Reimbursement Rate (Pet Insurance)
Plain English
The reimbursement rate is the share of a covered vet bill your pet insurance pays back, like 80%. You pay the rest, plus your deductible. A higher rate means you get more back on each claim but usually pay a higher premium. Check whether it applies to your actual bill or to a set schedule.
Read to the end to complete this term.
On this page
Definition
The reimbursement rate is the percentage of a covered veterinary bill a pet insurer pays back, such as 70%, 80% or 90%, after the deductible and up to the policy's limits. The policyholder pays the remaining percentage, which works like coinsurance. Some policies instead pay from a benefit schedule or usual-and-customary charges.
Why It Matters
Two policies with the same premium can pay back very different amounts. The rate, the deductible, the order the insurer applies them, and whether it pays your actual bill or a schedule all change what a claim is worth.
Real-World Example
Imagine a $2,000 covered vet bill and a $200 deductible. At 70% reimbursement, the insurer pays $1,260 if it subtracts the deductible first ($1,800 × 70%). At 90%, it pays $1,620. The owner's cost is $740 or $380.
Common Misconceptions
- 80% reimbursement means 80% of the whole bill. The deductible usually comes off first, depending on the policy.
- The rate applies to any bill. It applies only to covered costs, and some policies use a schedule instead of your actual bill.
- A higher rate is the cheaper choice. It usually raises the premium, so compare both.
Key Takeaways
- Common rates are around 70%, 80% or 90%.
- The deductible and limits also change what you get back.
- California's regulator: your vet will expect you to pay any balance the insurer doesn't.
- Washington law requires insurers to disclose how they calculate claim payments.
Frequently Asked Questions
What is a reimbursement rate in pet insurance?
The percentage of a covered vet bill the insurer pays back, after the deductible.
Is 80% or 90% reimbursement better?
90% pays back more on each claim but usually costs more in premium. Compare the yearly premium difference with what you'd expect to claim.
Does the deductible come off before the reimbursement rate?
Often, but it depends on the policy. Ask the insurer for its formula; Washington law requires it to be disclosed.
Related Terms
Related Coverages
- Pet Insurance
Related Scenarios
Explore the rest of the Pet Insurance category.
Browse Pet Insurance terms →Sources
The factual claims on this page were checked against these sources. Rules and figures change, so check the source itself if you need to confirm the current version.
- insurance.ca.govPet Insurance · California Department of Insurance
- app.leg.wa.govChapter 48.205 RCW: Pet insurance · Washington State Legislature
Educational information, not advice: This page is for general education only, not legal, financial, or insurance advice. Actual coverage, discounts, and requirements depend on your policy’s wording, your insurer, and the laws of your state. Confirm specifics with your own insurer or a licensed agent before making a decision. Insurpedia does not sell insurance and does not recommend specific insurers.