Key Takeaways
- Pet insurance typically excludes incurable pre-existing conditions like cancer, diabetes, and orthopedic issues.
- Some insurers cover “curable” pre-existing conditions (e.g., kennel cough) if your pet remains symptom-free and has not received treatment for a specified period, often 180 days.
- Pet insurance companies may require a medical exam when you purchase a policy or request veterinary records when you file a claim.
- Knowing the rules surrounding pre-existing conditions is critical before buying a policy to avoid unexpected expenses.
What Are Pet Pre-Existing Conditions?
A pet insurance pre-existing condition is an injury or illness your pet had before your policy’s effective date. These conditions generally fall into several categories:
- Curable Conditions: These are illnesses that can be fully resolved, like bladder infections or ear infections. Some insurers cover these if the pet has been symptom-free and received no treatment for a certain period.
- Incurable Conditions: These are chronic or lifelong conditions, such as diabetes, cancer, or arthritis, that are typically not covered if they existed before your policy began.
- Bilateral Conditions: These affect both sides of the body (e.g., hip dysplasia). If a condition was present on one side before the policy, any recurrence on the other side is generally excluded.
- Hereditary or Congenital Conditions: These are conditions that are either genetic or present at birth. Coverage often depends on when the symptoms first appear, with many policies covering them if they arise after the waiting period.
Curable Pre-Existing Conditions
Companies like ASPCA Pet Health Insurance may cover curable pre-existing conditions. These companies usually require that the pet is symptom-free and has not received treatment for a set period, often around 180 days. Here are examples:
- Bladder infections
- Diarrhea
- Ear infections
- Kennel cough
- Urinary tract infections
- Vomiting
Incurable Pre-Existing Conditions
Pet insurance won’t cover incurable conditions that existed before coverage began.
Examples include:
- Allergies
- Arthritis
- Bladder crystals
- Cancer
- Chronic conditions like inflammatory bowel disease
- Diabetes
- Epilepsy
- Heart disease
- Hip dysplasia
- Kidney disease
- Limpomas or skin bumps
- Orthopedic conditions like intervertebral disc disease
- Thyroid imbalances like hyperthyroidism or hypothyroidism
- Urinary blockages
Bilateral Pre-Existing Conditions
Bilateral conditions affect both sides of the body. If your pet had a condition on one side before coverage, a recurrence on the other side often isn’t covered. However, if a new bilateral condition develops after your policy’s waiting period, it is typically covered.
Hereditary or Congenital Conditions
Hereditary conditions are genetic and may not appear until later in life; congenital conditions are present at birth. Pet insurance often covers these conditions if symptoms start after the waiting period.
Examples of hereditary conditions:
- Cherry eye
- Hip and elbow dysplasia
- Intervertebral disc disease (IVDD)
Examples of congenital conditions:
- Congenital heart disease
- Hernias
- Hypothyroidism
- Idiopathic epilepsy
Which Pet Insurance Companies Cover Pre-Existing Conditions?
The specifics vary by company. Here’s a summary based on Forbes Advisor research.
Does My Pet Need To Be Examined Before Enrolling in a Pet Insurance Plan?
Some companies, like Embrace, may request a medical history review after your application. You can cancel if the policy doesn’t suit your needs after the review. Others don’t require a vet exam or medical records upfront. For example, ASPCA Pet Insurance doesn’t request them before you purchase. However, insurers might ask for records after a claim is filed to assess if the condition was pre-existing.
Expert Tips for Pet Insurance
Here are some expert insights to help you choose the right plan:
Buy a Pet Insurance Plan Early On
“I encourage you to buy a plan before your pet develops any health issues, like diabetes or orthopedic conditions. If you wait until after your pet develops health problems, you won’t be covered for vet bills related to those issues.” – Jason Metz, Insurance Lead Editor.
Be a Proactive Pet Owner
“I would urge pet owners to be proactive with their pet’s health care. Address any injuries and illnesses so they don’t worsen and stay current on your pet’s vaccinations to help reduce the chances of developing an incurable condition.” – Ashlee Valentine, Insurance Editor.
Look at Pet Insurance Special Waiting Periods
“I suggest you take special waiting periods into consideration. For example, some pet insurance companies have special waiting periods of six to 12 months for orthopedic issues. If your pet develops an orthopedic condition during the waiting period, it will be considered a pre-existing condition.” – Amy Danise, Insurance Managing Editor.
Not All Insurers Require a Vet Exam
“If you want to skip the veterinary exam before buying a policy, I recommend looking for a company that doesn’t require it, such as ASPCA pet insurance.” – Michelle Megna, Insurance Lead Editor.
Pet Insurance for Pre-Existing Conditions – Frequently Asked Questions (FAQs)
How do pet insurance companies know about pre-existing conditions?
Some companies, such as Lemonade, ask for medical records when you apply. Any symptoms or treatments before coverage begins or during the waiting period are considered pre-existing. Others request records when you file a claim.
Can symptoms be considered pre-existing conditions?
Yes. Even if your pet hasn’t been diagnosed, documented symptoms before coverage can be considered pre-existing, especially if they indicate an incurable illness.
Can I get pet insurance for a pet who has pre-existing conditions?
Yes, you can. Many insurers cover curable pre-existing conditions after a waiting period. You can also get coverage for new accidents or illnesses, even if your pet has a pre-existing incurable condition.
Does my premium increase if my pet has a pre-existing condition?
No. Your premium won’t increase because of a pre-existing condition. However, the policy won’t cover vet bills for those pre-existing, incurable conditions.
