Does Pet Insurance Cover Pre-Existing Conditions?
In most cases, pet insurance does not cover pre-existing conditions. Insurance companies see pets with these medical conditions as costly and high-risk investments, especially since they will need veterinary care in the foreseeable future.
However, some companies will distinguish between curable and incurable conditions, opting to cover curable conditions with specific stipulations. Companies also typically exclude developed bilateral conditions. Several pet insurance companies offer curable pre-existing coverage, but many come with restrictions.
Best Pet Insurance Companies For Pre-Existing Conditions Coverage
The following companies offer some coverage for curable pre-existing conditions.
Curable vs. Incurable Pre-Existing Conditions
Pre-existing conditions are illnesses for which your pet showed symptoms, was diagnosed, or underwent treatment before your pet insurance policy began. This includes any conditions that arose during your insurance provider’s waiting period (which is the time between purchasing a plan and being able to file a claim for coverage). A pre-existing condition is determined by when symptoms began, not whether or when a veterinarian diagnosed the condition.
Curable Pre-Existing Conditions
Curable pre-existing conditions usually include conditions that, once treated, do not chronically recur. Embrace defines a curable pre-existing condition as one that does not show repeated symptoms within one year of treatment. Spot does not consider a condition pre-existing if your pet has been treated for it and no signs have recurred within 180 days of the last episode (excluding knee and ligament conditions).
Curable conditions may include the following:
Curable Conditions | Average Treatment Cost* | Covered if Pet is Insured Before Diagnosis |
---|---|---|
Bladder infections | $3500 | ✔ |
Diarrhea (long-term) | $1,200 | ✔ |
Ear infections | $150 | ✔ |
Gastrointestinal issues | Up to $10,000 | ✔ |
Respiratory infections | $189 | ✔ |
Urinary tract infections | $274 | ✔ |
Chronic vomiting | $3,500 | ✔ |
*Cost data was collected from Pet MD, Great Pet Care, Embrace Pet Insurance and CareCredit.
Incurable Pre-Existing Conditions
Incurable pre-existing conditions are those that will likely require ongoing treatment, medication or even surgery.
Here are a few examples of what providers generally deem to be incurable pre-existing conditions:
Incurable Conditions | Average Treatment Cost* | Covered if Pet is Insured Before Diagnosis |
---|---|---|
Allergies | $500 | ✔ |
Arthritis | $324 | ✔ |
Cancer | $3,950 | ✔ |
Diabetes | $1,080 | ✔ |
Epilepsy | $3,030 | ✔ |
Heart disease | $1,000 | ✔ |
Hip dysplasia | $1850 per hip | ✔ |
Hyperthyroidism | $750 | ✔ |
Kidney disease | $350 | ✔ |
Orthopedic conditions | $2,000 | ✔ |
Any chronic condition | $2,075 | ✔ |
*Cost data was collected from Pet MD, Great Pet Care, Embrace Pet Insurance and CareCredit.
Unfortunately, pet insurance providers will not cover the above types of pre-existing conditions. However, if your pet has been insured since it was young and developed one of these conditions over time, it would be covered under your policy.
Pet insurance can protect against unexpected veterinary bills but may not be worth the cost if your pet has several pre-existing conditions. Insurance providers can exclude coverage not only for pre-existing conditions or symptoms but also for related problems. An alternative option for pets with multiple pre-existing conditions is an accident-only plan, which offers low premiums and coverage in case of a future accident rather than full health coverage.
Bilateral Conditions
A bilateral condition refers to an injury or illness that affects both sides of the body, such as a cruciate ligament tear, cataracts or hip dysplasia. As there is an increased risk that a pet will develop the same condition on one side of its body after experiencing it on the other, many pet insurance providers exclude bilateral conditions from their coverage.
For example, if your German shepherd were treated for hip dysplasia on the left side of its body before you enrolled in pet insurance, hip dysplasia on its right side would not be covered in the future.
Does My Pet Need an Examination Before Enrolling in Pet Insurance?
Most pet insurers want to establish a baseline for your pet’s health at the time of coverage enrollment. This requires taking your animal to the vet for a comprehensive check-up during the policy enrollment process. Or you may need to submit medical records from your pet’s annual exam within a specific timeframe.
For example, Embrace requires pet owners to submit records from a veterinary exam that occurred 12 months before the policy start date, or 14 days after the policy start date. Failure to submit examination requirements could result in a voided policy. You can read Embrace’s sample policy to learn more.
By reviewing your pet’s health through the opinion of a licensed veterinarian, companies can identify pre-existing conditions. However, not all providers have the same requirements regarding physical exams for your pet. Here are the examination requirements for the best pet insurance companies for pre-existing conditions:
Pet Insurer | Physical Exam Requirements |
---|---|
Embrace | Requires an annual health exam record from within 12 months prior to enrollment |
Spot | An exam is not required, but you’ll need to send your pet’s medical records as part of enrollment |
ASPCA | No exam required |
Fetch | Requires an exam within six months prior to enrollment or within the first 30 days of coverage |
Figo | Requires an annual health exam record from within 12 months prior to enrollment |
Pets Best | No exam required |
Should I Purchase Pet Insurance for a Pet With a Pre-Existing Condition?
