In pet insurance, a reimbursement is the money you could get back on covered costs after submitting a claim to your insurance provider.¹ But it’s not always as simple as that — there are deductibles, limits, and different methods of getting reimbursed that factor into the amount of money you actually receive.^2,3

We’ll discuss the methods of reimbursement you may come across and how reimbursements work, then provide you with examples of MetLife Pet’s process so it’s all a little easier to understand. 

Reimbursement Methods for Pet Insurance

A reimbursement in pet insurance is typically calculated in one of two ways: by percentage of covered costs or by benefit limit. Most of your standard pet insurance policies — like accident and illness plans or accident-only plans — utilize a percentage (or rate) to calculate your reimbursement. Optional plans, like a wellness add-on, might utilize a schedule of benefits with specific reimbursement limits to pay you back.

Reimbursement rate

If your plan calculates your reimbursement based on a reimbursement rate, this is expressed as a percentage of the vet bill you’d get back — but only on costs that are covered by your policy. Many pet insurance plans are customizable, so you can choose a reimbursement rate that works for you. The higher your reimbursement percentage, the more money you may be able to get back on covered costs.

Reimbursement limit

A schedule of benefits is a list of expenses that are covered under your plan, along with benefit (or reimbursement) limits for each. These limits are usually expressed as a dollar amount. With plans that utilize this method, you can only be reimbursed up to the dollar amount listed in your schedule of benefits during that policy period for those specific expenses.

How Does Pet Insurance Reimbursement Work?

As we mentioned, reimbursements aren’t as simple as a percentage applied to a vet bill. You may also have a deductible that needs to be met before you can start getting reimbursed.^1,2

Some pet insurance providers subtract this dollar amount from the vet bill first, and then apply your reimbursement rate to that. Other insurers may apply your reimbursement rate to the vet bill first, and then subtract your deductible from that.

MetLife Pet subtracts your deductible first, and then applies your reimbursement rate.^1,2 Mathematically, this method tends to result in a slightly higher reimbursement than if you subtract the deductible after applying the reimbursement rate.

You might also have annual limits that put a cap on reimbursements for a policy period. Once you’ve reached the maximum amount your insurance provider will pay out, you won’t be reimbursed until your policy renews. Some plans also have per-incident limits that may factor into reimbursements. MetLife Pet doesn’t have any per-incident limits.^1,3

Pet Insurance Reimbursement Examples

To help you see how reimbursements work, let’s look at a couple of hypothetical examples using MetLife Pet’s standard accident and illness plan, and our optional Preventive Care plan.

Percentage reimbursement

With our standard plan, say you have a reimbursement rate of 90%, a deductible of $100, and an annual limit of $10,000. Your pet goes to the vet for limping, and after testing, they’re diagnosed with patellar luxation and later get surgery to repair it. The entire vet bill totals $6,000, and all expenses are coverable under your policy.

Since this is your first claim of the policy year, we subtract your $100 deductible from the $6,000 and get $5,900. From there, we apply your 90% reimbursement rate to that number and get a reimbursement amount of $5,310.^1,2,3

Benefit limit reimbursement

One of the ways you can be reimbursed through our Preventive Care plan is according to a schedule of benefits. Say your plan lists vaccinations as a covered benefit, and the limit is $100 for the policy year. During that year, you could get up to $100 back on claims for vaccinations. If you submit claims for vaccinations after you’ve reached your $100 limit, you won’t get reimbursed until your policy renews.

MetLife Pet’s Reimbursement Process

The above examples should give you an idea of how reimbursements may be calculated with our plans. It’s also important to know how our reimbursement process works, so you can take full advantage of your benefits.

After a vet visit, you have 90 days to submit a claim, or it won’t be eligible for reimbursement. Before calculating your reimbursement amount, we must first figure out which expenses are covered by your policy. After we determine that dollar amount, we subtract any unmet deductible for your policy and then apply your reimbursement percentage. Most claims are processed within 5 days, but it could take up to 30 if additional information is needed.

Once we have a reimbursement amount for your claim, we ensure you haven’t met your annual limit yet. After that’s verified, we’ll send the money to you using your preferred method — this could be through a direct payment or physical check.

Get Reimbursed up to 90% on Covered Costs With MetLife Pet¹

MetLife Pet Insurance has reimbursement percentages of 50%, 70%, 80%, and 90% you can choose from when you enroll.¹ We also offer plenty of options for your deductible and annual limit.^2,3

Transparency is what we strive for with reimbursements and coverage, so that using your pet insurance can be easy. After all, making sure your pet can get the care they need is where we want your focus to be — instead of on how your coverage is going to work.

Explore your plan customization options by getting a free quote and seeing your personalized rates.