For pet parents looking for a way to protect themselves financially, buying pet insurance could be a good option. High-quality pet insurance companies with comprehensive policies will cover most of the medical issues your animal faces so you don’t have to empty your wallet if your pet experiences illness or injury. Unfortunately, these pet insurance policies do have some limitations — and one of those limitations focuses on pre-existing conditions.
Although some policies do provide at least some coverage for pre-existing conditions, finding pet insurance for pre-existing conditions can be difficult. Here’s what you need to know about your coverage options in these complicated situations.
On this page:
- What is a Pre-Existing Condition?
- Does Pet Insurance Cover Pre-Existing Conditions?
- Pet Insurance That Covers Pre-Existing Conditions
- Should I Get Pet Insurance if My Pet Has Pre-Existing Conditions?
A pre-existing condition is any medical issue your pet has already developed before the policy waiting period has passed — even if you don’t notice the condition until later.
Read More: Pet insurance with no waiting period
For example, if your pet has had a heart murmur since age 3 and you don’t buy a pet insurance policy until age 5, generally anything related to your pet’s heart would be considered a pre-existing condition. So, if it turns out your pet’s murmur is an indicator of heart disease and your pet has an enlarged heart and needs costly medications, your pet’s condition would be classified as a pre-existing condition even if you simply thought your animal had a murmur and no other problems.
Does Pet Insurance Cover Pre-Existing Conditions?
Thanks to the Patient Protection and Affordable Care Act (more commonly known as Obamacare), insurance policies sold to humans cannot exclude coverage for pre-existing conditions. However, there is no such regulation in place for pet insurance policies.As a result, there’s essentially no pet insurance provider that will provide broad coverage for pre-existing conditions. This makes sense because otherwise, you could wait until your pet gets sick with an expensive ailment and then go out and buy insurance coverage.
However, although insurers typically won’t pay for medical issues your pet had before you got covered, the specific coverage limitations can vary substantially from one policy to the next.Many pet insurers refuse to provide any coverage for a pet with pre-existing conditions, other than accident-only policies. Others, such as PetFirst, still allow you to insure your pet, but any health issues related to the pre-existing condition won’t be covered. Finally, some insurers are even more generous when it comes to providing coverage and will cover illnesses related to pre-existing conditions that can be cured if your animal has been symptom-free for a certain period of time.
Other Pet Health Issues That Aren’t CoveredIn addition to coverage exclusions for pre-existing conditions, there are other types of health issues that are often excluded from coverage, sometimes because there’s no cure for the condition.
Examples of situations where your pet may not be covered include:
- When treatment is considered experimental*
- If a condition is hereditary or genetic
- Treatment that is considered cosmetic
- Costs associated with breeding
- Procedures performed outside of the United States
*PetFirst is one company who covers some experimental and holistic treatments and medications for covered pets. These include things like acupuncture, chiropractic care, aqua therapy, and laser therapy.
Pet Insurance That Covers Pre-Existing Conditions
Although many pet insurers simply don’t want to give you a policy at all if your pet has a pre-existing condition, we’ve found some companies that carve out exceptions and allow you to buy a policy even when your animal is already sick. Here are some options pet owners should consider when seeking pet insurance that covers pre-existing conditions.
Pet Assure isn’t technically an insurance policy, so it doesn’t pay for part of the care your animal needs like an insurance policy would. Instead, it is a membership program that allows you to get discounts on pet care.
With Pet Assure, you can save 25% on in-house medical services, including office visits, diagnostic services, vaccines, dental cleanings, and specialty services such as surgeries. You’ll need to visit a participating veterinarian.
Pet Assure does not have any exclusions for animals with pre-existing conditions, so you can sign up your animal even if your pet has some serious chronic conditions. Becoming a member is affordable and enrolling your pet takes minutes. Just be sure there are participating vets in your area so you can benefit from the savings membership provides.
Unlike Pet Assure, Embrace actually is a pet insurance provider, which means you can buy a policy and get part of your care costs covered. Unlike many pet insurers, however, Embrace makes a distinction between pre-existing conditions that are curable and those that aren’t when reviewing your pet’s medical history.
If your pet has a curable condition and has not shown any symptoms of that condition for 12 months, your animal can be covered for that medical condition with Embrace pet insurance if a problem arises again in the future. For example, if your pet had kennel cough, has been symptom-free for two years, and gets kennel cough again after you have Embrace pet insurance, your pet should be covered for the diagnosis and treatment of this illness.
Trupanion is another pet insurance plan that will provide coverage for animals that have had past health problems. When you get covered with Trupanion, the insurer looks for any condition of which your pet presented symptoms within the 18 months prior to the time you enrolled in coverage, as well as for any conditions of which your pet developed symptoms during the waiting period.
If your pet had an isolated illness more than 18 months prior, this wouldn’t be considered a pre-existing condition and your pet should be fully covered.
Conditions are not considered pre-existing with Trupanion if the claims specialist finds a “medical disconnect” between the prior health problem and the current health condition. The example Trupanion gives is if your dog sprained his knee before getting covered and then developed hip dysplasia after enrolling. Since there’s a medical disconnect between the knee injury and the hip dysplasia, the hip dysplasia isn’t considered pre-existing and would be covered.
Should I Get Pet Insurance if My Pet Has Pre-Existing Conditions?
Oftentimes, pet insurance can still be worth it even if your pet has a pre-existing condition already. This is a smart financial decision for many pet owners because your animal could develop other covered problems that are costly to treat. For example, if you have a dog with a heart murmur, cardiac conditions won’t be covered — but if your dog develops a joint injury or pancreatitis, care for those particular ailments could be.
You’ll want to make sure you’re getting the most comprehensive coverage you can, especially if you have a pet with a pre-existing condition that causes you to run through your budget for vet bills. You should compare policy terms and quotes carefully to find the coverage you want at a price that meets your needs.
Bottom LinePets can require a lot of expensive care, and no pet owner wants to choose between their best friend’s health and their financial stability. Although you won’t find pet health insurance that covers all pre-existing conditions, you should still shop around to get the most comprehensive coverage you can for your animal. And if your pet is still in good health, it’s a good idea to get covered now before a condition does develop that would be excluded from coverage in the future.
Author: Christy Rakoczy