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 conditions.
Curable pre-existing conditions
Pet insurance companies such as Embrace cover curable pre-existing conditions as long as any recurrence is at least 12 months from the date of the last problem. ASPCA’s pet insurance plan will not consider a condition “pre-existing” if it’s curable and there are no symptoms for 180 days (excluding knee and ligament conditions). If the condition recurs after 180 days, it can be covered like a new problem.
Some examples of curable conditions include:
- Bladder infections
- Diarrhea
- Ear infections
- Respiratory infections
- 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, pet insurance companies like Embrace and Pets Best 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. “Pet owners who have pets with pre-existing conditions should know the financial burden vets bills have. Thus, purchasing a pet insurance policy early on can help minimize the cost associated with the same issue occurring in the future,” says Melissa Gutierrez, a spokesperson for Pets Best.
Consider pet insurance alternatives. Companies like Eusoh and Pawp offer alternatives to insurance that provide a way to help pay a pet’s medical expenses. Pawp, for example, offers a membership-benefits service providing up to $3,000 for emergency veterinary bills for a pet, including pre-existing conditions, for $19 a month.
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- Covers the veterinarian office visit fee for illness and accidents.
- Covers end of life expenses.
- Can pay a veterinary hospital directly—but generally only for very large claims where it would be prohibitively expensive for the policyholder to pay and wait for reimbursement.
- Lacks a range of options for annual coverage and deductibles.
- There’s a 6-month waiting period for coverage of orthopedic conditions, but it can be waived if your pet has an orthopedic exam after you purchase the plan.
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.
ASPCA pet insurance
ASPCA pet insurance covers curable pre-existing conditions (except for knee and ligament conditions) if your pet is free of symptoms and treatments for 180 days.
Costco pet insurance
Costco pet insurance from Figo may cover conditions that are considered curable and recommends you contact Customer Experience to determine if your pet’s condition qualifies.
Embrace
Embrace pet insurance covers curable pre-existing conditions if your pet is symptom and treatment free for 12 months.
Figo
Figo pet insurance may cover conditions that are considered curable and recommends contacting Customer Experience to determine if your pet’s condition qualifies.
Lemonade
Lemonade pet insurance will consider coverage for conditions that have been cured and resolved for at least 12 months. Eligibility requirements depend on your state.
Pets Best
Pets Best pet insurance covers common curable pre-existing conditions (except for knee and ligament conditions) if the condition has been free of symptoms and treatment for 180 days.
Prudent Pet
Prudent pet insurance may cover an illness or injury that is a one-time incident that resolves on its own or through treatment. If your pet’s condition has been resolved by a licensed veterinarian and remains free of treatment for related symptoms for at least one year, your pet’s condition may be covered.
Pumpkin
Pumpkin pet insurance covers curable conditions (except for knee and ligament conditions) that have been free of treatment and symptoms for 180 days.
MetLife
MetLife pet insurance covers curable pre-existing conditions when they have been resolved and free of symptoms for a period of time, such as 180 days or 12 months.
Nationwide
Nationwide pet insurance may cover certain conditions if they have been cured for at least six months.
Spot
Spot pet insurance does not consider a condition as pre-existing if your pet was free of symptoms and professional treatment for 180 days.
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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 health conditions before enrolling your pet.
But not all pet insurance companies have this requirement. For example, ASPCA pet insurance does not require a veterinary exam or medical records to purchase a pet insurance 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.
Can I get reimbursed for previous wellness services?
Pet wellness plans are optional coverage you can typically add to an accident and illness plan. They often cover expenses such as an annual wellness visit, heartworm treatments and vaccinations. But you won’t get reimbursed for wellness expenses that were incurred before your policy began.
For example, if your pet has an annual wellness exam in August and you purchase a pet insurance policy in September, you won’t get reimbursed for the wellness exam fees. But you will be able to submit a claim for reimbursement the following year, assuming your coverage is still in effect.
Related: What does pet insurance cover?
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