Pet insurance is a valuable tool for pet owners to manage unexpected veterinary costs. However, one of the most common questions pet owners have is whether pet insurance covers pre-existing conditions.

In general, pet insurance does not cover pre-existing conditions, but it’s not that cut and dry. Pet insurance coverage has several complexities. The classifications of pre-existing conditions, how insurers determine them and how to potentially get coverage for them depends on the company, the condition and the individual plan.

Pet insurance coverage for pre-existing conditions

A pre-existing condition refers to an illness, injury or symptom that your pet has before the start date of their insurance policy or during the waiting period that applies to some conditions after coverage begins.

Unfortunately, most pet insurance policies do not cover pre-existing conditions. If your pet has a medical issue before you purchase insurance, treatment for that condition will typically not be covered.

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Classifications for pre-existing conditions

When it comes to pet insurance, understanding how pre-existing conditions are classified is crucial for pet owners seeking coverage for their furry companions.

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Keep in mind: Pre-existing conditions can significantly impact the coverage options available and the overall insurance cost.

Curable pre-existing conditions

Some pre-existing conditions are considered curable, meaning that with treatment, the condition can be resolved or managed effectively. While coverage for curable pre-existing conditions may vary among insurers, some policies may offer coverage after a waiting period or if the condition has been symptom-free for a certain period.

    • Broken bones
    • Certain types of skin conditions
    • Cuts and bruises
    • Ear infections
    • Kennel cough
    • Non-chronic vomiting and diarrhea
    • Respiratory infections
    • Urinary tract infections

Incurable pre-existing conditions

Other pre-existing conditions are considered incurable, meaning that they cannot be fully resolved with treatment. Since these conditions require ongoing management and treatment, they are typically not covered by pet insurance.

    • Allergies
    • Arthritis
    • Bladder crystals
    • Cancer
    • Chronic kidney disease
    • Diabetes
    • Elbow dysplasia
    • Epilepsy
    • Heart disease
    • Hip dysplasia

Bilateral conditions

Bilateral conditions refer to conditions that affect both sides of the body and may present unique challenges in terms of coverage.

For example, if your pet has hip dysplasia in one hip before the start of the insurance policy, treatment for the other hip may not be covered if your pet develops the same condition later.

Hereditary or congenital conditions

Some pre-existing conditions are congenital or hereditary, meaning they are present at birth or develop early in life due to genetic factors. These conditions may not be covered by pet insurance, especially if they are diagnosed within a specified timeframe after the policy starts.

    • Allergic skin disease (golden and labrador retrievers, German shepherds)
    • Brachycephalic syndrome (in pugs, English bulldogs, French bulldogs, Boston terriers and Persian cats)
    • Chondrodysplasia (dachshunds, basset hounds)
    • Certain types of cancer such as lymphoma, hemangiosarcoma, osteosarcoma, mast cell tumors
    • Dilated cardiomyopathy (Dobermann pinschers, Great Danes, Irish setters and boxers)
    • Elbow dysplasia
    • Hip dysplasia
    • Hypertrophic cardiomyopathy (Maine coon and ragdoll breeds)
    • Hypothyroidism
    • Patella luxation (Pomeranian, Chow Chow, cocker spaniel)

How insurers determine pre-existing conditions

Insurers typically determine pre-existing conditions based on your pet’s medical history and previous veterinary records.

When you apply for pet insurance, they may ask you to disclose any pre-existing conditions your pet has or has had. Failure to disclose this information accurately could result in denial of coverage or cancellation of the policy.

Some insurance providers will request a recent vet check-up to establish a baseline of your furry friend’s health.

Medical history review

To prevent disappointment down the line, some insurance providers may offer the option to request a review of your pet’s medical history. This assessment provides a comprehensive overview of which conditions will classify as pre-existing for your pet.

If your insurer distinguishes between curable and incurable conditions, this review can also inform you which of your pet’s issues may qualify for coverage after a symptom-free duration.

How to find insurance options for pets with pre-existing conditions

If your four-legged friend has a pre-existing condition, finding insurance coverage can be challenging but not impossible.

