Nationwide pet insurance pays up to $10,000 per year on its most comprehensive plans, reimbursing between 50% and 80% of eligible veterinary costs after you meet your deductible. That is the ceiling. What you actually collect on any given claim depends on which plan you bought, the deductible and reimbursement rate you chose, and, on one plan sold only in New York, a fixed schedule that caps payment per diagnosis regardless of the bill.
Annual Dollar Limits by Plan
Nationwide sells its coverage in tiers, and the annual cap is the first number that matters.
- The Modular Pet Insurance Plan, the most widely available option, lets you pick an annual limit of $2,500, $5,000, $7,500, or $10,000.
- The Whole Pet plan carries a flat $10,000 annual limit. NerdWallet reports it is sold as a consumer product only in New York, though U.S. News notes it is also available through employer group plans.
- The Major Medical plan, available only in New York, has no single annual cap; instead, each condition has its own dollar ceiling set by a benefit schedule.
- The employer-based My Pet Protection plan has a $7,500 annual limit.
Once you hit the annual limit on a capped plan, Nationwide pays nothing more toward covered care until the policy renews. One further restriction worth knowing: if you add the hereditary and congenital conditions rider to a Modular plan, coverage for those conditions is capped at $5,000 per year even when the rest of the policy carries a higher limit.
How the Reimbursement Math Works
On the Modular, Whole Pet, and My Pet Protection plans, Nationwide reimburses you after the fact. You pay the vet, submit an itemized invoice, and the company sends back a percentage of the eligible charges once your annual deductible is satisfied.
A concrete example: you have a Modular plan with an 80% reimbursement rate, a $250 deductible, and a $5,000 annual limit. Your dog needs a $3,000 surgery, and it is the first claim of the policy year. Nationwide subtracts the $250 deductible, then pays 80% of the remaining $2,750, which comes to $2,200. You absorb $800. Because the deductible is annual, the next covered claim in that policy year would be reimbursed at 80% from the first dollar until you reach the $5,000 cap.
Reimbursement is paid to you, not to the clinic. Unlike Pets Best, Nationwide does not offer direct payment to veterinarians, so you cover the full bill at the time of service and wait for the money to come back. The company says it typically processes claims within five days of receiving complete documentation but asks policyholders to allow up to 30 days. Direct deposits land one to two business days after approval.
Why Major Medical Pays Differently
The Major Medical plan does not use a percentage. It pays a fixed dollar amount per diagnosis from a published benefit schedule, and that amount is the ceiling no matter what the vet charges. Surgical treatment for gastric torsion (bloat) has a primary allowance of $2,175. Surgical repair of an intervertebral disc problem pays up to $2,225. Pancreatitis carries a primary allowance of $1,220.
If a surgery costs $5,000 and the schedule allows $2,175, the plan pays $2,175 toward that condition for the policy term and nothing more. ConsumerAffairs reviews frequently cite this gap, with policyholders reporting that payouts fell well short of actual bills. Several conditions are excluded by name on Major Medical: hip dysplasia, elbow dysplasia, patellar luxation, von Willebrand’s disease, collapsed trachea, primary glaucoma, and progressive retinal atrophy, among others.
Deductibles and Reimbursement Rates You Choose
The deductible is annual. Pay it once in a policy year and subsequent covered claims reimburse without hitting it again. Most Nationwide plans default to a $250 deductible; the Modular plan also offers $500 or $1,000, which lowers the monthly premium at the cost of more upfront exposure.
Reimbursement rates on the Modular plan can be set at 50%, 70%, or 80%. The Whole Pet and My Pet Protection plans offer only 50% or 70%. U.S. News confirmed in May 2026 that 80% is the highest reimbursement available on any current Nationwide plan, and only on the Modular tier. Some competitor comparison pages reference a 90% Nationwide tier; that option does not exist.
What the Payout Covers
The dollars apply to accidents and injuries such as broken bones, lacerations, and poisoning; illnesses from allergies and ear infections through cancer; emergency care and hospitalization; surgery including anesthesia and post-operative care; diagnostics and lab work; and prescription medications. The Whole Pet and Modular plans also pay toward acupuncture, chiropractic care, and prescription diets when a vet prescribes them for a covered condition. You can use any licensed veterinarian, specialist, or emergency provider anywhere in the world, and every plan includes the 24/7 VetHelpline for virtual consultations.
