How pet insurance reimbursement works
By Raúl Vaquerizo · Published · Editorial policy
Most pet insurance doesn’t work like the health insurance you have through work. There’s usually no network and no copay at the front desk. You pay the vet, send the invoice to the insurer, and the insurer pays you back a percentage of the eligible cost. That percentage is the reimbursement rate.
The basic formula
For a single covered claim:
payout = (vet bill − deductible still owed) × reimbursement rate, up to your annual limit.
With a $2,000 bill and a $250 annual deductible not yet met:
| Reimbursement rate | Insurer pays | You pay |
|---|---|---|
| 70% | $1,225 | $775 |
| 80% | $1,400 | $600 |
| 90% | $1,575 | $425 |
Going from 70% to 90% is worth $350 on that one bill. Whether that’s worth the higher premium depends on how often you expect to claim. For a young pet with nothing on the horizon, 70% or 80% may be enough. For a breed with a documented chronic risk, the difference adds up year after year.
What insurers offer
Most insurers let you choose between 70%, 80% and 90%, but there are exceptions. MoneyGeek listed these in 2026:
- Trupanion: 90% only.
- Pumpkin: 80% or 90%.
- Healthy Paws: 50% to 80%.
- Nationwide: 50%, 70% or 80%.
- Lemonade: 60% to 90%.
- Figo: up to 100% (for select deductibles and annual limits).
- Wagmo: 80%, 90% or 100%.
The fine print that changes the payout
The formula above assumes the whole bill is eligible. In practice, a few things can shrink the eligible part:
How the insurer values the bill. Some insurers reimburse a percentage of what your vet actually charged. Others cap payments at “usual and customary” fees, or pay from a fixed benefit schedule per procedure. In states that follow the NAIC Pet Insurance Model Act, insurers have to explain the basis in the policy and on their website. That includes how they set usual and customary fees and, if they use benefit schedules, the schedules themselves. If your vet is in an expensive area, this matters.
Exam fees. Not every policy covers the cost of the vet visit itself. In a MoneyGeek comparison of five insurers for senior cats, Pets Best required an add-on for exam fees and Liberty Mutual didn’t include them. Pumpkin, ASPCA and MetLife did.
Exclusions and limits. Pre-existing conditions, waiting periods, per-condition caps and the annual limit all apply before the percentage does.
Getting paid faster
Waiting for reimbursement is the downside of this model, especially for a large emergency bill. Some insurers offer ways around it. MoneyGeek notes that Pets Best can pay licensed vets directly on request, and Pumpkin offers an “urgent pay” service for faster reimbursement. If paying a $5,000 bill up front would be a problem for you, ask about direct payment before you buy.
How to choose
Pick the reimbursement rate together with the deductible and the annual limit. Those three settings decide how much of a bad year you actually get back. The payout calculator lets you try them against any bill.
Estimates only, not a quote. Not financial or veterinary advice. We are not an insurer, agent or broker. Prices come from public data and change by insurer, ZIP code, policy options and your pet's medical history. Always read the policy and ask your veterinarian about your pet's health. Full disclaimer.