A Vet's Review of MetLife Pet Insurance
2024

by Frances Wilkerson, DVM

This review discusses the 5 important pieces of coverage and payout structure

To get the most from this review, please read the Guide to Pet Insurance first.
For a detailed look at MetLife, see MetLife's Comparison Sheet.



Overview

Started as PetFirst Pet Insurance Company in 2004. PetFirst became MetLife Pet Insurance in 2020. This review refers to the following plan: MetLife Accident and Illness Plan


Coverage Overview

In general, MetLife Pet Insurance covers examinations, diagnostics and lab tests, surgery, treatments, hospitalization, and prescription medications for accidents/injuries and illnesses as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.

Dental coverage for accidents and illnesses is limited.


Coverage For Chronic Diseases & Continual Coverage For Chronic Diseases

MetLife Pet Insurance covers chronic diseases and provides continual coverage for chronic conditions as long as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Hereditary & Congenital Coverage

Hereditary, congenital, breed-specific and genetic conditions are covered by MetLife Pet Insurance as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Cancer Coverage

MetLife covers cancer conditions as long as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout limit.



Coverage For Breed Specific Conditions

MetLife covers breed specific medical conditions, as long as your pet is not showing signs and the disease has not been diagnosed or suspected prior to enrollment or during the waiting period.



Maximum Payout Structure

MetLife has an annual maximum payout structure.

Depending on the state you live in, the maximum annual payout options range from $500−$25,000 in $1,000 increments. An Unlimited option may be available in some states.

You will need to see what payout amounts are available in your state and decide if a payout option meets your "Worst Case Scenario Costs". (See: Picking the Right Maximum Payout)


Summary of Coverage and Payout Structure

Limitations

  • For policies underwritten by Independence American Insurance Company:
    There is a 6 month waiting period for Intervertebral Disk Disease and Cruciate Ligament conditions. (May vary by state)
  • Their bilateral conditions policy is not clear at the time of this writing.
  • The full extent of dental coverage for accidents and illnesses not clear at the time of this writing.


Good Points

  • Strong underwriter
  • According to their website (at the time of this writing), they "...provide coverage for pre-existing conditions that were covered by a previous insurance provider." Contact the company to get a complete description of what would and would not be covered in this situation.


Concerns

  • In MetLife's sample policy it states, "...we may only cancel for one or more of the following reasons:...3. We have agreed to issue a new policy with the same or an affiliated company."

    Contact the company for clarity on what this means and whether your terms, conditions, and rates will stay the same as your original policy if they institute this reason for canceling your policy.

    After Nationwide unexpectedly announced the cancellation of over 100,000+ policies in the spring of 2024, it's important to have clarity in this area.
  • Based on their pre-existing conditions policy, signs and symptoms can be used to denote something as pre-existing. As with all pet insurance companies that use this wording, I have concerns that this can be used to deny claims even when these previous signs/symptoms are not directly related to the disease or condition currently in question.
  • Their bilateral conditions policy is not clear at the time of this writing.
  • It is not clear how reimbursements are calculated. (e.g. UCR vs Actual Bill) and (Is deductible applied before or after applying the reimbursement percentage?)



Additional Comments Regarding All Pet Insurance Companies:

  • Make sure you research what customers are saying about the company. A company may have the 5 components that should be part of a pet insurance plan, but the company may not be a hit with customers. Sites to check include but are not limited to BBB.org, Yelp.com and PetInsuranceReview.com. Things to look for include but are not limited to: How fast are payments paid?, What are customers saying about the pre-existing conditions policy?, How often are claims denied and for what reason?, What is the customer service experience like?, Are there issues with premium increases?
  • Check with your state's Department of Insurance to see if any complaints have been filed for the company you are interested in.
  • Make sure you understand what the waiting periods are.
  • Make sure you understand their bilateral conditions policy.
  • Make sure you understand any requirements that you must adhere to to maintain coverage.
  • Make sure you read the terms and conditions to get a thorough understanding of all exclusions.
  • Make sure you understand when and by how much your premium can increase.
  • If you change plan levels, there is a possibility that all medical conditions present under the old plan will be considered pre-existing in the new plan. Make sure you ask the company if this is the case.
  • For some companies, pre-existing conditions can be based on signs and symptoms alone, a diagnosis is not needed. For example, if your pet had a cough before you applied for pet insurance and this cough was discussed and written in the pet's medical record, there is the possibility that all future cough conditions, no matter what the cause, would be considered pre-existing - even if there was no treatment given. Make sure you ask the company if this is the case.
  • Pet insurance companies are businesses. The top priority of any business is to make a profit for their stakeholders. Pet insurance companies can and may change your rates and terms to meet that top priority. A change of business ownership or underwriters can also be a catalyst for changes in your rates and terms.

    When you purchase pet insurance make sure you have a realistic understanding of this and how it can affect you.


Additional Reviews:

24PetProtect | AKC | ASPCA | Bivvy | Companion Protect | Doggo | Embrace | Felix | Fetch | Figo | Hartville | Healthy Paws | Lemonade | Liberty Mutual | ManyPets | MetLife | Nationwide | Odie | Petco | Pet Partners | Pets Best | Physicians Mutual | Prudent Pet | Pumpkin | Spot | Toto | Trupanion | Wagmo


**Disclaimer: This review is meant to supplement, not replace your own due diligence. Terms and conditions can vary from state to state. Before buying a pet insurance plan, confirm all information by contacting the company or reading the most current policy for your state. We will not be held liable for errors or omissions. If you see something that is incorrect or needs clarifying, please let me know.

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