Money Research Collective’s editorial team solely created this content. Opinions are their own, but compensation and in-depth research determine where and how companies may appear. Many featured companies advertise with us. How we make money.
How Pet Insurance May Cover Pre-Existing Conditions
By Susan Doktor MONEY RESEARCH COLLECTIVE
Considering pet insurance to help cover the cost of vet bills? Coverage can deliver, but no policy is a panacea. Exclusions always apply.
Before choosing a health insurance plan, then, consider what it will and won’t cover. Let’s look at the most common and complicated pet insurance coverage exclusion: pre-existing conditions. Some of the best pet insurance companies cover certain pre-existing conditions, but the coverage is narrow. It’s smart to know the stipulations, which differ by company.
Table of contents
- Do pet insurance policies cover pre-existing conditions?
- What are pre-existing conditions for pet insurance?
- Which pet insurance companies cover pre-existing conditions?
- What is the average cost of pet insurance for pre-existing conditions?
- Pet insurance for pre-existing conditions FAQs
- Summary of our guide to pet insurance for pre-existing conditions
Do pet insurance policies cover pre-existing conditions?
Nearly all pet insurance policies exclude pre-existing conditions. When choosing a plan, you can select from making many coverage options. Those include whether your policy covers both accidents and illnesses, the amount of your annual deductible, and your reimbursement level. But you don’t have a choice about pre-existing conditions.
The good news is that individual pet insurance companies define these types of medical disorders differently. So there is some leeway built into their policies. Notably, some companies cover curable pre-existing conditions while excluding incurable ones.
Also, pets with pre-existing conditions can still get pet insurance. Such a condition doesn’t mean that you are ineligible for a policy; it just means treatment for that issue likely won’t be covered.
What are pre-existing conditions for pet insurance?
A pre-existing condition to a pet insurance company is a medical illness or injury that your pet had before the date you purchased the policy.
That means that even if the company offers coverage for chronic, hereditary and congenital conditions, it may not extend to your pet. These may not be covered if a veterinarian treated your pet for one of these issues in the past. That care would probably make the problem a pre-existing condition.
To determine whether a medical condition is pre-existing, you’ll need to know your policy’s effective date and consult your pets’ medical records. (Insurers may request these records as part of their approval process.)
Pet insurers typically deny claims if you were aware your pet had the health condition when you applied for coverage. They will have evidence of your foreknowledge if your pet’s medical history indicates that it was diagnosed with or examined for the condition, regardless of whether it ever received treatment.
So let’s say your pet needs treatment for a hereditary condition like hyperthyroidism. The issue may have existed for a long time without your awareness. Perhaps it had never shown any symptoms before. In such a case, your insurer would likely cover treatment after the effective date of your policy under coverage for hereditary conditions.
By contrast, though, consider if your pet was diagnosed with hyperthyroidism before you purchased insurance. Even if the animal had never been treated for it, the disease would be considered pre-existing and not covered.
Best for Parent Borrowers: SoFi
Which pet insurance companies cover pre-existing conditions?
It’s not a question of which pet insurance companies cover pre-existing disorders. It’s more about how an individual policy defines the term. Some are more lenient and offer more coverage than others.
Many pet insurance companies publish information on their websites about what they cover and exclude. Review the details of each plan you’re considering. If it’s not offered, ask the company for more information.
Does pet insurance cover curable pre-existing conditions?
Some pet insurance providers distinguish pre-existing conditions as curable or incurable and may cover curable ones even if the pet had it before enrolling in the plan under certain guidelines. Some companies limit coverage to the first occurrence of the condition — meaning it may not cover any recurrences in a certain timeframe. They also may only cover conditions if there haven’t been any symptoms of them for a certain period of time — usually 180 days or one year.
Examples of pre-existing conditions sometimes cited as curable include bladder infections, vomiting and respiratory infections. By contrast, companies consider cancer, allergies, diabetes and other chronic issues to be incurable pre-existing conditions, and therefore don’t cover them.
ASPCA, Spot, Figo, ManyPets and Embrace all offer some form of coverage for curable pre-existing diseases and injuries.
What does pet insurance for pre-existing conditions cost on average?
Pet insurance costs vary based on several factors, including your pet’s age, breed, location, and more. Your policy costs will increase if you seek coverage for preventive care, including vaccinations and tests your vet will perform during wellness visits.
Pet insurance can cost you anywhere from about $15 to over $100 per month for dogs. It’s typically more affordable for cats.
Your options will be limited if you seek a company that will cover your pet’s curable pre-existing condition. Request multiple insurance quotes online to compare the cost and coverage stipulations. Most companies allow policy customization to bring costs in line with your budget. You can reduce your pet insurance premiums by selecting lower coverage limits, higher deductibles and higher co-pays.
Pet insurance for pre-existing conditions FAQs
Do you need a pet's medical records to get an insurance policy?
Some companies require you to provide your pet's medical records before you can get a policy. Often, the documents must include a vet exam within the last year, depending on the company's rules. This helps the companies determine your pet's health status and if it has any conditions that would be considered pre-existing and ineligible for coverage.
Does pet insurance cover bilateral conditions?
Bilateral conditions — injuries or illnesses that affect both sides of the pet's body — are excluded from some pet insurance plans. Some examples of these conditions are cataracts, hip dysplasia and a cruciate ligament tear.
Suppose your pet received treatment for a problem on one side of its body before purchasing your policy. In that case, the insurance company might deny coverage for treatment of the same condition on the other side if that develops. However, if your pet develops the condition for the first time after your policy began, it may be covered. Bilateral condition exclusions are common in pet insurance policies but you can certainly find a policy that doesn't contain one.
How can you determine if a pet has a pre-existing condition?
Ultimately, your insurance company makes the decision of if your pet has a pre-existing condition. But you can make a fair guess if you know your policy's effective date and what's in your pet's medical history. Most commonly, if a vet treated your pet for a problem within one year of your policy purchase, the problem will most likely be considered pre-existing.
Is pet insurance worth it if your pet has a pre-existing condition?
Pet insurance is most likely not worth it if you want coverage for a pre-existing condition since most exclude that. But the policy would still cover certain future treatments your pet needs that aren't related to the pre-existing one.
Whether or not pet health insurance is worthwhile varies by the animal. Consider all policy limitations and what you'd have to pay. Your pet's age and breed considerably affect the cost.
Summary of our guide to pet insurance for pre-existing conditions
Pre-existing conditions — injuries or illnesses your pet had before you purchased insurance — are commonly not covered by pet insurance companies. But just as policy costs vary, so do pre-existing conditions clauses.
Some companies allow coverage for pre-existing conditions that are curable, like bladder or respiratory infections. Incurable ones are always excluded, like cancer, allergies and diabetes.
If you’re in the market for pet insurance to help cover the cost of veterinary care, don’t make a decision until you fully understand how insurers define pre-existing conditions. Look for a policy with a short look-back period.
Pet insurance may not be worth it if you want your pet’s pre-existing condition to be covered. However, even if your pet has such a condition, it can still get insurance for coverage of other accidents or illnesses.
