Will I have to provide client medical records to PurinaCare®?
Not ordinarily. In some cases, we may request medical records to clarify pre-existing conditions. We may also request medical records in some cases to assist with claims processing. Our goal is to make sure that all policyholders receive the maximum benefits available under their plan while minimizing any paper work on the part of the provider.
Are there any waiting periods after my client signs up before the policy is in effect?
Dogs and cats under 8 weeks of age are not eligible for coverage.
Afterwards, there are waiting periods for some kinds of care. There’s no waiting period for preventive care if your client has a PurinaCare® Plus Preventive Care policy. Your client can submit claims for covered preventive services that occur on or after the policy effective date.
There’s a 48-hour waiting period after the policy effective date for accident coverage and a 14-day waiting period for claims as a result of illness.
What is excluded under PurinaCare® policies?
Like all insurance, there are exclusions from coverage under PurinaCare
®. Items excluded under PurinaCare
® include, but are not limited to, the following:
- All pre-existing conditions
- Breeding, fertility and pregnancy
- Alternative Care – unless prescribed and performed by a licensed veterinarian in a clinical setting
- Cosmetic and elective procedures (spays and neuters are covered under PurinaCare® Plus Preventive Care policies)
- Training – even if prescribed or performed by a licensed veterinarians
- All pet foods for any reasons
- All nutritional supplements, vitamins, nutriceuticals, holistic medications, herbs, and natural remedies for any reason even if prescribed by a licensed veterinarian
- Grooming and bathing for any reason
- Preventable conditions are excluded if the policy holder does not provide vaccinations and other preventive care according to their veterinarian’s recommendations.
- Accidents or Injuries intentionally inflicted or intentionally caused by the policyholder
- Dogs and cats under eight weeks of age
- Accidents that occur before 12:01 am on the third day following the effective date of coverage
- Illnesses that manifest themselves before 12:01 am on the 15th day following the effective date of coverage
Sample policies are available at
PurinaCare® plus Preventive Care SAMPLE Policy and
PurinaCare® without Preventive Care SAMPLE Policy, but please refer to actual policy for complete terms, conditions, limitations and exclusions.
How does my client file a claim, and what assistance does the veterinary office need to provide?
Filing a PurinaCare® claim is easy. Your client simply prints out the one page claim form from our website before they bring their pet in for veterinary care. The client fills out the section at the top and your office fills out the rest, including a diagnosis (or clinical signs if a diagnosis is not available). Your client then sends the claim to us along with a copy of your receipt or invoice, keeping a copy for themselves. We pay eligible completed claims as quickly as we can.
Do we have to wait until my client is reimbursed to receive payment for services?
No. The client pays you directly at the time the pet receives care.
Is there a maximum amount for certain claims?
How long does it take for my clients to get reimbursed?
Our goal is to process all eligible completed claims as quickly as we can.
Are clients limited in their choice of veterinarians?
No. A client can choose any veterinarian licensed in the state in which the services were performed.
Is a referral needed to see a board certified veterinary specialist?
No.
Is PurinaCare® like an HMO?
No. PurinaCare® is pet health insurance. We will not attempt to negotiate fees with veterinary service providers.
Are there fee limits for routine annual services covered under a PurinaCare® Plus Preventive Care policy?
Yes, we used recent fee surveys from reputable national veterinary associations to help establish our reimbursement guidelines for routine preventive care procedures like vaccinations, flea control, physical exams and spays and neuters. In many cases, our fee limits actually exceed these guidelines. Our objective is to encourage clients to seek and obtain the latest and best available routine preventive care, not to set fees for these important procedures. Sample policies are available at
PurinaCare® plus Preventive Care SAMPLE Policy and
PurinaCare® without Preventive Care SAMPLE Policy, but please refer to actual policy for complete terms, conditions, limitations and exclusions.
Does PurinaCare® utilize a benefits schedule for claims not related to Preventive Care?
You say you cover hereditary conditions. Wouldn’t those be excluded as pre-existing conditions?
We cover hereditary conditions that have not manifested or been diagnosed prior to the effective date of the policy or otherwise met the requirements of a pre-existing condition under the terms of the policy.