Pet Insurance Reimbursement Explained
Reimbursement is one of the three dials that set your payout, alongside the deductible and the annual limit. The number itself is just the percentage of a covered bill the insurer hands back, after your deductible. But the model behind that number matters every bit as much as the percentage.
The formula
After a covered visit, the insurer takes the deductible off first (until it’s met for the year), pays its percentage of what remains, and counts that toward your annual limit. Put plainly: (covered bill minus deductible) times your reimbursement rate, capped at the limit. Not every insurer runs it in that order: Figo and Lemonade apply the percentage first and then subtract the deductible, which pays slightly less on a bill where the deductible isn’t yet met.
70, 80, or 90
The rate you pick trades off against your premium:
| Rate | You get back | Premium | Best for |
|---|---|---|---|
| 70% | Less per claim | Lowest | Keeping the premium down; can self-cover more |
| 80% | Balanced | Moderate | Most owners |
| 90% | Most per claim | Highest | Wanting the maximum back |
On a $2,000 bill with the deductible already met, 70% returns $1,400, 80% returns $1,600, and 90% returns $1,800. (Plug your own numbers into the reimbursement calculator to see the spread on a real bill.) On a big bill that spread is real money, and so is the gap in monthly premium. Pick based on whether you’d rather pay steadily (higher rate) or absorb more per claim (lower rate).
The benefit-schedule catch
Not every “reimbursement” is a true percentage of your bill, and this is where people get burned. Two models exist:
- Percentage of actual cost. The modern, usually-better one, you get your chosen percentage of the real bill.
- Benefit schedule. The older one, the insurer caps the payout at a fixed dollar amount per condition or procedure, regardless of what the vet charged.
Under a benefit schedule, a plan can advertise “90%” and still pay far less than 90% of your real bill if the scheduled cap is low. So confirm the plan reimburses a percentage of your actual cost, not off a fixed schedule. It’s the single most important thing to check here.
What to pick
A high reimbursement rate stacked on a very high deductible can still leave you paying a lot on smaller bills, so balance all three: the deductible (what you pay first), the rate (what comes back after), and the annual limit (the ceiling). Get those working together and the payout lands where you expect. For most people, 80% on a percentage-of-cost plan is the sweet spot, strong reimbursement, sensible premium, no nasty schedule surprises. If the premium still feels high, the cheaper pet insurance guide covers the other levers.
Frequently asked questions
What reimbursement rate should I choose?
80% is the common middle ground. Go 90% if you want the most back and can take the higher premium; go 70% to keep the premium down if you can absorb more of each bill yourself.
Is reimbursement calculated before or after the deductible?
After. The insurer takes the deductible off the covered amount first, then pays its percentage of what's left, up to your annual limit.
What is a benefit schedule?
An older payout model that caps reimbursement at a fixed dollar amount per condition or procedure, no matter your actual bill. True percentage-of-cost reimbursement is usually better and more predictable.
This article is general information, not insurance or veterinary advice. Coverage, prices, and terms vary by insurer, pet, and location. Always read the policy and confirm details with the provider before buying.