Should the need arise for surgery, treatment for an illness, or emergency veterinary care for your dog or cat, the bill can rise rather quickly. So what does Nationwide pet insurance really cover?
Nationwide provides pet insurance to help pay for veterinary bills that are related to accidents and illnesses, and also offers optional coverage for routine wellness care. The type of plan chosen will determine the coverage limits, the level of reimbursement, the deductible, and whether or not wellness benefits are included. The specific options, exclusions, eligibility criteria, and prices may differ from state to state and depending on the pet’s situation.
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What Does Nationwide Pet Insurance Provide Coverage For?
Currently Nationwide organises its pet insurance into three main categories: coverage for accidents, coverage for illness, and coverage for wellness.
Accident coverage is intended to provide for unforeseen injuries and incidents, and Nationwide gives examples such as broken bones, sprains, lacerations, and poisoning. Illness coverage may be applied to conditions such as allergies, ear infections, arthritis, and cancer, provided that the policy terms and exclusions allow it. Wellness coverage is meant for approved preventive care and not for the treatment of an accident or illness.
That distinction is important; a routine vaccination is different from treatment given after an injury and the two situations may be covered under different sections of the policy.
Accident Coverage
The coverage for accidents is meant to deal with unforeseen injuries or emergencies.
For example, if a dog is hit by a bicycle and needs an examination, diagnostic testing, medication, and treatment, the insurance company will reimburse the amount covered after the relevant deductible and coinsurance have been taken into account.
Broken bones, sprains, lacerations, and poisoning are given as examples by Nationwide of conditions which result from accidents and which can therefore be covered.
Illness Coverage
Illness coverage is intended to cover the cost of veterinary treatment when a pet falls ill.
Nationwide gives as examples allergies, ear infections, arthritis, and cancer. The veterinary costs that are covered will depend on the policy and may include those services which are involved in the diagnosis and treatment of a covered condition.
This is especially significant in the case of conditions that involve more than one visit to a vet. Yet the fact that the policy includes illness coverage does not mean that all medical conditions are automatically covered; exclusions in the policy, waiting periods, deductibles, the terms concerning reimbursement, and the coverage limits still apply.
Wellness and Preventive Care
Wellness insurance is different from traditional accident-and-illness insurance.
According to Nationwide, preventive care involves services like checkups, vaccinations, and measures to prevent fleas and ticks. However, wellness coverage will have to be chosen separately, depending on the plan you have.
A wellness plan can thus be useful when you want to have some coverage for foreseeable veterinary costs rather than just being protected against unexpected medical bills.
Before you enroll, make sure to examine the specific wellness benefits and their limitations; a policy might cover the cost of a certain preventive service without paying the full amount for that service.
Does Nationwide provide coverage for pre-existing conditions?
Usually, pre-existing conditions are not included in coverage.
Nationwide considers a pre-existing condition to be one that showed signs or symptoms, received veterinary advice, or was treated either before the policy took effect or during the waiting period. The company also states that in some cases conditions may be subject to review if they have been cured and have remained free from any treatment for a particular length of time, although in some instances chronic conditions will not be eligible for such a review.
For instance, if your dog had already been diagnosed with arthritis prior to you buying the policy, the treatment for that pre-existing condition would usually not be covered just because you then obtained insurance.
There is one reason why it is important to take into account the timing when taking out pet insurance: if you get the coverage after a medical issue has already occurred, that issue will not then be classified as a covered condition.
Can a veterinarian be used?
Nationwide states that its plans can be used with any licensed veterinarian, including specialists and emergency vets. The information provided to consumers also states that veterinary care can be obtained in the United States and in other countries, provided that the relevant policy terms apply.
This is in contrast to a traditional health insurance network in which you have to select from a list of participating doctors.
Yet it is necessary to differentiate between the possibility of visiting a veterinarian and having all the services covered. The fact that your veterinarian takes part in the plan does not cancel out the exclusions, limits, deductible, or reimbursement provisions of your policy.
How Does Nationwide Pet Insurance Reimbursement Work?
Normally, pet insurance works by you paying the veterinary practice and then sending in a claim for an eligible expense to receive reimbursement.
Nationwide states that, once the annual deductible has been reached, it will reimburse eligible expenses in accordance with the reimbursement percentage or benefit schedule chosen for the policy, provided that the applicable policy limit is not exceeded.
For instance, suppose your policy has a $250 deductible and offers 90% reimbursement; if the veterinary bill for your pet is covered, the deductible is deducted first and the amount left over is then reimbursed at the rate specified by the policy.
The amount that you end up receiving might differ from the straightforward percentage of the total invoice since certain charges may be excluded and there may be policy limits.
What are the primary exclusions?
Pet insurance does not aim to cover all the expenses that come with having a pet.