Pets with pre-existing conditions can still qualify for a full-service pet insurance policy at similar rates to other pets in your local area. However, an insurer may be more likely to deny claims related to your pet’s pre-existing conditions unless the health issue is deemed curable. Although insurers exclude coverage for incurable pre-existing conditions, you can still claim reimbursements for new health problems your pet experiences.
Elizabeth Kowalski, a veterinary technician in Wheeling, Ill., purchased pet insurance for her dog despite a pre-existing condition.
“My dog developed inflammatory bowel disease when she was only 2 years old,” Kowalski said. “Because I was already spending so much on care for this condition, I didn’t want to get stuck with major bills when she inevitably developed other expensive problems down the line. I purchased an insurance plan when she was 6 years old, and it has paid for arthritis treatments, expensive diagnostic tests for a heart condition and surgery to extract a broken tooth.”
For pets with a single pre-existing condition, pet insurance may help cover bills related to emergency room visits, age-related diseases or cancer. Each provider on our list has specific requirements regarding what it considers a curable pre-existing condition, some more strict than others. We recommend getting at least three quotes to best compare coverage for your pet’s needs and your budget.
How Can I Avoid Pre-Existing Conditions?
The best way to avoid having your pet insurance claim denied due to pre-existing conditions is to insure it while it is young. Insuring your pet before it has any medical issues can help ensure that any condition your pet develops over time is covered.
Waiting to get pet insurance until your dog or cat is older can increase your monthly payment due to policy age limits. It also increases the likelihood that your pet could develop a condition a pet insurance policy won’t cover in the future.
To avoid pre-existing conditions, be sure to keep up with your pet’s exercise regimen and any necessary medications or supplements and take them in for yearly check-ups to catch any issues early on.
Is Pet Insurance Worth It If Your Pet Has Pre-Existing Conditions?
Pet insurance can be worth purchasing for pets with pre-existing conditions, but pet owners should carefully consider plan parameters and monthly costs. Although some pre-existing conditions are considered curable, based on our review of policy documents, insurers always exclude non-curable pre-existing conditions from coverage.
Suppose your pet has multiple conditions when you sign up. To save money in this case, you may opt for an accident and illness plan with lower annual limits and higher deductibles, which will lower your premium. Or you may choose a provider offering an accident-only plan, which costs less each month, to cover your pet in the event of an accident or injury.
If your pet is young and has only one or two pre-existing conditions, you may still choose to purchase a full-coverage policy. As your pet gets older, the probability of other expensive conditions, such as cancer, orthopedic disease or an auto-immune disorder, increases and can make paying for insurance coverage worthwhile.
Frequently Asked Questions About Pre-existing Conditions
Some pet insurance companies require a vet exam prior to enrollment in coverage. If not, pet owners are usually asked to submit their pet’s medical records when they file a claim. One way or another, your pet insurance provider will need to know about your pet’s medical history, and from that it can determine whether a condition is pre-existing.
There is no pet insurance provider that will cover every possible condition your pet could face. Pre-existing conditions, elective procedures, cosmetic procedures, breeding and grooming are typically excluded from pet insurance coverage.
If a condition was not diagnosed but symptoms were present and documented prior to enrollment, it would still be considered a pre-existing condition. For example, if you took your dog to the vet because he was limping and the same symptom recurs after enrollment, it would not be covered.
If your pet had a heart murmur before enrolling in a pet insurance plan, most companies would consider it a pre-existing condition. However, if the heart murmur was detected after enrollment, your provider may cover the condition. Check with your insurance provider to learn more.
Hereditary or genetic conditions are considered pre-existing if symptoms or a diagnosis occurred before enrollment or during the waiting period. Common congenital conditions in pets include kidney disease, heart disease and epilepsy.
As with other conditions that could affect your pet, as long as symptoms, treatment or diagnosis occurs after the policy begins, your provider is more likely to cover a hereditary condition.
How We Selected the Best Pet Insurance Companies for Pre-Existing Conditions
Many pet insurance providers offer comprehensive and affordable plans for pet owners, but a select few offer policies for pets with pre-existing conditions. Although no provider explicitly covers pre-existing conditions, we used the following factors to help rank the top plans for flexible pre-existing condition coverage:
- Curable pre-existing conditions coverage: We ranked companies that cover certain curable pre-existing conditions higher than providers offering no coverage.
- Number of conditions and treatments covered: Companies that offer broader coverage for unique conditions, such as congenital and hereditary conditions, ranked higher on our list.
- Two or more plan options: Providers that offer more than one policy for pet owners to choose from ranked the highest. With multiple offerings, pet owners can weigh the pros and cons of each plan and premium to select the best coverage.
- Customizable coverage levels: Pet care plans with customizable coverage options for reimbursement rates, annual limits and deductibles scored higher than others.
- Vet exam requirement: We ranked companies that do not require a vet exam at sign-up higher than pet insurance providers that do. This allows more flexibility for pets that may have pre-existing conditions.
- Cost: Pet insurance companies with cheaper monthly premiums received higher scores. Our team analyzed four types of pets across the U.S. to determine each company’s average cost. Cost figures are up-to-date as of November 2023.
- Waiting periods: Companies with shorter waiting periods, such as two days vs. the average of 14 to 30 days, ranked higher on this list.
- Our rating: Our team rated over 35 pet insurance companies using our objective provider review methodology. Pet insurance providers with a higher overall score ranked higher on our list.
Read our editorial guidelines to learn more about our review process.
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