Pet insurance in Texas

What that means for you

Without the model law's standardized definitions, how a policy defines pre-existing conditions, waiting periods and exclusions can vary more between companies. Read the policy, not just the summary.

• How does the policy define a pre-existing condition, and can it ever be covered?
• How long are the waiting periods for accidents, illnesses and orthopedic conditions?
• Is there a per-condition, annual or lifetime limit?
• Are exam fees and prescription food covered?
• How are premiums expected to change as your pet ages?

Why Texas pet policies vary so much

In 2021 the Texas Department of Insurance amended 28 TAC §5.5002 to classify pet insurance as "non-regulated" inland marine insurance. TDI explained that this means pet insurance rules, rates and forms no longer need to be filed with or approved by TDI. Before the change, pet insurance rates and forms had to be filed and approved before use.

The same rule change allowed pet insurance to be sold as individual or group policies, which is why you may see it offered as an employee benefit. The upshot for shoppers is that TDI doesn't review the policy wording in advance, so comparing the actual policy documents matters more than it would for a filed product.

What TDI tells pet owners to check

TDI's own pet insurance tips focus on a few questions: how reimbursement works (most plans have you pay the vet and file a claim), whether the plan covers only accidents or also illnesses, whether it limits hereditary conditions for your breed, and whether you can use any vet. TDI also notes that pre-existing conditions are rarely covered, so the time to buy is before your pet gets sick or hurt.

Documents to read before you buy

Ask for the full policy, not just a summary or a quote page, and look for:

• The definition of a pre-existing condition, and whether a cured condition can ever become covered.
• Each waiting period, and whether orthopedic or cruciate ligament conditions have a longer one.
• How the deductible works: per year or per condition.
• Whether the insurer can raise rates as your pet ages, and whether there's an age cutoff for new enrollment.
• The cancellation and refund terms if you change your mind.

If a claim goes wrong

Pet insurance is still insurance regulated by TDI, even though its forms aren't filed. If an insurer denies a claim you think is covered, ask for the denial in writing with the policy language it relied on. If that doesn't resolve it, you can call TDI's consumer help line at 800-252-3439 or file a complaint online. Before buying, you can look up the company's Texas license on TDI's website.