Excess, co-payments and what these mean for you
We have added a requirement to have both an annual excess and a co-payment to your policy. As this is the first time we have both an excess and co-payment, we want to help you understand what the difference is between an excess and co-payment and how they work together when we reimburse you for a claim.
What is an excess and what are my options?
The excess that we have introduced is an annual excess. This is the amount that we will deduct (in total) when you claim for qualifying treatment before we reimburse you under your policy for each policy period. Your annual excess will apply again each policy year.
Options
We have 3 annual excess options for you to choose from - $100, $250 and $500.
An example of customer who might want to have a lower excess, is someone who wants to be reimbursed more for less expensive vet treatments as well as the larger unexpected claims, in exchange for a higher premium.
An example of a customer who might want to have a higher excess is someone who is comfortable to pay for less expensive vet treatment themselves, but is wanting to be reimbursed for the larger cost treatments, in exchange for a lower premium.
What is a co-payment and what are my options?
A co-payment is a percentage of vet charges that you agree to pay after the deduction of your annual excess. The level of co-payment that you choose will impact the amount you get reimbursed per claim, but also how much your premium will be.
Options
We have 3 co-payment options for you to choose from – 10%, 20% and 30%. The higher the co-payment you choose, the more it reduces your premium.
- An example of customer who might want to have a lower co-payment (such as 10%), is someone who wants to be reimbursed more for each claim they make, in exchange for a higher premium.
- An example of a customer who might want to have a higher co-payment (such as 20% or 30%) is someone who comfortable to pay a higher percentage themselves of each treatment their pet receives, in exchange for a lower premium.
We no longer offer a nil co-payment option.
How do the excess & co-payment work together?
When it comes time for you to make a claim, there are a few things you need to know.
Your annual excess will be applied to your claim first. Once your excess has been paid, then your co-payment will be deducted from each eligible claim before you get reimbursed.
Claim examples
We have pulled together a couple of examples below to help you understand how this works. These are illustrative only. The amount you would be reimbursed depends on your policy terms and conditions and the eligibility of your claim.
Example 1 - your claim is less than your annual benefit limit:
For example
Say you had a $100 annual excess and a 20% co-payment, and you claimed for $2,100 in vet charges. Here's how we would calculate your reimbursement:
- we would deduct your annual excess of $100 (leaving $2,000)
- we would deduct $400 for your co-payment (20% of the remaining $2,000)
- we would reimburse you $1,600.
excess
co-payment
(80% of claim)
Example 2 - your claim is higher than your annual benefit limit:
For example
Say your annual benefit limit was $5,000, with a $100 excess and a 20% co-payment and you claimed for $8,100 in vet charges.
Assuming this was the first claim in your policy period, here's how we would calculate your reimbursement:
- we would reimburse your full annual benefit limit of $5,000 (because $8,100 less your excess is $8,000, and 80% of $8,000 is $6,400, which is above your annual benefit limit)
- you would be responsible for paying the remaining amount.
