How pet insurance works
Most pet insurance is reimbursement-based. You pay the vet, submit a claim with the invoice, and the insurer pays back a share of covered costs after your deductible. A few insurers, such as Trupanion, can pay participating vets directly at checkout. Nationwide, for example, says you can use any licensed vet, including specialists and emergency providers.
Few owners have it. NAPHIA counted about 6.98 million insured pets in the US at the end of 2025 (5.23 million dogs and 1.75 million cats). That is up 9% from 2024 but still only 4.27% of the 163.6 million US pets, or about 6% of dogs and 2% of cats.
The main plan types
| Plan type | What it covers | Avg. annual premium, 2025 (dog / cat) |
|---|---|---|
| Accident and illness | Injuries and illnesses, after the waiting period, minus exclusions such as pre-existing conditions | $836 / $435 |
| Accident-only | Injuries such as broken bones or swallowed objects. Usually excludes illness, hereditary conditions, preventive care and dental illness | $190 / $112 |
| Insurance with embedded wellness | Accident and illness plus routine care such as checkups | $1,414 / $859 |
Source: NAPHIA State of the Industry 2026 (2025 data); coverage descriptions from Insurify.
Standalone wellness programs are not insurance. The NAIC model law requires wellness programs sold separately from a policy to be disclosed as "not insurance" and bars insurers from making you buy one to get a policy. (Wellness benefits written into the policy itself, like the embedded plans above, do count as insurance.) Either way, wellness coverage is essentially a prepaid allowance for routine care. Embrace's Wellness Rewards, for example, offers $300, $500 or $700 a year with no deductible, and unused money does not roll over. Add up what you actually spend on routine care before you decide if one pays off.
Deductible, reimbursement and annual limit
These three choices set both your premium and what you get back.
- Deductible: what you pay before coverage starts. Options typically range from $100 to $1,000. Most plans use an annual deductible that resets each policy year. Trupanion uses a per-condition deductible. You pay it once for each condition, then never again for that condition, which helps with chronic illness.
- Reimbursement rate: the share of covered costs the insurer pays after the deductible, commonly 70%, 80% or 90%. Figo offers up to 100%.
- Annual limit: the most the plan pays per year. Options range from $2,000 to unlimited. Healthy Paws and Trupanion have no annual or lifetime caps.
Deductible choice can move the price a lot. In one Insurify quote for a 2-year-old mixed-breed dog in Hartford, Connecticut, Trupanion cost about $137 a month with a $100 deductible, $79 with $500 and $47 with $1,000.
Worked example
Your dog needs $3,000 of treatment in a year. Your plan has a $500 annual deductible, 80% reimbursement and a premium equal to NAPHIA's dog average of $836:
- Covered amount after deductible: $3,000 − $500 = $2,500
- Insurer pays 80%: $2,000
- You pay: $1,000 at the vet plus $836 in premiums = $1,836, versus $3,000 uninsured
In a year with no claims, you are simply out the $836. Insurance makes the most sense when an unexpected bill of several thousand dollars would strain your budget. If you could cover it from savings, an emergency fund earmarked for the pet is an alternative.
Waiting periods and pre-existing conditions
Coverage doesn't start the day you buy. Typical waiting periods:
- Accidents: 0 days at Embrace, 5 days at Trupanion, 14 days at Nationwide.
- Illnesses: 14 days at Lemonade, Figo, Embrace, MetLife and Nationwide; 30 days at Trupanion.
- Orthopedic conditions (such as cruciate ligament injuries): Embrace applies 6 months, reducible to 14 days for dogs with an orthopedic exam and waiver.
The NAIC Pet Insurance Model Act, which states can adopt, would cap waiting periods for illness and orthopedic conditions at 30 days, ban waiting periods for accidents, and require insurers to offer a waiver after a vet exam. Rules depend on whether your state has adopted it, which is why the same insurer's terms can differ by state.
Pre-existing conditions are generally excluded. Under the NAIC model definition, a condition counts as pre-existing if a vet gave advice about it, it was treated, or the pet showed signs of it before coverage began or during the waiting period. Many insurers ask for a vet exam or records to check. Two details matter:
- Curable vs. incurable. Lemonade, Figo, Embrace and Nationwide may cover a "curable" pre-existing condition, once it has resolved. Figo, for example, may cover a condition that returns after the pet has been symptom-free for at least a year. Healthy Paws does not cover curable pre-existing conditions.
- Renewals. Under the model law, a condition covered under your policy can't be reclassified as pre-existing when you renew. Ask how your insurer handles this, and avoid letting coverage lapse.
