What the AVMA President Says Pet Insurance Actually Covers

Rising veterinary bills have made pet insurance a more visible topic for pet owners across the United States, but a recent interview with Dr. Michael Q. Bailey, a board-certified veterinary radiologist and president of the American Veterinary Medical Association (AVMA), lays out plainly what these policies do and do not do. Dr. Bailey pointed to two forces behind higher costs: everyday expenses like medications and labor have gone up, and veterinary medicine now uses advanced tools such as ultrasound, CT and MRI scanners that were once found only in human hospitals, extending pets' lives but adding cost.

He also described what he called the pet insurance gap, noting that fewer than 4% of dogs and cats in the U.S. are insured, based on data from the North American Pet Health Insurance Association. That leaves most owners exposed to sudden, large bills without a financial plan in place, often because they simply haven't discussed options with their veterinarian before a crisis hits.

A central point in the interview concerns exclusions. Dr. Bailey explained that most policies are built for new, unexpected medical problems rather than pre-existing conditions, meaning issues that existed before a policy began or before its waiting period ended. Categories like dental disease, prescription diets, behavioral treatment, alternative therapies, and hereditary or congenital conditions may only be covered under certain plans or as add-ons, so reading the fine print matters before an emergency, not during one.

He also flagged a lesser-known risk: switching insurers after a pet is diagnosed with a costly condition. A new insurer may treat that diagnosis as pre-existing, meaning related follow-up care, medications, and complications may not be covered going forward, even if the new plan has a lower premium.

For someone comparing providers, several practical takeaways emerge from this. First, understand the difference between a deductible, the amount paid before reimbursement starts, and the reimbursement level, the percentage of eligible costs paid after that deductible. Dr. Bailey suggested asking whether you could handle a bill of $500, $1,000, or $2,500 out of pocket, since that helps determine which deductible and reimbursement combination makes sense for your budget over the long term, not just in the first year.

Second, it's worth distinguishing wellness plans, which help spread the cost of routine care like vaccinations and cleanings, from actual pet insurance, which is meant for unexpected illness or injury. Relying on a wellness plan alone can leave an owner exposed to the larger, unpredictable costs that insurance is designed to address.

Finally, before signing up with any provider, Dr. Bailey recommended asking directly about exclusions, waiting periods, pre-existing condition rules, deductibles, reimbursement levels, and annual limits, and then discussing the results with your own veterinarian, who understands your pet's breed risks and medical history. There is no single plan that fits every pet, so comparing these specific terms across providers, rather than focusing on price alone, is the more reliable way to evaluate options.