One of the most common questions pet owners ask when it comes to pet insurance is, ‘Does pet insurance cover pre-existing conditions?’ Especially if your pet already has health issues, it’s important to understand how these conditions may affect your ability to receive insurance coverage.
To understand the finer points, you need to know what pre-existing medical conditions are, how different insurance companies treat them, and what options you have to ensure your pet receives the care it needs even if it has been previously diagnosed.
Pet insurance coverage for pre-existing conditions
A pre-existing condition is an illness, injury or condition that your pet has had before the start date of your policy or during the waiting period that applies to some conditions after coverage begins.
Unfortunately, most pet insurance policies don’t cover pre-existing conditions. If your pet has an illness before you buy the policy, the insurance company usually won’t cover the treatment of that illness, at least for a certain period of time. However, policies vary from pet insurance company to pet insurance company, so be sure to check the policy carefully for details.
Classification of pre-existing conditions
When it comes to pet insurance, it’s important for pet owners looking to insure their beloved dog to understand how pre-existing conditions are classified.
Curable pre-existing conditions
Some pre-existing conditions are considered curable, which means that symptoms can be eliminated or effectively managed with treatment. Coverage for curable pre-existing conditions varies by insurance company, but some policies provide coverage after a waiting period has passed or if the symptoms have gone away for a certain period of time.
Pre-existing conditions that cannot be cured
Other pre-existing conditions are considered incurable and cannot be cured completely even with treatment. Most pet insurance companies will not cover these conditions as they require ongoing management and treatment.
Bilateral symptoms
Bilateral disease refers to disease that affects both sides of the body, which can present unique challenges with regards to insurance coverage.
For example, if your pet had hip dysplasia in the left hip before the policy began, the insurance company may not reimburse the medical costs if the pet later develops hip dysplasia in the right hip.
Genetic or congenital disorders
Some pre-existing conditions are congenital or hereditary, meaning they are present at birth or developed during childhood due to genetic factors. Many pet insurance companies will not cover these conditions, especially if they are diagnosed within a certain time period after your policy starts.
How Insurance Companies Determine Pre-Existing Conditions
Insurance companies will usually determine pre-existing conditions based on your pet’s medical history and past veterinarian records.
When applying for pet insurance, you may be asked to disclose any current or past medical conditions your pet may have. Failure to accurately disclose this information may result in coverage being denied or your policy being cancelled.
Some insurance companies may require a recent veterinarian medical exam to establish a baseline of your pet’s health.
Reviewing medical history
To avoid disappointment later, some insurance companies offer the option to request a review of your pet’s medical history. This assessment will give you a comprehensive overview of any medical conditions that could be classified as pre-existing in your pet.
If your insurance company distinguishes between curable and incurable conditions, this review can also tell you what problems your pet may have that may be covered after a symptom-free period has passed.
How to Find Insurance Options for Pets with Pre-Existing Conditions
If your dog has a pre-existing medical condition, it may be difficult to find insurance coverage, but it’s not impossible.
Some insurance companies may offer limited coverage for certain pre-existing conditions, especially if the illness is deemed curable or if your pet has been asymptomatic for a period of time.
Additionally, there are insurance companies that specialize in insuring pets with pre-existing conditions. In these cases, premiums may be higher than standard insurance and the coverage limits may be lower.
Pet insurance companies that cover pre-existing conditions
When choosing pet insurance, is coverage for pre-existing conditions high on your list of priorities? Most reputable pet insurance companies offer coverage for several common pre-existing conditions. Here are a few examples:
ASPCA
The ASPCA’s Pet Health Insurance Plan covers pre-existing conditions that can be cured if they heal without treatment for 180 days. Knee or ligament injuries are not covered.
Embrace
Embrace covers any pre-existing curable illnesses if your pet remains untreated and symptom-free for one year.
Heart Building
With the exception of knee and ligament conditions, Heartville insurance will reimburse you for treatment of pre-existing conditions after 180 days of treatment and symptom-free period.
lemonade
In some states, pets that have been cured of pre-existing illnesses and have been symptom-free for 12 months may be covered under Lemonade insurance.
Lots of pets
Unless your pet suffers from hip dysplasia or cruciate ligament injury, ManyPets will cover future claims for pre-existing medical conditions that have been free of treatment or symptoms for 18 months.
MetLife
If you switch insurance policies, your new insurer may consider any conditions diagnosed during your previous policy period to be pre-existing, so you won’t be covered for those conditions if you switch to a new insurer. MetLife works a little differently and will cover conditions that were previously covered by your previous insurer.
Nationwide
Nationwide’s insurance will cover you for any pre-existing, treatable conditions that have been symptom-free for six months – your vet simply needs to provide proof in the form of medical records.
progressive
Progressive Pet Insurance covers the cost of pre-existing conditions that can be cured.
spot
Spot’s pet insurance covers pre-existing conditions that are treatable if there is no treatment or symptoms for 180 days. Knee or ligament injuries or conditions are not covered.
How to decide whether to insure a pet with a pre-existing condition
Deciding whether to get pet insurance can be a tough decision if your dog has a chronic illness.
1. Medical expenses
Evaluate the ongoing costs associated with treating your pet’s existing illnesses. Consider the costs of medications, veterinary visits, diagnostic tests, and potential surgeries or procedures.
Compare these costs to your pet insurance premiums and potential coverage limits.
2. Exclusions and Limitations
Be sure to carefully review the terms and conditions of your pet insurance policy to understand what is and is not covered for your pet’s pre-existing conditions. Some insurers offer limited reimbursement for certain aspects of treatment, while others exclude coverage altogether.
Consider whether the coverage offered by your insurance will exceed the out-of-pocket costs of treating your pet’s illness.
3. Concerns about future health
Consider the possibility that your pet may develop new health problems in the future. While pre-existing conditions can be an important factor in your decision to buy insurance, it’s also important to consider the possibility of future illnesses or injuries that are unrelated to pre-existing conditions.
With insurance, you can rest assured that your pet’s future healthcare needs will be covered.
4. Alternative Funding Options
If your pet is elderly or has pre-existing conditions, pet insurance can be cost-prohibitive, in which case it may be a more practical option to consider alternative funding options to cover your pet’s medical expenses, such as opening a dedicated savings account.
5. Pet Insurance Alternatives
Companies like Pawp offer emergency funds as a membership option: for a relatively small monthly fee, you can cover up to $3,000 in emergency vet bills for your pet, regardless of whether they have a pre-existing condition.
Another option is a veterinary discount plan, like those offered by Pet Assure, which offers discounts on medical services and procedures at participating veterinary clinics.
Ultimately, the decision to purchase pet insurance for a dog or cat with a pre-existing condition depends on your pet’s health care needs, your financial situation, and your risk tolerance. Weigh the costs and benefits carefully. Talk to your veterinarian and insurance company to make the best decision for you and your pet.
Conclusion
If your dog has a chronic illness, deciding whether to get pet insurance can be a difficult choice. Many insurers don’t cover these illnesses, but there are options for treatable cases, and specialist insurers may offer limited cover. It’s important to carefully consider the costs, exclusions, and your pet’s future health needs.
Remember, insurance isn’t your only option. Consider alternatives like savings plans and discount programs. Ultimately, the right choice will depend on your pet’s unique needs and your financial situation.
