Pet insurance claims and reimbursement, explained
If you’ve never submitted a pet insurance claim before (or even if you have), looking at your Explanation of Benefits can be a lot to wrap your head around. Let’s break down how a pet insurance claim and reimbursement works.
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Pet insurance claims examples
Here are some hypothetical pet insurance claim examples based on common conditions pet parents take their dogs or cats to the vet.
Your dog breaks a leg
You find your dog at the bottom of the stairs whining, it looks like he has fallen and can’t get up. You take him to an animal hospital and the vet says he has a broken leg. Here’s what your total bill and reimbursement might look like if you have a Fetch pet insurance plan with a $300 deductible, $15,000 max annual payout, and 90% reimbursement rate.
Example
Treatment
Services
Diagnostics & treatments
$3,539.00
• X-ray
$179.00
• Pain killer
$30.00
• Cefazolin (antibiotic) injection
$30.00
• Sedation
$30.00
• Anesthesia
$70.00
• Surgery
$3,200.00
Prescription medication
$62.00
• Amoxicillin (antibiotic)
$20.00
• Loxicom (pain medication)
$42.00
Total bill for covered services:
$3,601.00
Reimbursement rate:
(90%)
Annual deductible:
($300)
What you get back:
$2,940.00
How reimbursement works
Let’s assume this is your first claim with Fetch. After paying for your puppy’s treatment at checkout, simply log in to the Fetch Pet Insurance app or online portal and follow the easy steps to submit your claim, including uploading a photo of the detailed and fully paid invoice, and your dog's medical records. When we review your claim, we'll identify what is covered and multiply those charges by your reimbursement rate and subtract your annual deductible. With this example being your first claim, your full annual deductible was applied.
Your cat has stomatitis
You notice your cat isn’t eating as she regularly would, and the area around her mouth and gums look red and swollen. You take her to an emergency vet for treatment where she’s diagnosed with stomatitis. Here’s what your total bill and reimbursement might look like if you have a Fetch pet insurance plan with a $500 deductible, $15,000 max annual payout, and 90% reimbursement rate.
Example
Treatment
Services
Diagnostics & treatments
$540.00
• Exam
$55.00
• X-ray
$275.00
• Blood test
$120.00
• Lab test (Bartonella)
$90.00
Prescription medication
$62.00
• Azithromycin (antibiotic)
$42.00
• Gabapentin (pain medication)
$25.00
Total bill for covered services:
$607.00
Reimbursement rate:
(90%)
Annual deductible:
($300)
What you get back:
$246.30
How reimbursement works
For this example, let’s assume this isn’t your first claim with Fetch, and that you have $300 remaining out of your $500 annual deductible, meaning $200 was applied to your previous claim(s). After paying for your cat’s treatment at checkout and submitting your claim, we’ll review your claim. After identifying what's covered and multiplying those charges by your reimbursement rate, we’ll apply whatever is remaining in your annual deductible, in this case, it was $300.
Your kitten gets spayed
You take your 8-month-old kitten to the vet for a check-up, microchipping, and spay procedure. Let’s assume you are enrolled in Fetch Wellness, an optional routine and preventative care add-on to your Fetch pet insurance plan. Your wellness coverage level, Advantage, has $520 in annual benefits to use for this type of veterinary care. Here’s what your total bill and reimbursement might look like if you have Fetch Wellness.
Example
Treatment
Services
Diagnostics & treatments
$225.00
• Exam
$50.00
• Rabies
$15.00
• Microchip
$45.00
• Spay
$115.00
Total bill for services:
$225.00
Your Fetch Wellness Advantage level covers:
Annual exam
$50.00 per policy year
Rabies
$20.00 per policy year
Microchip
$20.00 per policy year
Spay/Neuter
$100.00 per policy year
Total cost Fetch Covers:
$185.00
You cover:
Remaining microchip cost
$25.00
Remaining spay procedure cost
$15.00
What you get back:
$40.00
How reimbursement works
For this example, your Fetch Wellness level covers a certain amount for each covered service (see above). You’ll pay the full amount and be reimbursed for covered services. For example, we’ll cover your kitten’s spay up to $100. The service was $115, so you’ll pay the full amount at checkout and be reimbursed for $100 after your claim is approved.
This example is for illustrative purposes only. The coverage for each policyholder will be governed by the terms and conditions of the applicable policy. All coverage and limit options may not be available to all customers and are subject to underwriting approval. If there is any conflict between the policy and this product information, the provisions of the policy shall prevail.
How long does it take to get reimbursed?
We typically process claims within 15 days. You can help speed up the process by submitting all necessary documents (like your invoice and pet’s medical records) on our app. Once your claim is approved, you could get paid back in as little as 2 days when you sign up for direct deposit.
Pet insurance claims FAQs
What’s a maximum annual payout?
Your max annual payout is the maximum dollar amount you can be paid back each year. Choosing a lower max annual payout will make your price lower.
What is an annual deductible in pet insurance?
Your annual deductible is the amount of veterinary care you need to pay for yourself each year before your provider reimburses you for claims. So if your annual deductible is $300, you have to pay for $300 worth of approved veterinary care before they start paying you back.
What can I claim on pet insurance?
We cover more types of injuries and illnesses than any other provider — everything from cuts and upset stomachs to ACL ruptures and heart disease.
But we also cover things that other providers charge extra for or don’t cover at all, like injury and illness in every adult tooth and the gums, breed-specific issues (think breathing problems in Frenchies or kidney stones in Burmese), and even the exam fees you pay when you go to the vet for a sick visit. And it’s all standard, no riders or add-ons required.
As for what we don’t cover:
Routine and preventive care is not covered. Pet insurance covers future accidents and illnesses — the stuff you can’t see coming. We offer Fetch Wellness, an optional add-on to Fetch Pet Insurance that covers routine and preventive care, like vaccinations or checkups. Like other pet insurance providers, we don't cover pre-existing conditions.
How does the claims submission method work?
1. What you need
There are two types of documents you need to submit a claim:
A finalized invoice from your vet showing what your pet was treated for and how much you were charged. An invoice has to show a zero balance or that it was paid in full in order for us to accept it.
Detailed medical records from your pet’s most recent checkup (a vet visit unrelated to your pet getting sick or hurt). Medical records show us your pet’s medical history and let us see what we can cover, which allows us to process your claim quickly.
NOTE: If you're not sure if you have the right medical records, ask your vet for “SOAP notes.” The records you receive should include any exam notes and lab results.
2. How to submit your claim
To submit your claim, either click here or follow these instructions:
1. Make sure you’re logged into the app or your online account
2. Go to Claims
3. Go to Submit a claim
4. Follow the instructions in the claim form
3. What happens next?
Claims are typically processed within 15 days from when we receive all your documents. We’ll email you with updates, so keep an eye on your inbox. And be sure to set up direct deposit now if you haven’t already — it gets you paid back 5-10 days faster than checks do.
Where can I find Fetch Pet Insurance medical and claims forms?
We strongly recommend that you submit your claim through the Fetch app or your online account — it’s the fastest, easiest way to get paid back. You can get the app in the App Store or Google Play.
How can I track my pet insurance claim?
You can track your claim status anytime in the Fetch app or your online account. To see the status of a claim, either click here or follow these instructions:
• Make sure you’re logged into your account
• Go to Claims
• Click on an individual claim to see its status
We’ll also email you with updates, so keep an eye on your inbox.