Pet Insurance That Covers Pre Existing Conditions

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Contributor, Benzinga
December 15, 2021

Many pets, like people, have health conditions that need treatment -- and these treatments can be expensive. And while pet insurance can help with medical expenses, you'll need to find pet insurance that covers pre existing conditions for some chronic illnesses and health problems that began before you got coverage.

Use our guide to learn more about pet insurance for preexisting conditions. 

Does Any Pet Insurance Cover Pre Existing Conditions?

At the time of publishing, ASPCA is the only carrier that covers pre existing conditions. That being said, providers such as SPOT pet insurance make note that they cover any new covered illness, condition or illness, even if these are a secondary result of a pre existing condition.

What is Considered a Preexisting Condition for Pets?

The definition of a preexisting condition may vary slightly from insurance company to insurance company. In general, however, a preexisting condition is any health condition that had symptoms before you purchased pet insurance. This includes conditions that a veterinarian didn’t officially diagnose. 

Example 1: Let’s say your dog has a noticeable limp after an active day. The limp goes away, and in the meantime, you purchase pet insurance. The limp returns, and your vet diagnoses arthritis. This condition may not be covered because there were symptoms before you purchased pet insurance. 

Example 2: Let’s say your cat has a respiratory infection before you enroll for pet insurance. Your pet is treated and doesn’t have any symptoms for a year, and then has another infection. Some pet insurance companies may pay for treatment for the second infection. 

Diabetes, allergies, arthritis and heart disease could all be preexisting conditions if you noticed symptoms before buying pet insurance. Injuries are also preexisting conditions. For example, if a cat broke their leg and had surgery on the leg, any further issues related to the broken leg would be considered a pre existing condition. That being said, some providers will cover secondary conditions resulting from a pre existing condition.

Pet Insurance Coverage with Pre Existing Conditions

Pet insurance companies vary in their approach to preexisting conditions. Some will not treat any preexisting conditions. Others will treat curable preexisting conditions as long as there haven’t been any symptoms or treatment for at least 6 months or more. 

Review potential pet insurance policies carefully to find out how they define a preexisting condition. 

Is Pet Insurance Worth It With Pre Existing Conditions?

Pet insurance can still be helpful, even for pets with preexisting conditions. Unfortunately, you never know when an accident or illness will happen. Pet insurance will cover conditions, accidents and injuries that occur after you purchase a policy, and that can save you hundreds, or even thousands, of dollars.  

If your pet has preexisting conditions, review the terms of potential pet insurance policies to see whether those conditions will be covered. The best way to do this is by reviewing a sample policy. 

Compare Pet Insurance

Which pet insurance providers are the best? Here are Benzinga’s picks. 

How Does Pet Insurance Work?

Pet insurance companies may also have general information about preexisting conditions, and you can also ask about any specific conditions your pet is experiencing. Disclosing your pet has preexisting conditions will not prevent them from qualifying for pet insurance. 

The best way to reduce issues with preexisting conditions is to purchase a policy for your pets before they have one. Buy a policy while they’re young and healthy so you have the coverage in place as they age. That way, you don’t have to worry about most preexisting conditions. 

If you’re concerned about your pet having a hereditary or congenital condition (a condition that the pet is born with but doesn’t show symptoms of until later in life), review and compare potential pet insurance policies carefully. Some policies will cover hereditary and congenital conditions as long as there are no symptoms or treatments for those conditions before you start the policy. Other policies exclude those conditions. 

How Policies Work

An important aspect of coverage is how pet insurance policies work. In general, pet insurance works on a reimbursement basis. This means that you pay your vet bill and then submit it with receipts to your pet insurance company. Your pet insurance will pay the bill according to the terms of your policy. 

Deductibles

Most pet insurance policies have a deductible. This is the amount you pay for covered services before your insurance plan will pay. Deductibles are usually annual, so you have to pay it each year. 

