85% of Vets See Care Declined at the $1,000 Mark, Survey Finds

85% of veterinary professionals say pet owners now decline recommended treatment once an estimate crosses $1,000, and nearly a quarter say affordability drives at least a fifth of the euthanasia decisions in their own practice. The finding comes from a survey fielded by Pawlicy Advisor and the American Animal Hospital Association, and it points to a fix hiding inside the same data: practices that recommend pet insurance before a client asks carry more than double the insured patient share of those that wait to be asked.

AAHA-Pawlicy survey pins vet care declines at $1,000

AAHA and Pawlicy Advisor fielded the survey in May and June among 451 veterinary professionals: veterinarians and medical directors (40.6%), practice managers (39.5%), technicians (10.2%), and other staff. Two-thirds work in independent hospitals rather than corporate-owned chains. It's the third edition of the project since 2023, part of a series that has now surveyed more than 1,500 professionals.

86% of respondents said they adjust a treatment plan because of cost at least once a week, averaging five such conversations, up from 4.7 a year earlier. 81% percent said they have a difficult financial conversation with a client weekly, now averaging 4.4 times versus four previously.

The euthanasia figures are the starkest. Thirteen percent of respondents said inability to pay is a factor in euthanasia decisions generally, and 22.9% said affordability drives at least a fifth of the euthanasia decisions inside their own practice.

The survey also isolated what changes the picture. Practices that recommend insurance to every client, rather than waiting to be asked, reported a median insured patient share of 7.5%, more than double the 3.5% median at practices that only raise it reactively. Eighty-seven percent of respondents agreed insurance helps clients accept more of the recommended care.

"Those who take a proactive approach see twice as many insured clients," said Woody Mawhinney, Pawlicy Advisor's chief executive.

Proactive insurance pitches double a clinic's insured base

The gap between those two numbers, 7.5% versus 3.5%, is the actual news. It suggests the constraint on pet insurance adoption isn't purely a demand problem sitting with pet owners. Some of it is a habit problem sitting inside the exam room.

That reframing matters because the category has enormous room to grow into. Fewer than 5% of American dogs and cats carry any pet insurance coverage, even after enrollment climbed roughly 9% in 2025, according to the North American Pet Health Insurance Association's latest state-of-the-industry report. A market that small can't blame saturation for its growth rate.

What's holding vets back from making the pitch is its own data point in the survey: 79.3% of respondents said they're uncomfortable recommending a specific insurer, citing licensing and liability concerns. A veterinarian steering a client toward one named carrier is a different regulatory question than a veterinarian recommending "get insurance" in general terms. That discomfort is precisely the gap a marketplace model is built to close, and it's worth noting plainly that the survey's own sponsor sells one.

A vet who points clients to a comparison platform, rather than a specific underwriter, sidesteps the licensing question entirely. It also happens to make the case for the product selling it.

The comparison that makes the habit argument stick is international. In the U.K., where pet insurance is commonly offered as a default add-on at the point of purchase rather than something an owner has to seek out, penetration runs several multiples higher than in the U.S. British pet owners aren't meaningfully wealthier than American ones. The difference is closer to the moment someone asks.

The rest of the category has been circling the same problem from other directions. Doubtless, the platform JAB built by folding Embrace, Figo, Pumpkin, and more than fifteen other insurance brands into one operating company, is betting that owning the full client relationship, not just the policy, is worth more than owning distribution alone. adoro went a different direction this summer, hiring a former direct-to-consumer insurance executive to build employer-benefits and broker channels, a bet that paid search had gotten too expensive relative to other paths to a new policyholder. Both moves share a premise with this survey: the vet's exam room, not a search ad, may be the cheapest place to find one.

If proactive recommendation roughly doubles a clinic's insured share, the ceiling on that lever is still a clinic's own patient volume. It multiplies value inside an existing relationship; it doesn't create new ones outside it. Pumpkin's recent move to sell wellness reimbursements as a standalone subscription, open to any pet owner regardless of insurance status, is an attempt to build exactly that kind of new-relationship funnel, running alongside the vet's referral rather than through it.

Whether more practices adopt a proactive playbook

The clearest signal to keep track of is adoption, not sentiment. Plenty of practices already agree, in principle, that insurance helps clients say yes to care. The survey shows a wide gap between practices that act on that belief by default and the larger group that only raises it once a client is already staring at a bill.

Watch whether AAHA or Pawlicy Advisor publishes practice-level guidance or training material aimed at closing that gap, rather than just documenting it again next year. A marketplace model only benefits from more proactive recommending if practices have an easy script for making the pitch without straying into carrier-specific advice.

Adoro's employer-benefits push and Doubtless's full-relationship bet both intensify heading into open-enrollment season this fall, when employer benefit menus get set for 2027. A vet-office recommendation habit and an employer-benefits channel are different distribution surfaces solving the same underlying problem, and whichever moves faster will shape where the next percentage point of that sub-5% penetration number actually comes from.

A fourth annual edition of this survey, if AAHA and Pawlicy Advisor keep the cadence, would be the cleanest test of whether any of this actually moves the needle, or whether next year's respondents report the same weekly cost conversations, the same euthanasia pressure, and the same gap between practices that ask and practices that wait.

Source: Pawlicy Advisor and AAHA via PR Newswire