Some insurers (Figo, Spot, Nationwide, Pumpkin) may offer limited coverage for certain pre-existing conditions, especially if they consider the condition curable or if the pet has been symptom-free for a specified period.

Additionally, some insurers specialize in providing coverage for pets with pre-existing conditions. In these cases, premiums may be higher, and coverage limits lower in comparison with standard policies. Some insurance providers (AKC) cover pre-existing conditions, even incurable ones, if you have been with them for some time.

How to decide if you should get insurance for a pet with pre-existing conditions

Choosing whether to take out pet insurance for your furry companion if they have a pre-existing condition can be a challenging decision.

1. Cost of treatment

Evaluate the ongoing costs associated with treating your pet’s pre-existing condition. Consider expenses such as medications, veterinary visits, diagnostic tests and any potential surgeries or procedures.

Compare these costs to pet insurance policies’ premiums and potential coverage limits.

2. Exclusions and limitations

Review the terms and conditions of pet insurance policies carefully to understand what is covered and excluded for your pet’s pre-existing condition. Some insurers may offer limited coverage for certain aspects of treatment, while others may exclude coverage altogether.

Consider whether the coverage provided by the insurance policy outweighs the out-of-pocket expenses for treating your pet’s condition.

3. Future health concerns

Consider the likelihood of your pet developing additional health issues in the future. While a pre-existing condition may be a significant factor in your decision to purchase insurance, it’s essential to consider the potential for future illnesses or injuries that may not be related to the pre-existing condition.

Insurance can provide peace of mind that your pet’s future healthcare needs may be covered.

4. Alternative financing options

Pet insurance may be prohibitively expensive if your pet is older or has one or more pre-existing conditions. In this case, exploring alternative financing options for covering your pet’s medical expenses, such as setting up a dedicated savings account, might be a more viable option.

5. Pet insurance alternatives

Companies like Pawp offer an Emergency Fund as an optional membership add-on. For a relatively small monthly fee, you can apply for up to $3,000 toward an emergency vet bill, regardless of whether it is for a pre-existing condition.

Another option is a veterinary discount plan like what Pet Assure offers, which gives you discounts on medical services and procedures at participating veterinary clinics.

Ultimately, taking out pet insurance for a dog or cat with a pre-existing condition depends on your pet’s specific healthcare needs, financial situation and risk tolerance. Weigh the costs and benefits carefully and to consult with your veterinarian and insurance provider to make an informed decision that is best for you and your furry companion.

The bottom line

Pet insurance coverage for pre-existing conditions is a complex issue that requires careful consideration. While most policies do not cover pre-existing conditions, options may be available for pets with certain conditions.

It’s essential to understand the classifications of pre-existing conditions, how insurers determine them and what coverage options exist. You can find the best solution to meet your pet’s health care needs by researching different insurance providers and policies.

Frequently asked questions

  • Yes, hereditary conditions are often considered pre-existing conditions in pet insurance policies. Insurance companies typically assess pre-existing conditions based on the pet’s medical history, which includes any hereditary conditions disclosed by the pet owner.

    Coverage for hereditary conditions can vary among insurers, with some policies excluding coverage altogether and others offering limited coverage or requiring additional riders or endorsements. Pet owners must inquire about coverage for hereditary conditions when selecting a pet insurance policy and carefully review the terms and conditions to understand the extent of coverage provided.
  • Deciding on pet insurance for a pet with a pre-existing condition depends on numerous factors. Consider treatment costs for the pre-existing condition, policy coverage, potential future health issues, and alternative financing.

    Assess expenses vs. premiums and how these relate to your budget. Also, review policy exclusions and consider future health concerns. Explore specialized coverage options if available. Consult with your veterinarian and insurer to make an informed decision.
  • If a pet has exhibited symptoms of a medical issue before the start or during the waiting period of the insurance policy, those symptoms may be classified as pre-existing.

    When applying for pet insurance, it’s essential to disclose any symptoms or medical history accurately to avoid issues with coverage later. Insurers assess pre-existing conditions based on the pet’s medical history, including any symptoms reported by the pet owner or documented by a veterinarian.