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A Vet's Review of Nationwide 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 Nationwide, see
Nationwide's Comparison Sheet.
PLEASE NOTE
In the spring of 2024, Nationwide unexpectedly announced it was canceling 100,000+ policies.
This left a lot of pet owners in an extremely bad situation. Pet owners reported that they were not grandfathered into another policy with Nationwide.
This meant that any medical conditions covered under the canceled policy could be deemed pre-existing under a new policy within Nationwide or under a new policy with a different pet insurance company.
This may be okay for young pets with no conditions, but many people reported that their older pets with chronic incurable conditions were dropped.
None of this is acceptable no matter what reasons a company may give.
A pet owner needs to have assurance that the policy will be there for them for the life of their pet. Otherwise, what is the point of having pet insurance. Trust is earned, not given.
For these reasons, I cannot recommend Nationwide Pet Insurance at this time.
Nationwide acquired VPI in 2015. VPI was started in 1982.
This review
refers to the following dog and cat plans: Modular Pet Insurance Plan, Whole Pet and Major Medical. |
In general, the Modular, Whole Pet and Major Medical plans cover 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.
The way the Modular Pet Insurance Plan is structured, illness coverage is optional so you must make sure this box is checked to receive this coverage.
Dental coverage for accidents and illnesses is limited for all plans.
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Modular Pet Insurance Plan
The Modular Plan offers chronic diseases coverage and continual coverage for chronic conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
You must purchase accident AND illness coverage to get this coverage. The way this plan is structured, illness coverage is optional so you must make sure this box is checked to receive this coverage.
Whole Pet Plan
The Whole Pet Plan offers chronic
diseases coverage and continual coverage for chronic conditions
as part of the base policy as long as the condition is not
pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
Major Medical Plan
For the Major Medical Plan,
chronic diseases listed in the benefit schedule are covered,
as long as the condition is not pre-existing, has not occurred during
the waiting period, and you have not gone over the maximum benefit
allowance for the diagnosis/treatment for the year.
Unfortunately, the benefit schedule structure makes it too difficult
to determine how comprehensive the chronic disease coverage will be.
It would take too much time to check the benefit schedule against
every known chronic disease. It would be much easier for the consumer
if Nationwide stated which medical conditions are not covered.
The Major Medical Plan offers continual coverage for chronic diseases.
Coverage for chronic conditions in subsequent years is available up
to the benefit allowance for the diagnosis/treatment. Benefit schedule
allowances are reset every policy year.
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Modular Pet Insurance Plan
The Modular Pet Insurance Plan covers hereditary and congenital conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
You must purchase accident AND illness coverage to get Hereditary and Congenital coverage. The way this plan is structured, Illness coverage is optional and comes with removable Hereditary and Congenital coverage.
To get this coverage, make sure Illness AND Hereditary and Congenital coverage are selected. They should be by default, but double check.
Hereditary and Congenital conditions (including hip dysplasia) will only be covered up to $5,000/year.
Whole Pet Plan
The Whole Pet Plan covers hereditary conditions as long as the condition is not
pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
It is unclear if congenital conditions are covered.
It is not explicitly stated on the website or in the sample policy at the time of this writing.
Major Medical Plan
Monetary and medical coverage for hereditary and congenital conditions
is low for the Major Medical Plan
The Major Medical Plan does not cover congenital conditions and has
limited coverage for hereditary conditions.
With the Major Medical Plan, coverage for a certain number of specified
hereditary conditions becomes available after you've had the plan
for one year. The monetary limits on this coverage are $275 per policy
period toward diagnosis or medical treatment and $550 per policy period
for surgical treatment. Hip dysplasia is one of these covered conditions.
Hereditary and congenital is one of the important pieces of coverage that must be part of any pet insurance plan you purchase.
(See: 5 Points of Coverage Your Pet Insurance Plan Must Have)
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Modular Pet Insurance Plan
The Modular Pet Insurance Plan covers cancer conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
You must purchase accident AND illness coverage to get this coverage. The way this plan is structured, illness coverage is optional so you must make sure this box is checked to receive this coverage.
Also make sure the illness coverage has hereditary and congenital coverage selected as well otherwise cancers deemed hereditary/congenital in nature will not be covered.
Whole Pet Plan
The Whole Pet Plan covers cancer conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
Major Medical Plan
Cancers listed in the benefit schedule are covered, as long as the
condition is not pre-existing, has not occurred during the waiting
period, and you have not gone over the maximum benefit allowance for
the diagnosis/treatment for the year.
Again, the benefit schedule structure makes it too difficult to determine
how comprehensive the cancer coverage will be. It would be much easier
for the consumer if Nationwide stated which cancer conditions
are not covered.
If a cancer is shown to be due to hereditary/genetic reasons, there
is a possibility that it will not be covered.
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Modular Pet Insurance Plan
The Modular Pet Insurance Plan covers breed specific medical conditions as long as the condition is not pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
You must purchase accident AND illness coverage to get this coverage. The way this plan is structured, illness coverage is optional so you must make sure this box is checked to receive this coverage.
Since, many Breed Specific conditions can occur as Hereditary/Congenital, make sure the illness coverage has hereditary and congenital coverage selected as well.
Whole Pet Plan
The Whole Pet Plan covers breed specific medical conditions as long as the condition is not
pre-existing, has not occurred during the waiting period, and you have not reached your maximum payout.
However, it is unclear whether or not Breed Specific Conditions that are Congenital in nature are covered. It is not explicitly stated on the website or in the sample policy at the time of this writing.
