Pet insurance might offer some valuable financial protection if your pet gets sick or injured. Some policies may even cover regular wellness visits in addition to providing coverage in the event of an emergency or illness, which could potentially save you a lot of money.
However, if your pet has a pre-existing condition, pet insurance coverage becomes a little more complicated. Getting pet insurance with pre-existing conditions can be tricky, and in some cases, certain treatments might not be covered at all. In this article, we'll define chronic and curable pre-existing conditions and discuss how waiting periods might affect your coverage.
What are pre-existing conditions?
Pre-existing conditions are illnesses or injuries your pet has before you purchase pet insurance. Some of these conditions may be considered chronic, such as diabetes or allergies; others are curable, such as a respiratory infection or a bladder infection. Chronic conditions typically require ongoing care and may last for your pet’s life. Curable conditions are temporary in nature, and your pet might recover with proper veterinary care.
Does pet insurance cover pre-existing conditions?
The answer is a little more complicated than a yes or a no. Pet insurance benefits and coverages vary widely from insurer to insurer, so it’s important to pay attention to what is included in the policy so you aren't surprised by vet bills when your pet needs veterinary care.
When you buy pet insurance, chronic pre-existing conditions are typically not covered. However, some insurers may cover treatment for curable pre-existing conditions. Typically, they require a waiting period from the prior episode or treatment before your pet can get covered for that particular issue. Once the waiting period is over, your pet might be covered if that illness or injury happens again.
Chronic pre-existing conditions
Pet insurance policies do not usually cover treatment for pre-existing congenital and hereditary conditions. Congenital conditions are illnesses or abnormalities that are present at birth, whereas hereditary conditions are illnesses that are common in certain breeds or passed from a parent to its offspring.
Treatment for these conditions could potentially get very expensive over the course of your pet’s life. For this reason, insurance companies will not typically cover treatment for chronic pre-existing conditions.
Chronic pre-existing conditions might include:
- Heart disease
- Hip dysplasia
- Cruciate ligament tears
- Lipomas or skin lumps
- Hyperthyroidism or hypothyroidism
- Urinary or bladder crystals or blockages
If your pet is not eligible for pet insurance due to chronic pre-existing conditions, consider veterinary discount plans. For instance, Pet Assure offers an affordable and simple plan that has no limitations or exclusions for treatments at participating veterinarians. Discount plans like this could act as an alternative to pet insurance and potentially help you offset vet costs.
Curable pre-existing conditions
Pet insurers may offer coverage to pets that have had or have a curable pre-existing condition. Once your pet’s condition has been cured and it is no longer receiving treatment, it may be covered for further treatment of that condition after a waiting period. The waiting period for curable pre-existing conditions can be up to 12 months.
For instance, if your pet has recurring urinary tract infections and has recovered, future treatments may be covered after a waiting period. The waiting period starts from when your pet is cured, or the prior treatment, whichever is most recent. During the waiting period, your policy might cover wellness or emergency visits unrelated to the curable pre-existing condition, depending on your coverage.
Curable pre-existing conditions could include:
- Respiratory infections
- Urinary tract/bladder infections
- Vomiting, diarrhea, and other gastrointestinal disorders
A note on waiting periods
A common pet insurance myth is that your pet is covered right away. However, this may not be the case. Pet insurance companies often require waiting periods for certain procedures to ensure a pet owner doesn't sign up immediately before a large vet bill.
Waiting periods vary based on the pet insurance policy terms and the type of claim. And if your pet gets injured or sick during the policy waiting period, that condition could potentially be considered a pre-existing condition, and treatment for it might not be covered in the future.
Here are few types of claims and the waiting periods for each from a few popular pet insurance companies:
|Orthopedic: 6 months
|Hip dysplasia: 12 months (younger than 6 years old; older N/A)
Can you get pet insurance if your pet is already sick?
Pet insurance is generally available for all pets to cover wellness visits and future injuries or illnesses. However, pre-existing conditions are usually not covered, so you cannot purchase insurance expecting it to cover treatment for a pet that is already sick.
Some policies may cover the same illness again after a waiting period once your pet has fully recovered. For instance, if your pet fully recovers from a respiratory illness and gets the same illness later on in life, the cost of treatment could potentially be covered by your pet insurance. Read through the details of your policy or contact your pet health insurance agency to confirm whether your policy covers curable pre-existing conditions.
What is not typically covered by pet insurance?
Pet insurance typically does not cover the treatment of chronic pre-existing conditions, cosmetic procedures, or breeding costs. Additionally, depending on the policy, pet insurance may require out-of-pocket copays for services or a deductible before coverage begins. There could also be a waiting period before coverage for a certain type of treatment kicks in. Review your policy or check with your insurer if you have specific questions about coverage.
What is typically covered by pet insurance?
Pet insurance policies often offer preventive care, injury, and illness coverage as well as wellness plans. For instance, many pet insurers offer reimbursement for expenses related to your pet's routine checkups, vaccinations, and flea and tick treatments. Some policies might also cover periodic treatments like teeth cleaning and one-time procedures such as implanting a microchip or spaying or neutering your pet. It’s a good idea to check with your pet insurance provider if you have questions about your coverage.
The bottom line
If you're wondering whether pet insurance is worth it when your pet has a pre-existing medical condition, the answer can still be yes. Your policy benefits could still offer reimbursement for other vet bills, such as wellness visits or future illnesses and emergencies, even if the pre-existing condition expenses are not included. In fact, FinanceBuzz recently surveyed 835 U.S. adults with one or more pets, and 50% of those with pet insurance had filed a claim in the past year.
The best solution to avoid being denied coverage is to consider enrolling your pet in a plan with one of the best pet insurance companies when they are young and don’t have too many health issues. Accidents and illnesses can happen when you least expect it, and not necessarily when you’re able to afford a large veterinary bill. Purchasing pet insurance might help to protect your finances and ensure your pet gets the treatment it needs to live a long, healthy life.