Pet Insurance That Covers Pre-Existing Conditions

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Updated: Feb 7, 2023, 4:29pm

Fiona Campbell
Forbes Staff

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If you’re shopping for pet insurance, it’s important to understand the limitations of the policy—such as treatment for pre-existing conditions, which can add up.

Just like car insurance, which doesn’t cover accidents before coverage begins, pet insurance typically won’t cover any expenses related to ailments or injuries that are already present. Knowing what counts as a “pre-existing condition” is crucial.

Does Pet Insurance Cover Pre-Existing Conditions?

Due to the cost of treating pre-existing conditions, and the relatively short lifetime of a pet (dogs live on average 10 to 13 years depending on the breed), pet insurance generally excludes pre-existing conditions from coverage. It’s a numbers problem: Pet insurers don’t have the luxury of charging many years of premiums in order to offset claims payments for pre-existing conditions.

Pet insurance companies usually consider a pre-existing condition to be an illness or injury that started prior to coverage beginning, including any waiting period.

“It’s important to point out that even if the pet wasn’t diagnosed with an injury or illness, an insurer may still deny coverage if they were showing any signs or symptoms of one prior to coverage starting,” says Alex Stone, founder Petinsurer.com, a pet insurance comparison provider.

For example, if your dog was limping before your waiting period and coverage started, treatment for the leg wouldn’t be covered by the plan.

What Are Pet Pre-Existing Conditions?

Some pet insurance companies put pre-existing conditions into two buckets: curable and incurable.

Curable pre-existing conditions

Some pet insurance companies cover curable pre-existing conditions after a certain waiting period with no recurrent symptoms, known as a temporary exclusion. For example, with Fetch pet insurance, as long as any recurrence is at least 12 months from the day you signed up and your pet shows no further symptoms, it may be covered in your plan moving forward. Spot’s pet insurance plan will not consider a condition “pre-existing” if it’s curable or cured and free of treatment and symptoms for 180 days (excluding knee and ligament conditions).

Some examples of curable conditions include:

  • Bladder infections
  • Diarrhea
  • Ear infections
  • Respiratory infections, such as kennel cough
  • Urinary tract infections
  • Vomiting

Incurable pre-existing conditions

On the other hand, there are pre-existing conditions that pet insurance companies consider incurable, such as:

  • Allergies
  • Arthritis
  • Bladder crystals
  • Cancer
  • Diabetes
  • Epilepsy
  • Heart disease
  • Hip dysplasia
  • Kidney disease
  • Orthopedic conditions
  • Urinary blockages

Many of these conditions require repeat veterinarian visits, ongoing medication and sometimes even surgery. Incurable pre-existing conditions won’t be covered by pet insurance.

Pay Close Attention to Bilateral Exclusions

A bilateral illness or injury is a condition that impacts the left and right sides of the body, such as hip dysplasia or a cruciate ligament tear.

Since there is a greater chance of a pet experiencing the same condition on the opposite side of their body, many insurance companies have bilateral exclusions in their policies. In other words, if your pet had treatment on one side of its body before the policy started, then the other side won’t be covered later.

If your pet experiences a bilateral condition after coverage starts, it’ll be covered just fine.

How to Determine What Pet Conditions are Insurable

As a pet owner, you may struggle to identify what qualifies as a pre-existing condition and what your pet insurance plan will cover. For this reason, some pet insurance companies like OVMA Pet Health Insurance, Petsecure and Pet Plus Us run medical history reviews on a pet.

Medical history reviews are designed to pinpoint any conditions that your policy won’t cover. You’ll know exactly what expenses you’ll be responsible for.

The medical review will take place after you apply for a policy. Once the review is complete, the insurers will often give you the option to cancel if you feel the coverage isn’t sufficient for your pet’s needs.

Finding the Right Insurance for a Pet with Pre-Existing Issues

Even if your pet has a pre-existing condition, you can still obtain pet insurance and it will cover conditions not related to the pre-existing condition. Here are things to keep in mind.

Be a proactive pet owner. “You’ll want to take care of the injury or illness as soon as possible, so the matter doesn’t worsen, resulting in astronomical vet bills. Taking the proper precautions can help prevent other accidents or illnesses from appearing due to the condition,” says Stone.

Keep up to date with your pet’s vaccinations. The last thing you want is your pet to get sick because you didn’t keep them up-to-date with their shots. Many insurers will deny a claim if your pet becomes ill because they weren’t vaccinated according to your veterinarian’s guidance.

Compare pet insurance policies Even though pet insurance won’t cover incurable pre-existing conditions, you can find suitable coverage to handle other medical expenses. Compare the obvious things like monthly price and deductible, but also look at other factors such as waiting periods and whether coverage is reduced when your pet gets older.

“When you select an insurance provider for your pet, you’re really trusting the provider to be your pet’s partner for life. This is really important when it comes to making a claim because if you switch to another pet insurance provider during your pet’s lifetime, then any claims with your previous insurer will be treated as pre-existing by the new provider, and therefore wouldn’t be covered,” Stone says.

Buy pet insurance early on. Owners who have pets with pre-existing conditions should be aware of the potential financial burden caused by skyrocketing vet bills. Purchasing a pet insurance policy early on can help ensure future injuries, ailments and/or illnesses are covered by the policy. Also, some insurers won’t issue new policies for senior pets.