The current consumer information provided by Nationwide gives examples of expenses which are not covered, such as grooming, taxes, waste disposal, boarding, and pre-existing conditions; the specific exclusions vary according to the policy and the state.
The policies might also include waiting periods as well as further exclusions or underwriting requirements, and Nationwide recommends that policyholders check their declarations page and coverage form to see the exact terms of their plan.
This point is especially important in relation to conditions which have special waiting periods or restrictions; it is the policy documents—not a general description on the website—that determine what is actually covered.
How much does Nationwide pet insurance cost?
A single price does not apply to all pets.
The price of policies for new enrollees can vary according to a number of factors, such as the dog’s breed, age, the coverage chosen and the ZIP code; furthermore, other policy features, like the deductible and the coverage selections, could also influence the amount you have to pay.
It therefore makes no sense to compare the general advertised price with the quote you receive for your particular pet.
A young mixed-breed dog in one ZIP code can get a completely different quote from an older purebred dog in a different state. When the cost is your main consideration, it’s better to look at the actual quote and the coverage it provides rather than just considering the monthly premium.
What other benefits are available?
In addition to the basic insurance coverage, pet insurance available nationwide can include a range of other services.
For example, Nationwide states that its members have access to VetHelpline, which gives them 24-hour, seven-day-a-week video access to veterinary professionals. The company also provides PetRxExpress, which allows preferred pricing on eligible pet prescriptions at participating pharmacies. However, the availability and terms of these services may change and will differ from state to state.
They ought to be considered as extra benefits for members not as a substitute for thorough veterinary care.
A Simple Example of How Coverage Could Work
Suppose the cat of yours becomes ill and requires a number of visits to the vet.
The vet carries out an examination and takes some diagnostic tests, prescribes medication and suggests further treatment. When the condition is within the scope of your policy, you can have the eligible costs submitted for reimbursement.
Your final reimbursement would depend on factors such as:
- Whether the condition is considered pre-existing
- Whether the applicable waiting period has ended
- Your deductible
- Your selected reimbursement percentage or benefit schedule
- The policy’s coverage limit
- Whether individual services or charges are excluded
The fact that the veterinary invoice is $2,000 does not mean that Nationwide will reimburse a fixed percentage of the whole amount of $2,000.
Pros and Cons of Nationwide Pet Insurance
Pet insurance from Nationwide might be of interest to people who would like the option of customising their coverage and want to use their own vet who is licensed.
Possible advantages include:
- Accident and illness coverage options
- Optional wellness coverage on eligible plans
- Different deductible and reimbursement choices
- Access to licensed veterinarians rather than a restricted veterinary network
- Additional services such as VetHelpline and prescription savings programs
Probable drawbacks to consider:
- Pre-existing conditions are excluded
- Waiting periods and other restrictions can apply
- Not every expense on a veterinary bill is eligible
- Plan availability and features can vary by state
- Premiums depend on the individual pet and selected coverThe better choice is more based on whether the policy’s exclusions, limits, deductible, reimbursement structure, and price suit your circumstances than on the name of the insurer.tion.
Frequently Asked Questions
Does Nationwide pet insurance cover vaccinations?
Vaccinations may be included under eligible wellness or preventive coverage when that option is selected and available under the applicable plan. Wellness benefits have their own terms and limits.
Does Nationwide cover cancer treatment?
Cancer is among the illnesses Nationwide lists as an example of potentially covered conditions. Coverage is subject to the policy’s terms, including pre-existing-condition exclusions, waiting periods, limits, and other restrictions.
Does Nationwide pet insurance cover emergency vet visits?
Eligible veterinary expenses related to covered accidents or illnesses can include emergency care, subject to the policy terms. Nationwide says its plans can be used with emergency providers.
Does Nationwide pet insurance cover older pets?
Eligibility and available coverage can depend on the pet and the plan. Nationwide states that premiums and policy options can differ according to factors such as age, breed, species, coverage selected, and state. Check the current quote and policy terms for your pet.
Can I use Nationwide pet insurance with my regular veterinarian?
Yes. Nationwide says its plans can be used with any licensed veterinarian, including specialists and emergency providers.
The Bottom Line
Pet insurance available nationwide will pay for eligible veterinary bills resulting from accidents and illnesses, and in some cases will cover preventive care. However, the details are important since pre-existing conditions are usually excluded, the deductibles and the rules about reimbursement influence the amount you will receive, and the policy limits and exclusions can greatly alter the value of the plan.
Before buying, compare the actual quote for your pet and read the declarations page and coverage documents attentively. Pay particular attention to waiting periods, exclusions, annual limits, deductible, reimbursement percentage, and wellness benefits. Those details—not the headline description of the plan—tell you what your Nationwide pet insurance policy will actually cover.
