How do reimbursements work?

Reimbursements are based on your actual veterinary bills. Claims representatives determine the total of the covered treatments, and reimburse you for the percentage of those bills that you selected for your policy, minus your remaining annual deductible, up to the annual limit you selected.

For example:

Say you have a policy with a $250 annual deductible, a reimbursement rate of 80% and an annual limit of $7,000.

  • You get a vet bill for $1,200 in covered treatments
  • Apply the reimbursement rate: 80% of $1200 = $960
  • Subtract your annual deductible: $960 - $250 = $710
  • Your are reimbursed $710 for that $1,200 bill

For your next bill, you would be reimbursed a full 80% for covered treatments. (Your pet's deductible is annual, meaning it must be satisfied only once per policy term and resets on the anniversary of your pet's enrollment.) 

Healthy Paws would continue to reimburse your approved claims until your $7,000 limit is reached (you'd have up to $6,290 of reimbursement left for the policy year in the above example). After that, you would be responsible for veterinary costs beyond the $7,000. Your annual limit resets each year when your policy renews, so that you'd be entitled to up to $7,000 of payouts for every policy year.

If a claim is approved, any reimbursement due will be issued on average within 2 business days. You can choose to be reimbursed via a mailed check or direct deposit.

Example 1: cat with urinary obstruction
Treatments
Services covered
Not covered
Diagnostic tests

X-rays, lab work

$344.82
Hospitalization

Hospital stay, meds, in-patient medical exam

$97.82
Surgery

Anesthesia, surgery, catheter placement

$257.09
Exclusions

Veterinary exam, pet food

$70.08
Total covered expenses:

80% of $699.16, minus remaining annual deductible

$599.32 – $250.00
TOTAL REIMBURSED
$309.32
Example based on 80% reimbursement with $250 annual deductible, un-met at time of treatment
Example 2: dog with Intervertebral Disk/Laminectomy (specialty care)
Treatments
Services covered
Not covered
Diagnostic tests

X-ray, myelogram, lab work

$921.40
Hospitalization

Hospital stay, physical therapy nursing, medications

$1,050.49
Surgeries

Anesthesia, surgery, catheter placement, medications

$2,089.04
Exclusions

Emergency fee, consultation fee, physical therapy consult

$395.00
Total covered expenses:

80% of $4,060.93, minus remaining annual deductible

$3,248.74 – $0.00
TOTAL REIMBURSED
$3,249.74
Example based on 80% reimbursement with $250 annual deductible which had been met at time of treatment

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