Ask for a review. If your pet has completely recovered from the pre-existing condition excluded from the policy at the time of signing (known as a “curable” pre-existing condition), some insurance companies, such as Fetch and Sonnet, allow pet owners to request a review of the exclusion. If your pet is symptom-free and does not require further treatment, the pre-existing condition may be removed from the policy going forward.

Which Pet Insurance Companies Cover Pre-Existing Conditions?

Generally, pet insurance companies do not cover incurable pre-existing conditions such as cancer, diabetes and hip dysplasia. But some pet insurance companies will cover what are considered “curable” pre-existing conditions, such as bladder infections, diarrhea and ear infections.

Here are examples of pet insurance companies that cover curable pre-existing conditions.

Fetch By The Dodo (formerly called Petplan)

Fetch covers curable pre-existing conditions going forward if your pet is symptom and treatment free for 12 months from the day you signed up.

Furkin

Furkin makes a distinction between permanent exclusions and temporary exclusions, typically minor, short-term illnesses. As long as there are no additional episodes during the rest of the policy year, the pre-existing condition would be eligible for review at the end of the year provided that a veterinarian certifies your pet is fully recovered.

OVMA Pet Health Insurance

If your policy contains an exclusion due to a pre-existing condition, you can review a review of the exclusion if your pet is free of symptoms and doesn’t require further treatment for a minimum of six months to one year.

Peppermint

If your policy contains an exclusion due to a pre-existing condition, you can receive a review of the exclusion if your pet is free of symptoms and doesn’t require further treatment for a minimum of six months to one year.

Pet Plus Us (includes Costco Pet Insurance)

Pet Plus Us advertises a “very liberal interpretation” of what medical conditions will be considered for pre-existing conditions. If the issue appears to be a “one-time event” they might “ignore it all together” or consider it a temporary exclusion.

Sonnet Pet Insurance

If your policy contains an exclusion due to a pre-existing condition, you can receive a review of the exclusion if your pet is free of symptoms and doesn’t require further treatment for a minimum of six months to one year.

Spot Pet Insurance

Spot covers common curable pre-existing conditions (except for knee and ligament conditions) if the condition is curable or cured and free of symptoms and treatment for 180 days.

Does My Pet Need to be Examined Before Enrolling in a Pet Insurance Plan?

Some pet insurance companies may want to see your pet’s medical records or proof of a full veterinary exam to check for any pre-existing conditions or other health conditions before enrolling your pet.

But not all pet insurance companies have this requirement. For example, Fetch By The Dodo pet insurance does not require a veterinary exam or medical records to purchase a pet insurance policy, but does require an annual checkup.

However, pet insurance companies will request medical records at the time of any claim to assess if there is evidence of any symptoms before the policy took effect. Also, an insurance company may reject your claim if your pet has not been assessed by a veterinarian within 12 months before the start of your policy.

What if a Condition Hasn’t Been Diagnosed Yet?

Conditions that have not been diagnosed could still be considered pre-existing conditions.

For example, let’s say your dog starts limping in May and you take your pup to the vet but the cause of the limp is undetermined. If you buy a pet insurance policy in June and your pet starts limping again, treatments related to this issue might not be covered because the symptoms occurred before your coverage began.

Pet Insurance for Pre-Existing Conditions FAQs

How do pet insurance companies know about pre-existing conditions?

Your pet insurance company may require your pet’s medical records or a full veterinary exam to assess your pet’s overall health before enrollment. Any symptoms or treatments for a health condition that occur before your coverage begins or during the waiting period may be considered a pre-existing condition.

It’s generally a good idea to buy a pet insurance policy while your pet is relatively young and healthy.

Can symptoms be considered pre-existing conditions?

Even if your pet has not been diagnosed with a condition, symptoms can be considered a pre-existing condition if they are documented by your veterinarian before your coverage begins. If the symptoms are of a condition that is incurable, it’s unlikely treatment for the underlying problem will be covered.

For example, if your dog has documented symptoms such as an increased appetite, thirst, urination or weight loss, that could be a sign of diabetes, which is an incurable pre-existing condition.

Can I get pet insurance after a diagnosis?

Yes, you can still buy pet insurance even if your pet has been diagnosed with a pre-existing condition. Your pet insurance plan can help pay for medical expenses for health conditions that are not related to your pet’s pre-existing condition.

For example, if your German shepherd’s hip dysplasia won’t be covered because it is an incurable pre-existing condition, but your dog develops an upper respiratory infection, medical expenses will be covered by an accident and illness plan.

What alternatives are there to pet insurance for pre-existing conditions?

Using the example from above, if you take your dog to the vet in May due to a limp and the cause was ruled ‘undetermined,’ but since buying a policy in June (from which the limp, or any related issues, were excluded), Fido has been diagnosed with hip dysphasia. According to Trupanion, you’re looking at a $7,815 out-of-pocket surgical bill.

Veterinary financing company Petcard offers coverage for part or all of the bill with terms ranging from six months to six years to pay back. Applications are approved quickly and payments are made directly to the veterinarian. Petcard covers any related veterinary treatment or item.

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