For example, if you have a $500 deductible and your 1st veterinary bill of the year is $1,000, you pay the 1st $500. Your insurance company would reimburse you for the rest of the bill according to the terms of your policy. You may be able to choose your deductible.

Reimbursement Percentage

Pet insurance policies typically reimburse you for a percentage of the bill. For example, a policy might pay 80% of the bill. Using the example above, you pay $500, and the insurance company reimburses you for 80% of the $500 balance. That’s $400, which means you pay a total of $600 for that $1,000. If you already met your deductible, you pay $200. Your insurance company would reimburse you for $800. 

Coverage Limits

Pet insurance policies may have an annual and/or lifetime limit on coverage. For example, you might have an annual policy limit of $3,000. That means your insurance company would reimburse you for up to $3,000 in covered veterinary costs. Any costs beyond that would be your responsibility. Some companies offer unlimited coverage with no limits. 

What Is and What Is Not Covered on a Pet Insurance Policy?

Pet insurance policies vary when it comes to what is covered. Let’s take a look at what policies typically cover, what coverage varies by plan, and what policies don’t cover. 

What Pet Insurance Covers

  • Accidents: Bites, broken bones, cuts, swallowed objects and more can happen easily. Policies typically cover services related to the accident, including X-rays, MRIs and other imaging, bloodwork, sutures, medications, hospital stays and surgeries. You can also buy accident-only pet insurance policies that exclusively cover these situations. 
  • Illnesses: These include respiratory infections, cancer, arthritis, ear infections, urinary infections and more, as long as they occur after you start the policy or after the policy’s waiting period. Policies typically cover tests needed to diagnose the issue and the medications needed to treat the illness. 

What Pet Insurance May Cover

  • Wellness and preventive care: Some policies include this care, while others have it available as an add-on or don’t cover it at all. This includes check-ups for your pet and their routine vaccinations. 
  • Routine medication: Plans vary when it comes to whether routine medications are covered. These medications treat chronic conditions like allergies. 
  • Alternative therapies: This includes acupuncture, chiropractic care and laser therapy. Some policies include this in the base policy, while others have it as an add-on or don’t cover it at all. 
  • Behavioral issues: This includes diagnosing and treating issues like anxiety.

What Pet Insurance Doesn’t Cover

  • Preexisting conditions: These are conditions that occur before you have the policy or during the policy’s waiting period. As noted above, some policies will cover curable preexisting conditions if enough time has passed. 
  • Cosmetic procedures: This category includes ear docking and declawing. 
  • Breeding: This includes costs relating to pregnancy and delivery. 
  • Dental care: Most policies don’t cover routine dental care, but they will cover dental care that’s related to an accident. 
  • Exam fees: These are charges for the pet’s examination, and many policies don’t cover the exams, although they cover testing and other expenses. 

Should You Get Pet Insurance?

Pet insurance is worth considering for any pet. Vet care has advanced significantly, but it’s also gotten more expensive. Even if your pet already has a health condition, it’s best to be prepared and have insurance in place. 

Frequently Asked Questions

Q

Can you still get pet insurance after diagnosis?

A

You can get pet insurance after your pet has been diagnosed with a disease or illness. Depending on the policy, that specific condition might not be covered at all, or it may be covered after a wait of 6 months to a year.

Q

Can you insure a dog with a preexisting condition?

A

You can insure a dog with a preexisting condition. That particular condition will not be covered immediately, and some insurance plans will not cover preexisting conditions at all. The best approaches are to discuss your concerns with potential pet insurance companies and review the policy language carefully.

Q

How does pet insurance know about pre existing conditions?

A

Your pet insurance company may request your pet’s vet insurance records in order to determine if your pet has pre existing conditions or if a claim is eligible for reimbursement.

Melinda Sineriz

About Melinda Sineriz

Melinda specializes in writing about mortgages. student loans, personal loans, insurance, managing credit and debt, and credit cards.