Pet insurers compared
Options with published plan details, listed alphabetically. Average prices are Insurify's quote medians and will differ for your pet.
| Insurer | Deductible | Reimbursement | Annual limit | Illness wait | Avg. monthly (dog / cat) |
|---|---|---|---|---|---|
| Embrace | $100–$1,000 | 70%–90% | $5,000–unlimited | 14 days | $53–$65 / $11–$30 |
| Figo | $100–$750 | 70%–100% | $5,000–unlimited | 14 days | $47 / $14 |
| Healthy Paws | $250–$1,000 | 50%–90% | Unlimited | Varies by state | $50 / $41 |
| Lemonade | $100–$750 | 60%–90% | $5,000–$100,000 | 14 days | $38 / $21 |
| MetLife (PetFirst) | $50–$2,500 | 50%–90% | $2,000–$10,000 | 14 days | $45–$50 / $18–$27 |
| Nationwide | $250 | 50%–80% | $2,500–$10,000 | 14 days | $20–$21 / $20–$21 |
| Trupanion | $0–about $1,000 per condition | 90% (lower options in some states) | Unlimited | 30 days | Varies widely by deductible |
Source: Insurify best pet insurance 2026 and Trupanion review; Pawlicy Advisor (Embrace limits and waits, Trupanion state variations). Confirm current terms with the insurer.
- Embrace: enrolls pets from 6 weeks to 14 years (new accident-and-illness plans aren't available at 15 and older). Exam fees need an add-on. Dental illness is covered up to $1,000 per term. There is a $25 enrollment fee and a $1 monthly processing fee.
- Healthy Paws: no per-incident or lifetime caps and no wellness add-on. New policies are available for pets up to age 13.
- MetLife: one deductible and limit can be shared across several pets.
- Nationwide: also covers exotic pets such as birds, reptiles and small mammals.
- Trupanion: doesn't cover exam fees. It can pay participating vets directly.
For deeper looks at individual companies, see our Healthy Paws review and Nationwide review.
What drives your premium
- Age: Insurify's medians run $40 a month for a puppy, $46 for an adult dog and $116 for a senior dog; $21 for a kitten and $62 for a senior cat. Many insurers won't enroll dogs under 8 weeks or over 14 years, or offer only accident-only cover to older pets.
- Species and breed: dogs cost roughly twice as much as cats. Breed matters too: Insurify's median for a French bulldog was $69 a month with a $5,000 limit and $134 with an unlimited limit.
- Location: Insurify's dog medians ranged from $32 a month in Alabama and Mississippi to $66 in Alaska.
- Plan choices: a lower deductible, higher reimbursement and higher limit all raise the price.
- Rising prices: NAPHIA's average accident-and-illness premium rose 11.5% for dogs and 12.6% for cats in 2025. Ask how the insurer adjusts premiums as your pet ages.
For full price breakdowns by age, breed and state, see our pet insurance cost guide.
How to choose a plan
- Enroll young if you can. Fewer pre-existing exclusions and lower starting premiums.
- Pick a limit you would actually need. Insurify has put cancer treatment at about $4,000, so a $5,000 limit can go quickly. Unlimited plans cost more.
- Compare the same deductible and reimbursement across insurers.
- Read the sample policy for exam fees, dental illness, hereditary conditions and orthopedic waiting periods.
- Use the free look. The NAIC model gives 15 days to return a policy for a full refund if you haven't filed a claim.
Frequently asked questions
How much does pet insurance cost per month?
NAPHIA's 2025 averages for accident-and-illness plans were $836 a year for dogs (about $70 a month) and $435 for cats (about $36). Accident-only plans averaged $190 for dogs and $112 for cats. Your quote depends on age, breed, location, deductible, reimbursement rate and annual limit.
Does pet insurance cover pre-existing conditions?
Generally no. A condition counts as pre-existing if it was diagnosed, treated or showed signs before coverage began or during the waiting period. Some insurers, including Lemonade, Figo, Embrace and Nationwide, may cover curable conditions after they resolve; Healthy Paws does not.
How long is the waiting period for pet insurance?
Commonly 14 days for illnesses, and 0 to 14 days for accidents (Embrace 0, Trupanion 5, Nationwide 14). Trupanion's illness wait is 30 days, and Embrace applies 6 months for orthopedic conditions unless you complete an exam and waiver. The NAIC model law, where adopted, caps waits at 30 days and bans accident waits.
Is wellness coverage worth it?
Only if the allowance exceeds what it costs you. Wellness add-ons work as prepaid routine-care allowances, and standalone wellness programs are not insurance. Embrace's Wellness Rewards offers $300, $500 or $700 a year, and unused amounts don't roll over.
What's the difference between an annual and a per-condition deductible?
An annual deductible resets each policy year. A per-condition deductible, used by Trupanion, is paid once for each condition, which can save money on chronic illnesses that need treatment for years.
Can I cancel pet insurance if I change my mind?
Under the NAIC model law, you get a 15-day free look to return the policy for a full refund if you haven't filed a claim. Check your state's rules and the policy.
Sources
- NAPHIA – State of the Industry 2026 report highlights
- dvm360 – US pet insurance enrollment increased 9% in 2025
- NAIC – Pet Insurance Model Act (#633)
- Insurify – Best pet insurance 2026
- Insurify – Trupanion review
- Insurify – Pet insurance guide (May 31, 2026)
- Insurify – Pet insurance cost
- Insurify – Average pet insurance cost by state
- Insurify – Cheapest pet insurance
- Insurify – How much the vet costs
- Pawlicy Advisor – Embrace pet insurance
- Pawlicy Advisor – Trupanion pet insurance
Rates, fees and terms change often. Figures were checked in October 2026; confirm current details with the provider before you apply.