Pre-existing conditions are the largest category of exclusion. Anything documented in the pet’s records before coverage began, or showing signs or symptoms before the policy effective date, is not covered. Nationwide will reconsider a previously excluded condition if the pet has been symptom-free and treatment-free for at least six months and you request a formal review.
Other exclusions reduce what the plan will pay toward:
- Cosmetic and elective procedures including tail docking, ear cropping, declawing, and cosmetic dental work.
- Breeding-related expenses such as artificial insemination, pregnancy exams, and cesarean sections.
- Grooming and boarding, including nail trims, baths, shampoos, and kennel stays.
- Experimental treatments outside the standard of care accepted by a state veterinary medical board.
- Non-veterinary fees such as taxes, waste disposal, record-copying charges, and bank fees.
Waiting Periods Before Coverage Pays
The Modular plan imposes a 14-day waiting period for both accident and illness coverage. Dental cleanings and spay or neuter procedures carry a 90-day wait. Cruciate ligament and meniscus injuries have a 12-month waiting period in most states, with exceptions: Delaware, Louisiana, Maryland, Mississippi, Nebraska, New Hampshire, Ohio, Pennsylvania, and Washington impose no cruciate wait at all; Maine requires 30 days; Georgia requires six months. Hereditary conditions on the Major Medical plan carry a 12-month wait. Employer-based plan waits vary by the agreement.
Nothing filed during a waiting period is covered, and any condition that first shows symptoms during the wait is treated as pre-existing going forward.
Wellness Coverage Pays by Line Item
No base plan covers routine care. Annual checkups, vaccinations, flea and tick prevention, and dental cleanings require the optional wellness rider, which can attach to the Modular or Major Medical plans but not to Whole Pet. It is not available in every state, and Nationwide does not publish the rider’s premium.
The rider comes in two annual maximums. The $450 tier reimburses specific amounts: physical exams up to $40 each (two per term), vaccinations $80, heartworm or FeLV/FIV testing $35, fecal testing $30, deworming $25, microchipping $50, a health certificate $50, and flea control or heartworm prevention $100. The $800 tier adds a diagnostic test (blood work, X-ray, or EKG) at $100 and either a dental cleaning or spay/neuter surgery at $250. The 90-day wait for dental cleanings and spay/neuter procedures applies here as well.
For birds enrolled under the Modular plan, wellness is available at either a $300 or $500 annual maximum. Other exotic species cannot add wellness coverage.
Exotic Pet Payout Limits
Birds and exotic pets have their own ceilings. Under the Modular plan, exotic pets carry annual limits of $1,500 to $3,000 with reimbursement rates of 50% to 80%. Under Whole Pet, they get the full $10,000 annual limit at 50% or 70% reimbursement. Eligible species include parrots, cockatiels, macaws, canaries, finches, rabbits, guinea pigs, ferrets, mini pigs, goats, lizards, reptiles, and frogs. Venomous, endangered, or illegally owned animals are excluded, as are animals kept in flocks or on display.
How the Payout Ceiling Compares
Nationwide’s $10,000 annual cap is lower than what several major competitors offer. Healthy Paws provides unlimited annual payouts, and other insurers run to $15,000 or higher. Forbes characterizes Nationwide as “Best for Budget,” noting the Modular plan represents solid value but warning that anyone needing more than $10,000 of annual coverage should look elsewhere. The 80% reimbursement ceiling also falls below the 90% tier available from ASPCA, Healthy Paws, and others, and the $250 deductible floor is higher than the $100 minimum some competitors offer.
A Note on Coverage You Can Keep
How much a policy pays only matters if the policy stays in force. Between mid-2024 and the summer of 2025, Nationwide canceled roughly 100,000 pet insurance policies, about 8% of its 1.2 million insured pets, citing rising veterinary costs and inflation. The company said the decisions were made at the state level and were not based on a pet’s age, breed, or claims history. The Whole Pet plan was discontinued in certain states as part of the restructuring, and affected policyholders kept their coverage through the end of their current term before losing it. Agency Checklists reported in June 2025 that a class-action lawsuit had been filed over the cancellations. Pets that developed conditions while covered would, as a practical matter, carry those conditions as pre-existing exclusions at any new insurer.