How Much You Will Get Back?
Pet insurance companies usually determine how much to reimburse for a claim in one of two ways.
1. Under a Benefit Schedule
With a benefit schedule the pet insurance company decides in advance how much it is willing to reimburse for a diagnosis, regardless of what it cost you. The benefit schedule may not vary by geographic location and traditionally has not increased every year to take into account veterinary inflation.
If the benefit schedule is not updated, your reimbursement will shrink about 20% every three years.
2. Under UCR
UCR stands for "Usual, Customary, and Reasonable" and is a way of reimbursing claims based on the actual costs of procedures in a geographic area. Actual costs tend to recognize not only the relative veterinary costs where you live (for example, veterinary care in Manhattan is often much more expensive than in Cleveland), but it also allows for higher costs for emergency care (emergency facilities are usually more costly than your family vet clinic because they are 24/7 and 365 days a year), and veterinary inflation over time.
Embrace reimburses claims using the UCR method.
Benefit Schedules Can Reimburse Too Little
If you have a policy with a benefit schedule, you might be in for a surprise when you make a claim. Many pet parents are shocked when their claims reimbursement is much less than their veterinary bill. They had no idea their insurance would not recognize what they had actually paid. The benefit schedule limits their payout no matter what the veterinary bill was.
Usual, Customary, Reasonable is Fairer
UCR reimbursements are much more closely tied to your vet bill. They are less likely to give you a shock at claim time than a benefit schedule. For the current pet insurance policies on the market, your premium is usually higher for a policy with UCR benefits than one with a benefit schedule because you receive a higher claims payout.
More Information on Veterinary Fees
Many pet insurance companies, including Embrace, utilize the Veterinary Fee Reference Guide, 5th Edition, to help determine how much to reimburse. This guide compiles average veterinary fees on hundreds of procedures from thousands of veterinary hospitals across the United States.