To visit any licensed veterinarian you choose. This includes specialists and emergency animal hospitals.
- After paying for the treatment, we give you three easy options for completing your claim:
While you're helping your pet get better, we'll work on getting your claim processed. If it's your first claim, we need a little extra time to review your pet's complete medical records. Please request your pet's full medical records, including the doctors' notes, to be faxed to us. We will work hard to process your claim within 7-10 business days. If it's a second claim or higher, please send the medical records for the most recent service date. Second claims or higher can often be processed within 72 business hours, excluding weekends and holidays.
We know that when your pet is sick or injured, the last thing you want to worry about is how to submit a claim. With no more claim forms, we've created the fastest and easiest claim process for our customers.
Just send us your veterinary hospital's invoice through our online Customer Center or Healthy Paws Mobile App! If you prefer, you can still submit your claim using our claim form and send it to us by email.
We'll process your claim quickly and send you a reimbursement check. Claims are often processed in just a few days. Of course, if it's your first claim, we'll need your pet's medical records to complete your claim. We may also pre-authorize very expensive treatments (on a case-by-case basis) with your veterinarian hospital to help reduce your upfront burden.
You can expect that we'll try to keep this process as simple as possible. Having pets ourselves, we want you to be able to focus on getting your pet healthy. After you file a claim, we will send you a confirmation email letting you know that your claim is in process. If you do not receive this confirmation email within 48 hours of submitting your claim, we recommend that you contact us. You can expect that if we have any questions, we'll contact you. You can also expect that we'll process the claim as quickly as possible.
If you have questions, you can call us at 855-898-8991 or email us at email@example.com.
We are available Monday-Friday from 6 a.m. to 6 p.m. and Saturday-Sunday 8 a.m. to 5 p.m. Pacific Time.
Reimbursements are based on your actual veterinary bill. We determine the total of the covered treatments and multiply that by your reimbursement rate. We then subtract your remaining annual deductible. For example:
|$ 1,200||Covered treatments|
|x 90||%||Your Reimbursement Level|
|- $ 100||Remaining Annual Deductible|
|$ 980||Reimbursement Amount|
Once your annual deductible is met, you will receive even larger reimbursements. Healthy Paws is the only company to offer unlimited lifetime benefits with an annual deductible which helps you get more back over the life of your pet.
Our customer care commitment:
Our goal is to process your claim as quickly as possible. For repeat claims, we typically respond and process the claim within 72 hours. First-time claims may take more time to review, usually between seven and ten business days; this also depends on when we receive all of your pet’s medical records.
Healthy Paws Pet Insurance & Foundation customer care hours: Monday-Friday, 6:00 a.m. - 6:00 p.m. and Saturday and Sunday 8:00 a.m. – 5:00 p.m. PST.
Managing Your Policy
We are environmentally friendly and do not mail any paper documentation. All of your policy documents and claim forms are easily accessible online at our website under "My Account." Less paper, less waste!
To view your policy documents, please visit our website and select "My Account." Login with your email address and Healthy Paws password. There is assistance if you've forgotten your password.
Be sure to add firstname.lastname@example.org to your address book or safe sender list so our emails get to your inbox.
Congratulations on a new addition to the family!
You can use the Add a Pet feature in the Customer Center to add the new pet to your policy or call us at 1-800-453-4054 and we'll be happy to help you add your new pet to your policy.
The annual deductible is by "coverage term" which means that the deductible is for 12 months following your pet enrollment date. For example, if you signed up on May 25th, 2010, your coverage term would be until May 24th, 2011.
To maximize the annual deductible, we recommend that you submit all claims pertaining to accidents, illnesses and injuries. Once the annual deductible has been exhausted, we reimburse you at your chosen level of reimbursement.
You may raise your pet's deductible level and/or lower your pet's reimbursement level at any time. You may do this once your policy is effective and can do so using our Change Policy Options feature in the Customer Center. This will become effective on your next monthly coverage period.
You may lower your pet's deductible and/or raise your pet's reimbursement level, provided that you have not previously filed a claim for your pet. You may do this once your policy is effective and can do so using our Change Policy Options feature in the Customer Center. This will become effective on your next monthly coverage period.
All changes are subject to approval by Healthy Paws Pet Insurance, LLC.
Download the sample Healthy Paws Pet Insurance policy for the comprehensive explanation of coverage, terms, conditions, limitations, and exclusions.
Our goal is to reimburse you for your claims as quickly as possible. So the longest you should expect to wait to be reimbursed for repeat claims is 72 hours. First-time claims may take a little longer, between seven and ten business days, depending on how quickly your vet provides us with the records necessary for us to complete the claim process. If you ever have any questions or concerns, please don't hesitate to email or call us.
As helpful as pet health coverage may be, especially to your peace of mind, we realize it's not always for everyone. That's why we invite you to take 30 days to see how good it feels to know your pet is protected. If pet insurance isn't for you, we'll give you a complete refund as long as you cancel during the first 30 days of your policy and you have not submitted a claim.
To update your profile or billing information, please visit our website and select "Log In" under the "For Customers" menu. Login with your email address and Healthy Paws password. There is assistance if you've forgotten your password.
You can also call us at 1-800-453-4054 and we'll be happy to assist you over the phone. Our office hours are Monday-Friday, 6:00 a.m. - 6:00 p.m. and Saturday and Sunday 8:00 a.m. – 5:00 p.m. PST.
For customers that enrolled using credit or debit cards: Your monthly premium will be charged automatically to your credit or debit card each month on the same date that your policy became effective. For example, if your policy was effective on the 15th of the month, all payments going forward will be on the 15th of each month.
For customers that enrolled using payroll deduct (subject to employer participation): Your monthly premium will be requested each month from your employer and deducted from your paycheck.
We currently accept credit cards from VISA, MasterCard, American Express and Discover. We also accept debit cards. We do not add extra monthly processing fees for the convenience of monthly billing.
For employers participating in our payroll deduction program, we also offer the convenience of deducting your premium from your paycheck. Please request Healthy Paws Pet Insurance to be added to your voluntary employee benefits plan if this is not available.
Due to the increasing cost of new technology and advances in veterinary care, your rates will increase slightly each year. Our plan has factored the expected increase in the cost of veterinary care into your rates so that the annual premium increases are manageable. These manageable annual increases provide you the opportunity to offer your pet the best medical and diagnostic options available today.
Rest assured, we will never penalize you with higher rates for making claims. It's not your fault your pet is unlucky!
All pet insurance companies, no matter how they market their benefits, will raise rates periodically to keep up with the rapidly rising cost of veterinary care.
We'd sure be sorry to see you go, but you may cancel your policy at any time by using our Cancel Policy feature in the Customer Center.
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