What each plan covers
| Accident only | Accident and illness | |
|---|---|---|
| Covers | Injuries and emergencies from unexpected events: foreign body ingestion, lacerations, motor vehicle accidents, ligament tears, poisoning. | Everything in accident-only, plus illnesses such as cancer, infections and digestive problems. |
| Does not cover | Illnesses. | Pre-existing conditions and other exclusions listed in the policy. |
| Average annual premium, dogs (2025) | $190 | $836 |
| Average annual premium, cats (2025) | $112 | $435 |
The definitions come from NAPHIA's industry report. The average gap is about $646 a year for a dog and about $323 for a cat.
What the claims data suggest
NAPHIA lists the most common medical conditions in its members' 2025 claims. Among the most common for dogs are gastrointestinal problems, ear infections, skin conditions, anxiety or behavioral and neurological conditions, and allergies. For cats they include gastrointestinal problems, dental disease, urinary tract infections, anxiety or behavioral and neurological conditions, and respiratory problems.
Many of these are illnesses rather than accidents, and an accident-only plan would generally not cover them. This is not proof of what any single plan pays, because coverage rules differ by insurer, but it explains why an accident-only plan protects against only part of the risk.
What about wellness plans?
Wellness coverage is a separate matter. It usually reimburses a set list of routine services, such as vaccines or checkups, up to a fixed amount each. It is available as an add-on or embedded in a plan. Because it pays for predictable costs, it is not insurance in the usual sense, and NAIC's model act requires wellness programs to be clearly distinguished from insurance policies. Plans with embedded wellness averaged $1,414 a year for dogs and $859 for cats in 2025.
How to choose
- Accident-only can suit you if your budget is tight and you mainly want protection against a big, sudden injury bill.
- Accident-and-illness can suit you if you want protection against costly illnesses such as cancer or chronic conditions, and can afford the higher premium.
- Whichever you choose, compare the deductible, reimbursement rate and annual limit as well as the plan type.
- Coverage for a condition only helps if it is not excluded as pre-existing, so buy before symptoms appear. See waiting periods and pre-existing conditions.
Frequently asked questions
Does accident-only insurance cover cancer?
No. Cancer is an illness, and accident-only plans cover injuries from unexpected events. Illnesses such as cancer are covered by accident-and-illness plans, subject to the policy's exclusions.
How much cheaper is accident-only?
In 2025 the average accident-only premium was $190 a year for dogs and $112 for cats, compared with $836 and $435 for accident-and-illness plans, according to NAPHIA.
Can I upgrade later from accident-only to accident-and-illness?
It depends on the insurer. Conditions that appear before you upgrade may be treated as pre-existing, so ask the insurer before you buy.
Is wellness coverage worth it?
It depends on your routine costs. Because wellness benefits reimburse a fixed list of predictable services, compare what the add-on pays with what those services cost you directly.
Sources
Figures and statements on this page were checked against the following sources on 20 September 2026. Prices, rules and policies change, so always confirm details in the policy documents and with your state department of insurance.