A healthy, two-year-old Labrador retriever comes in for his annual wellness examination. The appointment is routine, and his owners leave with a clean bill of health, a year of heartworm prevention, and plans for many adventures ahead. Six months later, the same dog is rushed into an emergency hospital after swallowing a sock. Surgery is recommended immediately. The prognosis is excellent, but the estimate is several thousand dollars. The medicine is straightforward. The financial decision is not. Scenarios like this unfold in veterinary practices every day. As our profession has advanced, we have gained remarkable tools to diagnose disease earlier, treat conditions once considered untreatable, and improve both the quality and length of our patients’ lives. At the same time, those advances have increased the cost and complexity of veterinary care, and conversations about money have become an unavoidable part of clinical practice. For many veterinarians, those conversations remain uncomfortable. We worry discussing costs too early may make clients think we are motivated by profit. We hesitate to mention pet insurance because we do not want to appear to endorse a particular company. We often wait until an estimate is in hand before talking about finances at all. Unfortunately, that is often the worst possible time. Caring Pathways veterinarian Dr. Mindy speaks with Bonnie’s owners about the importance of financial planning for their dog’s care. Photo courtesy Josh Lewis Pet insurance has become an increasingly important part of the veterinary landscape. According to the North American Pet Health Insurance Association (NAPHIA), more than seven million pets were insured across North America at the end of 2024, reflecting sustained double-digit market growth over the past decade.1 Even so, the vast majority of companion animals remain uninsured, leaving many families to face unexpected veterinary expenses without a financial plan. Financial conversations are most effective when they occur before a crisis, not during one. When practices normalize discussions about pet insurance, payment options, and financial planning as part of preventive care, they help clients prepare for the unexpected, preserve trust, and expand access to veterinary medicine.2-4 Financial conversations are part of patient care Today’s veterinary professionals practice in a very different environment than they did 20 years ago. Referral medicine has expanded dramatically, advanced imaging is increasingly available, and treatments, such as chemotherapy, minimally invasive surgery, rehabilitation, and specialty critical care, are no longer uncommon. Clients rightfully expect access to these options when they offer the best chance for a positive outcome. At the same time, many families remain unprepared for the financial realities of advanced veterinary care. As a result, many pet owners first encounter the true cost of modern veterinary medicine during an emergency or following a life-changing diagnosis. When this happens, emotions are already running high. Clients are trying to absorb complex medical information while simultaneously making significant financial decisions. Veterinary teams, meanwhile, may experience frustration or moral distress when financial limitations prevent them from pursuing what they believe is the best medical option for a patient.5 These situations are emotionally taxing for everyone involved, but they are not simply financial problems; they are communication challenges. Research in veterinary medicine consistently demonstrates that clients value clear communication, empathy, and transparency as much as they value clinical expertise.2-4 When financial conversations are delayed until the moment an estimate is presented, they can feel transactional. When those same conversations begin earlier, such as during wellness visits or new-patient appointments, they become part of preventive healthcare and shared decision-making. Caring Pathways veterinarian Dr. Kristin goes over resources with a client during an in-home euthanasia appointment. Photo courtesy Josh Lewis Reframing pet insurance Many veterinary professionals avoid discussing pet insurance because they fear crossing the line into salesmanship. In reality, educating clients about pet insurance is no different than educating them about parasite prevention, nutrition, or dental care. The goal is not to persuade clients to spend more; it is to help them make informed decisions by understanding both the medical recommendations and the financial options available to them. Practices should remain neutral regarding specific companies and avoid recommending one insurer over another. Instead, the conversation should focus on the role insurance can play in helping families prepare for unexpected medical expenses. Rather than saying, “You should purchase pet insurance,” consider a broader message: “One of the things we discuss with all new pet owners is how they plan for unexpected veterinary expenses. Some families choose pet insurance, some build a dedicated savings account, and others prefer financing options if they ever need them. There isn’t one right answer, but it’s much easier to make those decisions before an emergency happens.” This approach accomplishes several important goals. It normalizes planning for unexpected veterinary expenses, avoids assumptions about a client’s financial situation, and