Does Pet Insurance Cover Pre-existing Conditions?

No matter what pet insurance policy you buy, most pet insurance companies don’t include pre-existing condition coverage. Since pets require veterinary care to manage these health issues, insurance companies consider them expensive and risky investments, but there are some exceptions. Some key things to understand about pre-existing conditions are:

• Pre-existing conditions are medical conditions that a pet has before it’s insured.

• Pet insurance is important for pets with pre-existing conditions. It can help pay for annual checkups, vaccinations, and any unexpected illnesses or injuries.

• Pet insurance can sometimes cover “curable” pre-existing conditions. Otherwise, pet wellness plans and insurance alternatives are available if your companion has a long medical history.

What are considered pre-existing conditions?

“A pre-existing condition is any illness or injury your pet has shown symptoms of before your coverage begins,” says Anthony Martin, founder and CEO of Choice Mutual and a member of the Forbes Financial Council. While different types of pre-existing conditions exist, “the most common can include allergies, arthritis, cancer, and diabetes,” says Martin.

He warns that symptoms are enough for the insurance company to consider it a pre-existing condition, even if you don’t have a diagnosis. “For example, if your dog is constantly licking its paws pre-policy, and after enrollment, they are diagnosed with allergies, the allergies will not be covered by your insurance,” says Martin.

Curable pre-existing conditions

Pet insurance doesn’t typically cover pre-existing conditions. But many providers make an exception if it’s considered “curable.” Urinary tract infections, diarrhea, infected ears, breathing infections, and vomiting are examples of curable pre-existing conditions, according to Garrett Yamasaki, founder of Trending Breeds.

Curable conditions that occur before the policy’s effective date can also include broken bones and kennel cough.^[1]

For example, “an illness won’t be deemed ‘pre-existing’ under the ASPCA’s pet insurance program if it can be treated and there have been no symptoms for 180 days (excluding knee and ligament conditions),” says Yamasaki.^[2] “After 180 days, if the ailment returns, it may be treated as a brand-new issue.”

Incurable pre-existing conditions

Yamasaki warns that pet insurance providers classify several pre-existing diseases as incurable. The types of pre-existing conditions that insurance companies don’t generally cover include allergies, crystalline bladder inflammation, cancer, diabetes, epilepsy, heart conditions, dysplastic hips, kidney illness, orthopedic ailments, and urinary obstructions.

Pay special attention to the fine print when considering coverage for a pet with an incurable diagnosis. Many pet insurance providers don’t distinguish between curable and incurable pre-existing conditions. For the best long-term coverage, you’ll need to know specifically what your policy includes.

Bilateral conditions

Bilateral conditions are those where the disease or condition has a high probability of affecting both sides of your pet’s body. Common ailments include hip dysplasia, cruciate ligament problems, cataracts, and luxating patellas.

Many pet insurance companies classify bilateral conditions as pre-existing. While some pet insurance policies cover bilateral conditions, pet insurers can exclude them or group them together as a single issue.

If your pet has conditions before you’ve purchased pet insurance, find out if any are considered bilateral. Bilateral coverage is crucial to treat conditions like hip dysplasia, which can be very expensive to treat without insurance.

Hereditary and congenital conditions

Your policy may also include hereditary and congenital conditions, such as arthritis, diabetes, eye disorders, and heart disease.^[3]

While related, the two types of conditions are very different. When a pet inherits a condition from a parent, it’s a hereditary condition. A congenital condition is developed in utero, although symptoms may not appear for months or years.^[4]

Check Out: Is Pet Wellness Insurance Worth It?

How to find the best insurance for a pet with pre-existing conditions

Purchasing health insurance for pets with pre-existing conditions is very important. Without coverage, you may have to pay significant out-of-pocket costs should your pet face any serious medical problems.

Before you shop for pet insurance, decide how much you’ll need:

1. Choose the scope of coverage. Policies can be accident-only or comprehensive plans that cover both accidents and illnesses. Pet wellness plans are also available as an alternative to insurance coverage.

2. Select a deductible amount. Most companies offer deductibles that range from $100 to $1,000.

3. Consider the reimbursement rate and policy limit. Reimbursement rates typically fall between 50% and 90%, while policy limits could be as little as $2,000 or as much as $10,000, or even more.^[5]

Once you know the coverage you need, get pet insurance quotes. You’ll want to compare rates from multiple companies. Make sure you understand your monthly premium costs, your coverage limitations (and exclusions), and your deductible.

Pet insurance providers for pets with pre-existing conditions

Pet insurance companies often cover curable pre-existing conditions. If your companion has one, consider the following providers:

• Pets Best has coverage for dogs and cats. It covers accidents, illnesses, surgeries, and cancer, as well as routine care.

• Fetch has insurance for dogs and cats. You can choose your coverage limit, deductible, and reimbursement rate for a custom policy.^[6]

• Embrace offers protection for dogs and cats. Forbes ranked it as the No. 1 pet insurance provider in 2022.^[7]

• ASPCA offers both accident-only insurance and complete coverage plans for dogs and cats. You can also add preventative coverage for an additional monthly fee.^[8]

• MetLife for dogs and cats covers care for chronic conditions without lifetime or per-incident limits. It’s available to buy independently, but coverage is also available for purchase through employers.^[9]

“For pets with pre-existing conditions, the best option may be to set aside a savings fund specifically for vet treatment for the condition, while your insurance policy can cover anything else that might occur with your pet’s health,” says Josh Snead, CEO of Rainwalk Pet Insurance.

Pet insurance alternatives that cover pre-existing conditions

Pet parents can’t hide their pets’ pre-existing conditions or medical history from their provider. “When you first start a policy or upon your first claim with the pet insurance company, they will contact your vet for your pet’s records,” says Snead.

For some pet owners, alternative pet insurance plans may be a better option than typical pet insurance coverage. For example, discount plans and wellness plans may benefit pets with a long medical history.

Wagmo is one provider offering wellness plans in addition to insurance coverage. If your pet has pre-existing conditions that make finding a policy difficult, the wellness plan can help offset costs. Plans start at $20 per month and can pay for vet visits, vaccines, routine blood work, grooming, and more.^[10]

Pet Assure is another option. It doesn’t provide insurance but can help lower your veterinary bills through discounts. Pet Assure covers pre-existing and hereditary conditions without putting a cap on your discount usage. However, it’s only available as an employer benefit — check with your company to see if you can enroll.^[11]

Pet insurance and pre-existing conditions FAQs

Here are answers to some commonly asked questions about pet insurance and pre-existing conditions.