Pet insurance coverage can be a great way to ensure that your pets always have the veterinary care they need, in case of a new and unexpected injury or illness. These policies provide you with up to thousands of dollars in financial protection each year, but does pet insurance cover pre-existing conditions, too?
Here’s a look at the types of care a pet insurance policy may provide and whether your pet will still be covered for an existing condition.
What Pet Insurance Does
As with most other types of insurance coverage, a pet insurance policy is designed to provide you with financial support if your pet is unexpectedly injured or gets sick. Instead of footing the entire bill for veterinary or related pet care, pet insurance coverage will reimburse you for a portion of those covered costs.
Depending on the pet insurance policy and carrier you choose, you may be protected for a percentage of expenses related to your cat, dog, horse, rabbit, or other animal. Covered expenses can relate to injuries and illnesses, such as a:
- Broken bone
- Torn ligament
- Dental infection or abscess
- Cut or puncture wound
- Diagnosed disease like cancer or diabetes
If the condition is covered, you can expect most pet insurance policies to provide at least partial reimbursement for things like urgent care visits, blood test, diagnostic scans (such as X-rays and ultrasounds), medication, surgery, post-surgical boarding, and more. Your policy may even cover some of your pet’s prescription food, behavioral therapy training, and acupuncture.
However, one thing that pet insurance won’t cover is a pre-existing condition.
What Is a Pre-Existing Condition in Pet Insurance?
A pre-existing condition (in pet insurance or any other type of policy) is an injury, illness, or condition that was already present when your policy went into effect.
If your pet was previously diagnosed with diabetes, for example, or was already receiving care for a torn knee ligament, those conditions would be considered pre-existing. As a result, any future medical expenses related to those conditions would be denied.
This can be tricky, as a condition may be marked as pre-existing even if you didn’t receive a diagnosis. For example, if you took your pet to the vet for unexplained vomiting twice in the last few months, then bought a pet insurance policy, future claims could be denied if the eventual diagnosis is tied back to those previous visits and symptoms.
Will Pet Insurance Cover Pre-Existing Conditions?
No, standard pet insurance policies will not cover care related to pre-existing conditions in your pet. This can apply whether you knew about the previous injury, illness, or diagnosis, or if you received care for an unexplained symptom that was later diagnosed.
Conditions are considered pre-existing if they were present and symptomatic prior to buying your pet insurance policy. So, if your pet has ever received care for a certain injury or illness, you may find that the same care in the future is denied. This is also why many carriers have a waiting period when you first buy a policy, before your coverage kicks in: this prevents pet owners from buying a new policy and getting reimbursed when their pet is already sick or hurt.
When buying pet insurance, you’ll be asked to disclose your pet’s previous medical conditions, treatments, and diagnoses. Your carrier may also request records from your vet’s office. Even if records aren’t obtained when buying your policy, they will likely be requested if you ever need to file a claim in the future… so it’s important to be transparent!
The pre-existing condition exclusion also applies if you switch pet insurance carriers. Even if you have coverage when your pet’s injury, illness, or condition first occurs, it will usually be marked “pre-existing” (and therefore, denied) if you later switch to a different pet insurance company.
Other Pet Insurance Exclusions
Pre-existing conditions aren’t the only exclusions your policy may have. Depending on the carrier and coverage you choose, and even your pet’s age and breed, you may encounter waiting periods or care denials for new conditions, too.
Some common exclusions include:
- Routine care (pet insurance doesn’t cover things like wellness exams, vaccinations, or routine dental cleanings)
- Hip dysplasia (some carriers only apply this exclusion to certain breeds or pet ages)
- Torn cruciate ligaments (ACL)
- Dental care (some carriers may exclude specific teeth)
- Care related to pregnancy and/or breeding
Alternatives to Pet Insurance for Pre-Existing Conditions
If your pet has already had a serious injury or illness, you can still buy pet coverage for them. In fact, buying coverage can still be a great decision, as you’ll be financially protected against any new situations that may arise!
There are some other alternatives to consider, though, which can further protect you and your pet.
One option is a pet wellness plan. For a monthly fee, these plans offer financial reimbursement for things like routine pet care and vet visits, up to a certain amount each year. This helps you keep your pet in excellent health and may save you money on typical annual expenses.
Another option is a pet discount plan. With these plans, you can save on veterinary exams and more, with either instant discounts at the provider’s office or reimbursement for expenses that you pay out of pocket. These discount plans may apply to any veterinary provider you choose, too, so you don’t have to worry about switching offices or finding an in-network office.
Bottom Line
Pet insurance is a great way to protect yourself against unexpected veterinary bills and care for your furry friend. For a monthly or annual premium, these policies provide you with reimbursement for some of your covered expenses, should your pet be unexpected injured or fall ill.
While pet insurance is a valuable product, though, it doesn’t protect you against conditions that already existed when you purchased coverage. These pre-existing conditions are almost always excluded from pet insurance policies, but you may still get discounts or partial reimbursement with a wellness or pet discount plan.
FAQ About Pet Insurance and Pre-Existing Conditions
What does pet insurance not cover?
Pet insurance doesn’t cover pre-existing conditions or routine veterinary care. Insurance policies provide reimbursement up to a certain percentage and/or dollar amount per year, based on the specific condition and the type of policy you buy.
Will pet insurance cover previous injury?
A pet insurance plan will not reimburse you for previous illnesses or injuries that your pet has experienced. If those conditions were known or treated prior to buying coverage, they are considered pre-existing and will be excluded from future claims.
When does pet insurance kick in if I buy it today?
Nearly all pet insurance policies have a waiting period, to prevent pet owners from buying coverage when their pet is already sick or injured. While the details of these waiting periods will vary from one carrier to the next, they are usually between seven and 14 days for illnesses and as few as two days for accidents. You may also need to wait up to three or even six months for cruciate ligament injuries or hip dysplasia-related claims.
Can I use pet insurance the same day I buy a policy?
Due to exclusions for pre-existing conditions and most policies’ waiting periods, you cannot buy pet insurance and use it for a covered claim that same day. You can, however, purchase a pet discount plan or pet wellness plan and use that coverage immediately.
Do pet insurance pre-existing conditions last forever?
Some pre-existing conditions will follow your pet forever and always be excluded from coverage. This might include a broken bone, torn ligament, or diagnosis of a disease. Some conditions may fall off of the pre-existing condition list over time, though.
For example, if your pet has unexplained vomiting and nausea before you buy a policy, don’t expect to get coverage for a newly-diagnosed stomach condition a month later. However, if that bout of vomiting was two years ago and your pet hasn’t had any trouble since, you may get coverage if they are later diagnosed with a related condition.