emphasizes preparation rather than fear. Most importantly, it reinforces the discussion is standard practice for every client, not a judgment about any individual family’s resources. Pet insurance is really about access to care It is easy to think of pet insurance primarily as a financial product. From a clinical perspective, however, it is more helpful to think of it as an access-to-care tool. One of the greatest challenges in veterinary medicine is treatment decisions are often influenced as much by financial constraints as by medical considerations. Veterinarians encounter these situations every day: an owner declines advanced imaging because of cost, delays surgery while exploring alternatives, or elects euthanasia because the recommended treatment is financially out of reach. Pet insurance cannot eliminate every financial barrier, nor is it appropriate for every family. Most plans exclude pre-existing conditions, making early enrollment an important consideration.5 Policies differ substantially in their premiums, deductibles, reimbursement percentages, annual coverage limits, waiting periods, and exclusions, underscoring the importance of encouraging clients to compare plans carefully before enrolling.1 However, when insurance is already in place before illness or injury occurs, it may allow clients to make decisions based more heavily on what is medically appropriate rather than what is immediately affordable. Even when reimbursement occurs after payment has been made, insurance may provide clients with greater confidence in pursuing recommended care by reducing the potential financial burden associated with unexpected illness or injury. The conversation should never be about selling insurance. It should be about reducing one potential barrier that prevents pets from receiving timely medical care. The best time to talk about financing is before it’s needed One of the most common mistakes practices make is waiting until a financial crisis develops before introducing pet insurance or payment options. Imagine trying to explain waiting periods, reimbursement models, or pre-existing condition exclusions while an owner is deciding whether to authorize emergency surgery for their dog. At that moment, the information is no longer educational–it is simply frustrating. Routine wellness visits offer a much better opportunity. Puppy and kitten appointments naturally lend themselves to conversations about long-term healthcare planning. Annual examinations provide another opportunity to revisit those plans as pets age, and their healthcare needs evolve. New-client appointments can include a brief discussion about how the practice approaches financial transparency and what resources are available should unexpected medical needs arise. These conversations need not be lengthy. In many cases, a single-minute elevator pitch or an easy-to-understand handout discussing financial preparedness during a wellness visit may prevent a much more difficult conversation years later. Caring Pathways veterinarian Dr. Maria answers a client’s questions about her cat’s care during an outdoor quality of life assessment. Photo courtesy Josh Lewis Beyond insurance: Expanding financial options Pet insurance is an important tool, but it is not the only one. Even insured clients remain responsible for deductibles, co-pays, and services that may not be covered. Likewise, many pet owners choose not to purchase insurance or may not be eligible for comprehensive coverage because of their pet’s age or pre-existing conditions. For these families, discussing other financial options can be equally important. Third-party financing programs allow many clients to spread the cost of unexpected veterinary expenses over time. These programs can improve access to care while allowing practices to receive payment promptly. However, financing should never be presented as the “expected” solution. Clients should be encouraged to review repayment terms carefully, understand any promotional financing periods or interest charges, and determine whether financing is appropriate for their individual circumstances. Financial flexibility extends beyond financing programs. In some situations, a staged diagnostic approach or phased treatment plan may allow clients to move forward with care while working within financial constraints. These conversations require careful medical judgment, but when appropriate, they can preserve patient welfare while respecting a client’s circumstances. The goal is not to persuade clients to spend more money. The goal is to help them make informed decisions by ensuring they understand both the medical recommendations and the financial options available to them. Communication builds trust While practices often focus on what to say during financial conversations, how those conversations occur may be even more important. Research in veterinary communication has consistently shown that clients value empathy, partnership, and transparency.2-4 They want to understand why a recommendation is being made, what it is expected to accomplish, and what it is likely to cost. Just as importantly, they want to feel their concerns are heard. Simple communication techniques can make these conversations more collaborative. Open-ended questions invite clients to share their perspective before assumptions are made. Asking, “What concerns do you have about today’s treatment plan?” or “Have you thought about how you’d like to prepare for unexpected veterinary expenses?” often reveals important information that might otherwise remain unspoken. Normalizing financial discussions can also reduce embarrassment or guilt. Statements such as, “Many families are surprised by the cost of advanced veterinary care,” or “We have these conversations with all of our clients because unexpected illnesses happen to pets at any life stage,” reassure clients they are not being singled out. Transparency is equally important. Presenting the medical recommendation first, followed by a clear explanation of anticipated costs and available options, reinforces that recommendations are based on the patient’s needs rather than financial considerations. Finally, listening may be the most powerful communication tool of all. Clients who feel heard are often better able to process difficult information and participate in shared decision-making, even when financial limitations ultimately influence the plan. Creating a practice-wide approach Financial conversations should not begin and end with the veterinarian. Like client education, they are most effective when they are reinforced consistently throughout the patient experience. Client service representatives can ask whether a pet is insured when establishing a new client account. Veterinary technicians can revisit the conversation during wellness appointments or while reviewing preventive care recommendations. Practice managers can ensure educational resources about insurance and payment options are readily available on the practice website or in new-client materials. Veterinarians, meanwhile, remain responsible for discussing how financial considerations intersect with medical recommendations. When every team member understands their role, clients receive consistent messaging rather than fragmented information. Practices may also benefit from establishing written communication guidelines. These need not be elaborate. A simple protocol identifying when insurance, payment options, and estimates should be discussed helps ensure these conversations occur proactively rather than only during emotionally charged situations. Consistency also benefits clients. When client service representatives, technicians, and veterinarians share a common approach to financial conversations, clients receive consistent information throughout their interactions with the practice, reinforcing trust and supporting shared decision-making.2-4,6 Looking ahead Veterinary medicine continues to evolve at an extraordinary pace. New diagnostics, advanced therapeutics, specialty services, and emerging technologies are improving patient outcomes and expanding what is medically possible. Yet every advance also brings financial considerations that clients must navigate. The profession cannot eliminate the cost of care, nor should it apologize for the expertise, technology, and dedicated teams required to deliver high-quality medicine. What we can do is help clients prepare for those realities before they find themselves making decisions in the middle of a crisis. When conversations about pet insurance, payment options, and financial planning become routine rather than reactive, they strengthen the veterinarian-client relationship. They encourage transparency, reduce uncertainty, and help clients make decisions based on both their values and their circumstances. Ultimately, these conversations are not about insurance policies or financing programs. They are about preserving access to care. Most veterinary clinicians have experienced the heartbreak of knowing what a patient needs while recognizing that financial limitations may prevent it. Although no single strategy will eliminate those difficult moments, thoughtful, proactive communication can reduce their frequency. Helping clients prepare for the unexpected may be one of the most meaningful ways we can support both the families we serve, and the patients entrusted to our care. Chelsea McGivney, DVM, MBA, attended veterinary school at Colorado State University. She has practiced general medicine, emergency medicine, and in-home end-of-life veterinary care. Currently, Dr. McGivney is the executive director of operations of Caring Pathways, a multi-practice in-home end-of-life veterinary company focused on providing compassionate hospice and palliative care, as well as in-home euthanasia at life's end. References North American Pet Health Insurance Association (NAPHIA). 2025 State of the Industry Report. Available at: https://naphia.org/industry-data/. Accessed July 2026. Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians’ and pet owners’ perceptions of veterinarian-client communication in companion animal practice. J Am Vet Med Assoc. 2008;233(7):1072-1080. Shaw JR, Adams CL, Bonnett BN, Larson S, Roter DL. Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice. J Am Vet Med Assoc. 2008;233(10):1576-1586. Pun JKH. An integrated review of the role of communication in veterinary clinical practice. BMC Vet Res. 2020;16:394. doi:10.1186/s12917-020-02558-2. Moses L, Malowney MJ, Boyd JW. Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians. J Vet Intern Med. 2018;32(6):2115-2122. doi:10.1111/jvim.15315. Brown BR. The dimensions of pet-owner loyalty and the relationship with communication, trust, commitment, and perceived value. 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