Frequently Asked Questions
A waiting period helps to ensure that a pet is healthy at time of enrollment and not awaiting care for a current or pre-existing injury or illness. Any such injury or illness would be excluded under PHI Direct’s eligibility requirements.
Does PHI Direct pay the veterinarian directly, or do I have to pay the veterinarian first before being reimbursed?
Under normal circumstances PHI Direct clients initially pay for their veterinary services and then are reimbursed promptly, usually within 10 business days or less. Many people pay with a credit card and are reimbursed long before their monthly credit card payment is due. For larger procedures however, arrangements can be made to have PHI Direct pay the veterinarian directly. If you wish for us to pay the veterinarian directly, please complete the Pay Practice Direct form and submit a request by following the Claims & Forms page: https://www.phidirect.com/claims-forms.
On the anniversary date the policy will renew and can continue to be used for any accident or illness that isn’t listed as a pre-existing condition on the policy. This includes A) Any pre-existing conditions you disclosed prior to enrolment or B) Any conditions you claimed in the previous year that are now considered pre-existing conditions upon policy renewal. You will be advised in advance of your annual renewal date. A new policy will be issued upon renewal.
The average claims turnaround is less than 15 days from submission. This is for straightforward claims. If it is more complex, it may take more time due to the additional follow-up with the veterinarian that may be required.
Your premium will be determined based on factors including your pet’s age, species, breed and where you live. Costs to provide veterinary care vary widely across the country which impacts the cost of insurance. Quotes are free and immediate. Quote prices can change periodically. You can save your quote for 30 days during the quote and enroll process.
A deductible is the fixed amount of your eligible expenses which you are responsible for paying, and which is deducted from your claim reimbursement after co-insurance has been applied. All PHI Direct policies have an annual $200 deductible. Once this $200 has been satisfied each year, no further deductible is applied for the remainder of the policy year.
No, your renewal won’t be denied. However, any injury or illness that occurred up to the renewal date will be considered pre-existing for the next policy year and all subsequent years. Any new conditions that occur after the renewal date are eligible for coverage for the balance of the new policy year.
You can decrease your annual policy limit at any time. Any change will take effect on your next policy monthly billing date following the date we receive you change request. Any conditions being diagnosed and/or treated at the time of change will then only be reimbursed up to the lower coverage amount. You can increase your annual policy limit at any time during the first 30 days from the date you purchased your policy, or during the open enrollment period, which is the first 30 days after your policy anniversary date. If you increase your annual policy limit, and you have any conditions being diagnosed and/or treated at the time the increased annual policy limit is purchased, the coverage applicable to those conditions will remain at the lower coverage amount.
No. Your premium will not increase if you submit a lot of claims. Other pet health insurance companies almost always consider a pet’s claim history when determining the premium upon renewal. A pet who has had many claims, or large claim amounts, would generally expect to have their premium increased to offset these costs incurred by the insuring company. This is referred to as claims risk management (CRM). However, this is not the PHI Direct approach and so your pet’s claim history will not affect your future premium.
One factor we do consider that applies to all the pets we insure is the 'cost of living' increases within veterinary medicine. Every year the costs to provide good quality veterinary medicine may increase and it is this percentage increase that is taken into consideration when the annual premium is determined.
One factor we do consider that applies to all the pets we insure, is the increasing cost of veterinary medicine due to advances in veterinary medicine and the increasing costs of running a veterinary hospital.
A Time-Limited policy offers coverage for accidents and new illnesses your pet may experience for up to one year. Your pet will be covered up to the anniversary date of your policy’s issuance date after the condition is first noted by you or your vet. If a claim is made for a condition which occurred during a policy year, this condition, if it is otherwise eligible for coverage, will have coverage up to the policy limit and until the policy anniversary date (the renewal date). Once the policy limit has been reached, or the policy anniversary date has been reached, upon renewal this specific illness, injury or condition will no longer be eligible for coverage in the following policy year. An exclusion regarding that illness or injury will then be applied to your policy, as it is now considered a pre-existing condition.
Your pet will only be eligible for diagnosis and treatment of that condition for the remaining time left in that policy year and the remaining monetary amount of insurance coverage for that policy year. This condition will not be covered in the next year, as this will now be considered a pre-existing condition.
Updating your profile, including your mailing address is simple and easy through our online member portal (coming soon) or contacting the PHI Direct Customer Care Team. However, your premiums may change, based on your new location. Because the cost to provide veterinary care varies significantly across the country, where you live is one of the key factors in determining your premium. You will be notified if it does, and the change will take effect on the next billing date.