Pet insurance pays 70–90% of covered costs — you handle the 10–30% coinsurance and the annual deductible. But policies vary wildly on what they exclude, how they price, and how fast they pay. We compared the three biggest US pet insurers across real claims scenarios.
How pet insurance actually works (read this first)
Most US pet insurance is regeneration-based (not indemnity). You pay the vet, submit a claim, and get reimbursed up to the plan's limit. Three levers control your out-of-pocket cost:
- Annual deductible ($0–$2,500): you pay this once per year before reimbursement kicks in.
- Reimbursement % (70–90%): after the deductible, insurance pays this fraction of the bill.
- Annual/lifetime limit ($5K–$15K+, or unlimited): the cap on what they'll pay in a year or over your pet's lifetime.
Example: $5K bill, $250 ded, 80% reimbursement = you pay $250 + $1,000 = $1,250 out of pocket.
Head-to-head comparison
| Feature | Pets Best | Lemonade | Spot |
|---|---|---|---|
| Monthly premium (approx) | $52 | $48 | $65 |
| Reimbursement options | 70/80/90% | 80/90/100% | 70/80/90% |
| Deductible | $250/500/1000 | $0/250/500 | $250/500/1000 |
| Annual max | $5K–$15K / unlimited | $5K–$20K | $5K–$15K |
| Illness + accident | Yes — no payout cap for Unlimited | Yes | Yes — no payout cap |
| Wellness add-on | $8–$26/mo | $12–$22/mo | $10–$24/mo |
| Average payout time | 5–10 days | 3 days (auto) | 4–7 days |
| Hereditary/ chronic after 2 yrs | Limited | Excluded | Limited |
| Telehealth included | Yes (AskVet) | Yes (Pawp) | No |
| Pre-existing condition | Waiting period 14 days (12 mo for hereditary) | 14 days (12 mo hereditary) | 14 days (12 mo hereditary) |
Who each plan is best for
Pets Best: Best for chronic conditions. Once a hereditary condition has been treated and stable for 24 months, it's covered for life under their chronic care plan. Their telehealth benefit (AskVet) is included at no extra cost.
Lemonade: Fastest claim payouts (auto-approve in 3 days, no vet form needed). Best for owners who want speed and simplicity. The 100% reimbursement option exists here alone, but it's the most expensive tier.
Spot: Strongest network of affiliated providers and a 90% reimbursement that stacks with their wellness plan. Best if you want an all-in-one pet care platform, not just insurance.
Common exclusions that bite people
| Excluded category | Details |
|---|---|
| Pre-existing conditions | Any condition diagnosed before the waiting period ends. Chronic conditions managed post-coverage may be covered. |
| Hereditary / genetic | Breed-specific problems (hip dysplasia in German Shepherds, heart issues in small breeds) are excluded or capped. |
| Routine care | Vaccines, wellness exams, flea prevention — only covered if you add the wellness rider. |
| Alternative therapy | Acupuncture, chiropractic, and laser are covered only at specific providers. |
| Behavioral | Most plans exclude behavior modification training; some cover it under limited circumstances. |
How much does the average claim cost?
The industry average claim is $420. Accident claims average $370; illness claims average $660. A single ACL surgery can exceed $4,000 — more than a year of premiums. For a healthy dog, insurance mostly pays for itself in peace of mind (not dollars); for pets with a medical event, it pays for itself many times over.