You will only need to pay the annual deductible if you are reimbursed for a claim in a policy year.
If your pet doesn’t have any new unexpected illnesses or accidents and you do not file any eligible claims in a policy year, you will not have to pay the $200 annual deductible. You will only need to satisfy your annual deductible if you submit an eligible claim for your pet.
Helpful Deductible Scenarios
- You file a claim and it is denied: If you file a claim and it is not eligible for coverage, you are not required to pay towards the $200 deductible.
- You file a claim for more than a $200 vet bill and it is approved / covered: If your pet has a new unexpected illness or accident and it’s over $200, submit a claim for this condition and you will get 80% reimbursement for the eligible vet bills, after you’ve satisfied your $200 deductible. For instance, if you have a $300 eligible vet bill then $200 will go towards the deductible and of the remaining $100 you will be reimbursed 80% or $80.
You will only need to satisfy the deductible once in a policy year. Therefore, if your pet experiences another eligible condition in that policy year, you will not need to pay the $200 deductible again. You can view examples of how this works in our sample policy. - You file a claim for a $150 vet bill and it is approved / covered: If your pet has a new unexpected illness or accident but it is under the $200 annual deductible amount, please still submit a claim for this as we keep track of how much of your deductible you’ve paid toward in a given year. This way, if you need to submit another claim for your pet in that policy year, you will already have some or all of your deductible satisfied, so we can start paying out sooner.
For example: PHI Direct member, Luna, ingests a toxic plant and her guardian brings her to the vet. After the vet’s diagnosis and treatment for Luna, the bill is $180 in eligible expenses. Luna’s pet guardian submits the vet bill to PHI Direct even though they know they won’t get reimbursed for it.
If Luna experiences another new illness or accident during this policy year, her pet guardian will only need to satisfy $20 of the remaining $200 deductible and then PHI Direct will start paying out at an 80% reimbursement level.
If Luna’s pet guardians hadn’t submitted this previous $180 claim, PHI Direct would not have known this was already satisfied and they would need to satisfy the $200 deductible for any new illnesses or accidents in that policy year.