The lump that opened pandora's box: my pet insurance search journey

A pet is like a member of the family, who may face unexpected illnesses, conditions, or medical emergencies as a child, spouse, or relative might.

That truth recently hit home for me when the vet recommended for my 8-year-old American shorthair, Gati, to get a biopsy and/or extraction of the small, cyst-like, fluid-filled lump he's had between his ears for the last several months.

The estimate I received in January for the medical stay at the hospital, sedation, biopsy, surgery extraction fee, pain meds, patient monitoring, and fluids was a whopping $1,017.41.

Though the vet told me that the lump was likely due to hyperpigmentation because it released black fluid when it was aspirated, I decided to explore what my pet insurance options are to see if it could potentially cover the procedure.

How pet insurance works

According to NerdWallet, "more than 6.4 million U.S. dogs and cats were covered by pet insurance in 2024," which was an increase of nearly 13 percent from 2023, per the North American Pet Health Insurance Association.

Pet insurance mainly works by reimbursing out-of-pocket costs incurred for accident and illness, accidents only, or wellness/standard visits, depending on the policy.

However, Rhode Island Insurance Division's Chief of Consumer and Filing Services Beth Vollucci said, "whether a pet insurance policy reimburses a pet owner or the veterinarian would be up to the terms of the policy and the veterinarian's business practice."

Representatives from Ferguson Animal Hospital in North Providence and Warwick Animal Hospital in Warwick said pet owners typically pay out of their own pockets and are then reimbursed by their insurance company.

Similarly, Abbott Valley Vet Center in Cumberland confirmed that their clients typically come in, receive their services, and then submit invoices to their insurance company directly.

NAPHIA states that some pet insurance policies may also offer other benefits, such as third party liability coverage if a pet injures someone else or damages someone else's property, as well as "the cost of looking after a pet if the policy-holder is hospitalized or requires emergency medical treatment," or even, "the cost of advertising a reward for the return of a lost or stolen pet."

Once enrolled, a monthly fee is charged that goes toward the annual cost of the plan, along with a potential one-time enrollment fee to activate the plan.

In the Ocean State, Vollucci said that to the best of her knowledge, "there are no vets in R.I. that are licensed insurers."

"And there may be vets in Rhode Island that advertise or recommend pet insurance policies to their clientele, but these programs would need to be underwritten by either a licensed insurer (allowed) to do business in R.I., or a surplus lines insurer that is allowed to write policies in the state," she added.

Covered services can range from dental treatment to diagnostic test fees or prosthetic devices, but according to Warwick Animal Hospital, any condition that is pre-existing typically won't be covered.

Uh oh.

When I asked if Gati's case was considered pre-existing, I was told that it was, since he currently doesn't have any pet insurance and didn't at the time the lump was examined. However, I was encouraged to check with the insurance policies directly, just to make sure.

Shopping for pet insurance

When it comes to actually shopping for a pet insurance policy, the experience can seem a little daunting at first, since there are so many policies available from different companies.

One resource that can help simplify and speed up the process is Pawlicy Advisor, a free online search portal where one can compare policies from different providers in one place.

The visitor can either enter their zip code and answer a few questions to get the best recommendation based on your pet and their needs, or visit Pawlicy Advisor's comparison page to click through extensive guides for the different companies that offer pet insurance.

Each guide provides pricing, coverage options, waiting periods, as well as pros and cons lists and what is covered or not covered by each provider.

Among the policies used most by pet owners in North Providence, Warwick, and Cumberland are Embrace, Lemonade, and Pets Best, which all turned out not to cover pre-existing conditions. But I asked for quotes anyway, to gauge what the best deal is among the three, should I need pet insurance in the future.

Embrace — According to Pawlicy Advisor's guide, sample rates for Domestic Shorthair cats were quoted at $23 for six-month-old cats, $27 for 3-year-old cats, and $54 for 10-year-old cats.

To enroll in Embrace's policy, pets must be at least six weeks old, must not exceed 14 years old, and owners must pay a one-time $25 fee.

Visits are paid for up-front first, and policyholders are then required to file a claim with Embrace through their app, before they are reimbursed for a percentage of eligible vet expenses.

Since Gati is close to the 10-year mark, I was quoted at $51.86 per month for the $500 annual deductible plan, which reimburses 90 percent of covered services up to $5,000. I was told that the quote would be valid for 24 hours and while I wasn't required to sign up right then, the rate would be subject to change at another time.

Lemonade — Sample rates for a domestic shorthair cat to be insured by Lemonade's policy appear to be far more economical, with 6-month-old cats quoted at $17.17, 3-year-old cats quoted at $20.90, and 10-year-old cats quoted at $28.92.

They reimburse 70, 80, or 90 percent of eligible veterinary expenses up to $100,000 per year, once the yearly deductible is paid.

Lemonade does not charge an enrollment fee, and pets must also be at least 6 weeks old and not more than 14 years old to be enrolled.

When one reaches them by phone, Lemonade redirects them to their website for a quote, which asks questions about the pet's age, what kind of pet they are (cat or dog), and where the caller lives.

The interested customer starts off getting quoted for a base policy, and then is asked about extra add-on coverage for vet visits, physical therapy, behavioral conditions, dental illness, and end of life.

The caller can also add a wellness package, depending on their pet's age. I was quoted $34.51 for just a base plan to cover diagnostics, procedures, and medications.

Coverage specialist Kaitlyn Powaserys confirmed that procedures or services to diagnose or remove a cyst or growth from a pet still wouldn't be covered if it turns out to be cancerous. This is because the issue was first identified before coverage was active.

Pets Best — To enroll a pet in Pets Best, the pet must be at least 7 weeks old, but there is no maximum age requirement.

A vet exam is not required for enrollment but may be requested when filing a claim, and pets must reside with you at the primary residence listed on the policy.

Sample rates are $32, $32, and $85 for domestic shorthairs that are 6 months old, 3 years old, or 10 years old.

Pets Best mainly covers injury and illness and has a separate add-on option for routine care as well.

For a $500 deductible injury and illness plan with unlimited coverage and 80 percent reimbursement rate, including office visits and take home prescriptions, I was quoted $32.00 per month and $359.99 for a year.

Other alternatives to pet insurance

According to the Rhode Island Insurance Division, some vets offer their own wellness plans, "for items traditionally not covered by pet insurance, such as vaccinations and examinations."

At Warwick Animal Hospital, many clients are part of the Trupanion Veterans program, to receive veterinary care for their service dogs.

The Rhode Island Insurance Division also mentions national discount programs, where pet owners can get vet service discounts for a monthly fee.

Other local discount programs include The Companion Animal Foundation (CAF), which provides $125 vouchers for general veterinary care to low-income residents, and the Rhode Island Veterinary Medical Association (RIVMA), which offers also a spay/neuter assistance program, providing discounted spay/neuter surgeries.