Major Medical Plan
Breed specific medical conditions often occur as hereditary/congenital
issues. The Major Medical Plan does not cover congenital conditions and
has limited coverage for hereditary conditions, therefore coverage
for breed specific conditions is low.
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Modular Pet Insurance Plan
The maximum annual payout for Accidents is $2,500 or $5,000 AND the maximum annual payout for Illnesses is $5,000 or $10,000.
This may vary by state.
You will need to see what payout amounts are available in your state to decide if the payout options meets your "Worst Case Scenario Costs".
Note: Hereditary and Congenital conditions will only be covered up to $5,000/year.
Whole Pet Plan
The Whole Pet Plan has an annual maximum payout structure of $10,000. This maximum payout structure will
meet the needs of those whose calculated "Worst Case Scenario Costs" are $10,000 or less. (See: Picking
the Right Maximum Payout)
Major Medical Plan
The Major Medical Plan has a benefit allowance structure. This means
there is a benefit allowance that will limit what you will receive
for the medical condition's diagnosis and treatment each year. The
benefit allowance may be too low for those with high calculated "Worst
Case Scenario Costs". (See: Picking
the Right Maximum Payout)
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Summary of Coverage and Payout Structure
Limitations
Modular Pet Insurance Plan
- The way this plan is structured, illness coverage is optional. Make sure this box is checked to receive illness coverage.
- 12 month waiting period for cruciate and meniscal damage or rupture. After 12 months has passed, you must remember to call the company and apply for this coverage as it is not automatically attached to the base plan. (May vary by state)
- Bilateral Conditions Policy is not clear (See 'Concerns' section below)
- Hereditary and Congenital conditions (including hip dysplasia) will only be covered up to $5,000/year.
- Dental coverage for accidents and illness is unclear
Whole Pet Plan
- 12 month waiting period for cruciate and meniscal damage or rupture (May vary by state)
- Bilateral Conditions Policy is not clear (See 'Concerns' section below)
- It is unclear whether congenital conditions are covered
- Dental coverage for accidents and illness is unclear
Major Medical Plan
- No congenital coverage
- Limited hereditary coverage
- 12 month waiting period for cruciate and meniscal damage or rupture (May vary by state)
- 12 month waiting period for hip dysplasia (May vary by state)
- Bilateral Conditions Policy is not clear (See 'Concerns' section below)
- If a cancer condition is shown to be hereditary or genetic, there
is a possibility it will not be covered
- The payout structure for the Major Medical Plan may be to low for
those with high calculated "Worst Case Scenario Costs".
- Calculating the amount you will be reimbursed using the benefit schedule
can be confusing
- Dental coverage for accidents and illness is limited
Good Points
- Strong Underwriters
- You can use any licensed vet worldwide
Concerns
- I cannot, in good faith, recommend Nationwide Pet Insurance at this time. In the spring of 2024, Nationwide unexpectedly announced it was canceling 100,000+ policies. This left a lot of pet owners in an extremely bad situation.
Pet owners reported that they were not grandfathered into another policy with Nationwide. This meant that any medical conditions covered under the canceled policy could be deemed pre-existing under a new policy within Nationwide or under a new policy with a different pet insurance company.
This may be okay for young pets with no conditions, but many people reported that their older pets with chronic incurable conditions were dropped. None of this is acceptable no matter what reasons a company may give. What assurances do people have that this won't happen again? Absolutely none. A pet owner needs to have confidence that the policy will be there for them for the life of their pet. Otherwise, what is the point of having this insurance.
Nationwide needs to make this right for those that were hurt by this move. A company's slogan needs to be in alignment with their actions, otherwise they are just words.
- The bilateral conditions policy is not clearly defined. This provides a potential loophole a company can use to deny claims.
- The wording "whether or not the condition was ... diagnosed" in their pre-existing conditions policy may leave the door open for signs and symptoms to be used as reason to deny claims even when these previous sign or symptom is not directly related to the disease or condition currently in question.
- The way the Modular Pet Insurance Plan is structured, illness coverage is optional. This can lead to the consumer getting inadequate coverage. What the consumer feels should fall under the category of accidents and injuries isn't always how the insurance company sees it. (e.g. cruciate ligament injuries fall under the category of illness, not accident/injury)
- The Modular Pet Insurance Plan appears to use a utilization level factor when calculating initial/renewal premium pricing. Does this mean that premiums can increase based on the number of claims and dollar amount of claims filed?
- For the Whole Pet Plan, the website explicitly states that Hereditary conditions are covered. However, it is not explicitly stated on their website or sample policy that Congenital conditions are covered. I have concerns that by it not being explicitly stated it could be used to deem a condition pre-existing.
- It is not clear if the reimbursements are calculated by taking the deductible first or the reimbursement percentage first.
- Another concern I have is in regards to Nationwide's claim that they are the ones that issued the first pet insurance policy in 1982 to the dog playing Lassie at the time. The way they word it makes it seem as if they created the policy and issued it.
It was actually the leadership of VPI that created and issued this policy. Nationwide acquired VPI in 2015, but that is not the same as being the company that actually issued the policy. I truly hope that this is an honest mistake on the marketing department's side and not a form of marketing spin, as marketing spin breeds a lack of trust.
m.facebook.com/NationwidePet/photos/a.230393421318/10157721220216319/
www.linkedin.com/posts/heidisirota_nationwide-celebrates-40-years-of-pet-insurance-activity-6918204460527734784-s6zi?trk=public_profile_like_view
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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