Veterinarian FAQs
FAQ Sections
Enrollment
Coverage
Claims
VetsFirst
Enrollment
Q: Is there a waiting period for my client’s policy to become effective?
A: Once their application is complete and accepted by PetFirst Healthcare, there is a 14-day waiting period on illness protection. There is, however, no waiting period on accident protection or routine care coverage.
Q: Can you still enroll pets with pre-existing conditions?
A: Yes, we can enroll pets with pre-existing conditions, but those conditions should be disclosed at the time of enrollment. PetFirst will not provide coverage for treatment of any condition determined to be pre-existing.
Q: Do you insure other animals besides cats and dogs?
A: We exclusively insure dogs and cats.
Q: Must a pet be of a certain age before it can be enrolled for protection?
A: No. PetFirst offers a coverage option for pets of all ages.
Coverage
Q: Is coverage for routine care available?
A: Yes, Basic, Preferred and Preferred Plus plans include routine coverage.
Q: What is a pre-existing condition?
A: A pre-existing condition is any illness, accident or injury that has contracted, manifested or incurred prior to the effective date of your policy. Pre-existing conditions are not covered by PetFirst Healthcare plans.
Q: If my client purchases one kind of plan, can they upgrade to a higher level of coverage at a later time?
A: Yes, all plans can be upgraded at renewal.
Q: If I refer my client’s pet to a specialist, are the specialist’s services covered by PetFirst Healthcare plans as well?
A: Yes. PetFirst Healthcare plans offer coverage for treatment from any licensed veterinarian nationwide. This includes specialists and urgent care centers.
Q: Is there a multiple pet program available?
A: Yes, the Family Plan is designed especially for multi-pet households. With this option, pet owners can insure up to three pets under one plan for a fraction of the cost. Family coverage may include cats, dogs or a blend of the two.
Q: How are prescriptions and medications paid on your policy plans?
A: Medications are reimbursed according to the medical condition that has been diagnosed. Medication claims are considered a continuation of the original incident until the per incident maximum is reached.
Q: Are there ways to enhance a PetFirst plan?
A: PetFirst offers optional coverage riders for policyholders. Riders offer coverage for conditions related to breeding, hereditary, chronic and congenital conditions as well as prescription food.
Claims
Q: Is there a deductible or co-pay as part of the policy coverage provided by a PetFirst Healthcare plan?
A: There is a $50 or $100 deductible per incident for accidents and illnesses that must first be satisfied before claims are paid for veterinarian services to a pet owner. There is no deductible for supplemental benefits or routine care coverage. After the deductible is satisfied, PetFirst Healthcare plans pay 90% of any covered treatment and of any supplemental benefit.
Q: What is an incident?
A: A single incident can include several diagnoses. For example, if a pet has been hit by a car and incurs multiple injuries, each of these individual injuries would serve as a diagnosis, but all would derive from one incident.
Q: How long does it take to process a claim?
A: Our processing time is 10 business days once we have all of the needed information.
Q: How long does my client have to file a claim?
A: Policyholders have 90 days from the treatment date if claiming an accident, illness or routine care coverage. If filing a supplemental benefit claim, they have 90 days from the receipt date for services provided.
Q: Will my clients receive an explanation of how my claim was processed?
A: Policyholders will receive a letter explaining the conditions or treatments for which benefits were paid or denied. If the claim has been processed for payment, the letter will be accompanied by a claims check.
Q: Who is responsible for submitting pet insurance claims to PetFirst?
A: The pet owner has the responsibility of submitting claims by mail.
VetsFirst
Q: Is a minimum enrollment required to qualify for participation?
A: No. VetsFirst is available to clinics of all sizes.
Q: Can someone enroll in a plan or cancel their coverage at any time or is there a contract obligation? What happens in the event of a death of pet?
A: Policyholders may cancel anytime. In the event of the death of a pet, we request that the policyholder notify us in writing. They will receive a pro-rata refund.
Q: Are there any setup fees or administration fees for the clinic?
A: No, there is no cost to the veterinary clinic for participation.
Q: Can my employees use any veterinarian to be eligible for reimbursement from PetFirst?
A: Yes, PetFirst policyholders have the freedom to use any veterinarian nationwide – including emergency clinics and specialists.
Q: How are claims filed?
A: Policyholders may file claims via mail or claims may be faxed directly to PetFirst from the veterinary clinic.
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