Choosing a reimbursement rate
Reimbursement is the share of the eligible bill the insurer pays after your deductible. Moving from 70% to 90% raises your premium by a modest amount and cuts your share of every large claim by two thirds. Which one wins depends on a single threshold — and it is lower than most people expect.
Illustrative comparison
$500 annual deductible, $10,000 limit. Premium differences shown reflect the typical $5–$8 per month step between tiers.
| Rate | Monthly | Your share of a $4,000 bill | Total cost, $800 year | Total cost, $4,000 year |
|---|---|---|---|---|
| 70% | $68 | $1,550 | $1,406 | $2,366 |
| 80% | $74 | $1,200 | $1,448 | $2,088 |
| 90% | $80 | $850 | $1,490 | $1,810 |
| 100% | $86 | $500 | $1,532 | $1,532 |
The threshold
In this example every step costs about $72 a year and buys an extra 10 points of payout on everything above the deductible. The arithmetic therefore has one answer:
10% of (annual bills − deductible) = $72 → bills of about $1,220.
Below roughly $1,200 of eligible bills a year, the cheapest rate wins. Above it, the highest rate wins — and the gap widens quickly, because the extra premium is fixed while the extra payout scales with the bill.
How to decide
- Estimate your pet’s likely annual eligible spending. Use the breed guide for a starting range, then adjust for age and any past history.
- If the estimate is above about $1,200, take 90%. Below it, take 80% and put the saving aside.
- Take 100% only when the premium step is small. The last 10 points are usually the most expensive per point of coverage, because the insurer is absorbing the entire deductible-adjacent cost.
- Check whether the rate applies before or after the limit. Some policies apply the limit to the gross bill, which effectively reduces your rate.
Questions
Is 100% reimbursement always the best?
No. It is the most expensive tier and, on policies with a low annual limit, buys nothing extra. It makes sense for owners of high-risk breeds with an unlimited limit who know they would treat aggressively.
Does the reimbursement rate apply to the exam fee?
Usually yes, if the exam is part of an illness claim rather than a routine visit. Routine exams are normally excluded entirely, so the rate never applies to them.
Can I lower the rate later to save money?
Often yes at renewal. Raising it later is harder: any condition diagnosed in the meantime is typically excluded, so the upgrade covers less than it appears to.
What about a per-condition limit?
Treat it as a second cap. A policy with unlimited annual cover but a $2,500 per-condition limit will not pay a $6,000 cancer course in full, whatever the reimbursement rate says.