A Vet's Review of Wagmo Pet Insurance
2024

• 6 month waiting period for damage or rupture of cruciate ligaments, luxation of the patella or other soft tissue disorders of any knee.
  
  While the orthopedic waiting period can be waived with a healthy orthopedic exam completed within the first 30 days of policy period, please note that a Vet may want additional diagnostics (e.g. x-rays, ultrasound, etc) before they will feel comfortable certifying this. The cost of this will be out of your own pocket.
• If a cruciate or soft tissue knee injury happens on one side before they policy starts or during the 6 month waiting period, and appropriate treatment has not been performed, the other knee is automatically excluded from coverage. Once appropriate treatment has been performed, the other knee is excluded from coverage for a period of 6 months from date of last treatment of the originally affected knee.
• It is not clear if Cancer conditions are covered. Wagmo's FAQ section states Cancer is covered with a 30 day waiting period. However the sample policy, under exclusions, it states that Cancer is not covered.
• Only covers 50% of prescription drug costs
• Hip Dysplasia coverage is only available to pets under 6 years of age.
• Dental coverage for accidents and illnesses is limited.
• Your premium can increase based on your claim submission history.

• Strong underwriter
• In their policy they state, "If You choose to increase Your coverage, then any Illness or Injury Your Pet had, or any Illness or Injury that first showed Clinical Signs before the change was made will be subject to the Annual Benefit in place at the time the condition was first diagnosed or showed Clinical Signs." I take this to mean that those conditions will still be covered, just at the original Annual Benefit. If this is true, this is a welcomed feature. For many of the pet insurance companies out there, if you increase your coverage, a new policy will be created and all conditions that were covered under the old policy will be deemed pre-existing in the new policy.
• Reimbursements are calculated by subtracting the deductible before applying the reimbursement percentage.

• In Wagmo's sample policy it states that they may cancel or non-renew your policy if there is "...A substantial change in the condition, factor or Loss experience material to insurability". Contact Wagmo for information on the specific reasons they may cancel a policy. Given that Nationwide unexpectedly announced the cancellation of over 100,000+ pet insurance policies in the spring of 2024, it's important to have clarity in this area.
• Based on their pre-existing conditions policy, clinical signs 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 are not directly related to the disease or condition currently in question.
• It is not clear if cancer conditions are covered. Wagmo's FAQ section states Cancer is covered with a 30 day waiting period. However the sample policy, under exclusions, it states that Cancer is not covered.
• It is not clear if bilateral conditions are treated as one condition when it comes to their Per-Incident Maximum Payout structure.

• 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.

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