What a pet insurance policy pays is decided in three places: the policy’s own wording, the insurer’s decision on each claim, and, in some states, a pet insurance statute. There is no federal pet insurance law. As of 12 November 2026, 15 states have a statute in force that gives the buyer of a new policy a set number of days to return it for a refund and limits how long a policy can make you wait before cover starts.
General information about costs, insurance and the rules, not veterinary, legal, insurance, tax or financial advice. Your vet decides what care is right for your pet; your policy’s wording and your insurer decide what a claim pays; your card or loan agreement decides what credit costs. It is not a substitute for the advice of an attorney.
Every rule and figure below comes from the five guides in this section, each cited there to its source, read 12 November 2026. Insurers are named only as publishers of public sample policies; we don’t rank or recommend any.
The reading path
- You want to know what a policy pays for: start with what pet insurance covers and excludes.
- Your dog or cat is no longer young: read pet insurance for older pets.
- You have a vet bill to claim, or a claim was cut or denied: go to how a pet insurance claim works.
- You want the law where you live: the table of pet insurance laws in all 50 states and DC has each state’s statute and start date.
- You are thinking of handing a policy back: read cancelling pet insurance and the free look first.
If the deductible, the reimbursement percentage and the limits are new to you, our section on how pet insurance works comes first.
What a policy covers, and what it leaves out
A standard accident and illness policy pays toward finding and treating a new accident or illness: tests, surgery, hospital stays and medicines. It does not pay for conditions the pet had before the policy began, and it usually leaves out routine care unless a wellness add-on is bought.
The coverage guide counts what four insurers’ public sample policies say (read 12 November 2026). Four documents are examples, not the market:
- Pre-existing conditions are excluded in all four.
- Exam fees for a sick or injured pet are covered in one, excluded in one and an optional extra in two.
- Teeth cleaning is excluded in three. Dental disease is covered with conditions in two, excluded in one and not addressed in one.
- Spaying and neutering, and vaccines, are excluded in three (in one of them unless a wellness rider is bought).
What an accident-only policy leaves out, and how wellness plans work, have their own pages.
No federal law, and no state pet insurance statute we read, sets what a policy must cover. Nebraska’s act says nothing in it “shall prohibit or limit the types of exclusions a pet insurer may use” (Neb. Rev. Stat. 44-6503(2), read 12 November 2026). What they require is disclosure, including which conditions are excluded and the formula used to work out a claim payment (Neb. Rev. Stat. 44-6505(1) and (3), read 12 November 2026). The summary goes in a separate document titled “Insurer Disclosure of Important Policy Provisions” (44-6505(8)).
Older pets: age limits, price and the pre-existing rule
An older dog or cat can usually still be insured, but three things change. Some insurers stop taking new pets at a set birthday or offer them accident-only cover. The price depends on age and, in the policies we read, can rise at each renewal. And a longer vet record means more can fall under the pre-existing exclusion.
No state law we read sets an enrollment age, caps a premium rise or requires an insurer to renew. What the 15 states do require is that the insurer discloses whether it raises premiums because of the pet’s age, and 14 of them bar it from requiring a vet exam before it renews a policy (we found no such sentence in Ohio’s chapter 3970). That is a duty to tell you, not a limit.
The guide gives each state’s section. The definitions are on our page about pre-existing conditions.
Claims: paying first, direct vet pay and denials
With most pet insurance you pay the vet in full, send the insurer the itemized invoice and your pet’s records, and the insurer pays you back the covered part: minus your deductible, at your reimbursement percentage, up to the policy’s limit. “Direct vet pay” changes only where the insurer’s money goes. The clinic has to agree to wait for it, and you still owe the clinic everything the policy does not pay.
The time limit for sending a claim is in the policy. Among the six public policy documents the claims guide read on 12 November 2026, one sample sets 90 days after the date of service (MetLife Pet, form PET21-01-V) and others set 180 days (the Pets Best booklets; Physicians Mutual, form P970). These are examples, not a rule. None of the state pet insurance statutes we read sets a claim-filing deadline or says how fast a claim must be paid.
The pet insurance payout calculator runs both orders of deductible and percentage on your own bill, and how pet insurance pays explains each term.
If a claim is cut or denied
- Ask for the reason in writing and the policy provision relied on.
- Use the appeal step in your policy, inside its own time limit.
- Contact your state insurance department. The NAIC keeps a directory of state insurance departments.
Where the reason is a pre-existing condition and a pet insurance statute applies, the proof is the insurer’s to carry. Nebraska’s reads: “The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made” (Neb. Rev. Stat. 44-6506(1), read 12 November 2026). That does not mean a claim has to be paid, and we cannot tell you whether a denial is right.
What state law adds
The 15 states are named in the free look line below. Each statute was read in official text on 12 November 2026, except New Hampshire, read in an archived copy of the official text dated 17 December 2025. The common parts:
- A free look. 10 days in Maryland (with a pro rata refund), 15 days in Louisiana, Maine, Montana, Rhode Island and Washington, and 30 days in Delaware, Florida, Hawaii, Nebraska, New Hampshire, Ohio, Pennsylvania and Vermont; California says at least 30. The count starts when you receive the policy (in Maryland, when it is delivered).
- Waiting-period limits. All 15 bar a waiting period for accidents and cap it at 30 days for an illness or an orthopedic condition that does not result from an accident. The cover-start checker sets a policy’s waits beside the state’s limit.
- Pre-existing conditions. None of these laws bans the exclusion. They put the burden of proof on the insurer, and most say a condition the policy covered can’t become pre-existing at renewal.
Mississippi has a law that only requires disclosures. New Jersey’s law (P.L.2025, c.224) starts on 1 January 2027. New York’s bill was not law when we checked on 12 November 2026, Illinois has no pet insurance law, and Tennessee’s older section could not be read in current official text. In 30 more states and the District of Columbia we found no statute like these (from the NAIC’s Summer 2026 adoption chart, not a search of each code); there the policy, general insurance law and the insurance department decide.
Cancelling, and the free look
A free look is a right to hand a new policy back shortly after you get it and have premium returned. Two points change the answer most often:
- A claim can end it. In 12 of the 15 states the right is gone once a claim has been filed under the policy; Maryland and Ohio word it as a claim having been “made”. California’s section takes it away when the insurer has paid a claim or said in writing that it will (Ins. Code 12880.2(j)(2)(C), read 12 November 2026).
- Maryland returns a share, not the whole premium: “a pro rata premium for the unexpired term of the policy” (Md. Code, Ins. 19-1104(b)(1)(ii), read 12 November 2026).
After the free look, or where there never was one, no pet insurance statute read for these pages sets the refund: the policy’s cancellation clause does. A policy bought later is a new policy with a new effective date, so its waiting periods and pre-existing definition are measured from then. Whether to keep, cancel or switch a policy is your decision.
Sources checked on 12 November 2026, as cited on the pages linked above: the state statutes, the NAIC model act (paraphrased by section) and the public sample policy documents named on each page. Insurers revise their forms without notice.
