Pet Insurance For Pre-Existing Conditions

Dog during vet visit for a pre-existing condition

Getting hit with an unexpected vet bill is one of the most challenging parts of having a furry family member. Fortunately, pet insurance can help cover some of these costs, protecting your wallet and your pooch. However, most pet insurance policies come with their own set of limitations which are essential to understand as a pet parent. 

Below, we’ll outline everything you need to know about pet insurance for pre-existing conditions and outline the ins and outs of what you might expect from a typical pet insurance policy. Let’s jump into it!

Pet insurance typically does not cover pre-existing conditions, but there are alternatives to help you cut back on costs while you’re waiting to acquire your policy. It’s still a good idea to get pet insurance as early as you can in your pet’s life. 

Takeaway Points

  • Pre-existing conditions are defined as any ailment that was diagnosed before you acquired your pet’s insurance policy. 
  • Pet insurance companies do not cover payments for pre-existing conditions. 
  • Certain ailments like orthopedic or bilateral conditions have special considerations that make them less likely to be covered by pet insurance companies.
  • There are alternatives to pet insurance, but if you intend to get it, it’s essential to acquire a policy as early as possible. 

What Are Pre-existing Conditions? 

Pre-existing conditions are defined as an illness or injury that was identified before a pet patient has signed up for insurance and completed the waiting period. 

Let’s say your dog is diagnosed with patellar luxation or a misaligned kneecap. Even if you go home and sign up for pet insurance that night, your insurance won’t be able to cover any issues relating to the affected kneecap for the duration of his or her life. 

Since the issue was diagnosed before the insurance was acquired (and the waiting period was completed), it’s considered a pre-existing condition. 

Senior cat sleeping with pre-existing condition

How Does Pet Insurance Work? 

When it comes to pre-existing conditions, pet insurance companies typically don’t cover them. Most pet insurance plans have a waiting period of around 30 days before coverage kicks in, so if your pet is already unwell or injured, it’s unlikely you’ll be able to take out insurance to cover medical costs.

Some insurance policies require a documented visit to the vet within 12 months of purchasing your policy. It’s a good idea to get your pet insurance as soon as possible to protect your wallet and your furball. 

Pre-existing conditions are one of the top ways that owners get caught out by pet insurance. Remember that, depending on your policy, your insurance may exclude conditions based on symptoms your pet showed before your cover started – such as a dog who has been seen a couple of times for mild itchy skin then not having cover for allergies. Taking out pet insurance when your pet is young is the safest way to avoid pre-existing conditions and give you the peace of mind of knowing that any illness or injury that occurs is covered. 

Dr. Lizzie Youens, Veterinary Surgeon

What Are Curable, Incurable, and Bilateral Conditions?

Some pet insurance companies are more nuanced, breaking down pre-existing conditions into two groups: curable and incurable. 

Curable pre-existing conditions are common, treatable and typically non-life threatening conditions like: 

  • Diarrhea
  • Vomiting
  • Urinary tract infections 
  • Ear infections

For some policies, curable pre-existing conditions are covered, so long as it’s been 12 months since the last issue. 

As the name suggests, incurable conditions are ailments deemed lifelong by insurance companies, often needing ongoing medication and care, such as:

  • Orthopedic conditions
  • Hyperthyroidism
  • Diabetes
  • Cancer 
  • Allergies 
  • Hip dysplasia
  • Heart disease 
  • Epilepsy
  • Urinary crystals 

Pet insurance companies do not cover incurable pre-existing conditions.

Bilateral conditions

It’s also worth noting that pet insurance companies won’t cover bilateral conditions, which are those ailments that are likely to affect both sides of the body. 

If your dog is diagnosed with a bilateral condition like a cruciate ligament tear on his left side of the body, before having insurance in place, the insurance company then won’t cover a cruciate ligament tear on the right side.

What counts as a pre-existing condition?

A pre-existing condition could be a formal diagnosis of an illness, or merely the presence of symptoms that show signs of a developing diagnosis. Defining a pre-existing condition may not be as cut and dry as some pet parents may expect.

For example, let’s say your dog is taken in for a slight limp before getting pet insurance. After you’ve acquired pet insurance and completed the required waiting period, your dog is diagnosed with hip dysplasia. Even though your dog wasn’t formally diagnosed until you were properly covered, this might still be considered a pre-existing condition, since limping could be seen as an early sign of hip dysplasia. 

In some cases, insurance providers like Embrace and Lemonade may run a medical history check to determine which conditions may be considered pre-existing (or not covered) based on your pet’s medical records. 

Woman getting pet insurance for dog with pre-existing condition

Does Pet Insurance Cover Pre-existing Conditions?

Unfortunately, it’s unlikely that pet insurance companies will cover a pre-existing condition. This is because there’s a higher chance pre-existing conditions will carry out over the course of a pet’s lifetime, adding to the expenses of an insurer. 

Anything diagnosed, or mentioned on a previous medical exam, before your pet insurance’s waiting period is completed, will be considered pre-existing. The waiting periods for most pet insurance groups usually range between 15 days to 30 days. However, orthopedic conditions may have a much longer waiting period of around 6 months.

What To Do If Your Pet Is Uninsured 

In the best-case scenario, your pet has been insured as soon as possible to increase his or her chances of maximizing lifetime insurance coverage. That being said, this isn’t always possible for one reason or another. Fortunately, there are steps you can take to save money if you don’t have insurance:

  • Work with your veterinarian. Some veterinarian clinics may offer custom payment plans if you’re caught off guard by a large bill. See if your vet is willing to help you split up a larger bill over a couple of months. 
  • Apply for grants. Certain organizations like PetSmart Charities and Brown Dog Foundation may help you pay vet bills or find more affordable options for care. 
  • Open a line of credit. In a pinch, it might make sense to open a line of credit or take on a personal loan for your furball. As with any other credit card or loan, it’s critical that you understand any associated annual fees, penalties, and interest rates before signing on. 
  • Open a savings account. Instead of opting for pet insurance, it may make more sense to set aside regular savings for your furry friend. Make a spending plan that accounts for your pet’s typical wellness visits with plenty of padding for unexpected expenses. 
  • Consider opting in for pet insurance as soon as possible. Even if your pet has already been diagnosed with a pre-existing condition, it’s never too late to invest in health insurance. Pet insurance policies can help save you peace of mind (and dollars). This is particularly important as your pooch approaches old age, where trips to the vet may become more necessary. 

Ultimately, selecting the right pet insurance for your pet is a highly personal decision, especially if your pet suffers from a pre-existing condition.

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Katharine Brunotts

Kate Brunotts is a pet-care content specialist with past experience at Heart of Chelsea Animal Hospital in NYC. When she's not crafting articles for pet parents, Kate enjoys relaxing with her Shih Tzu Poodle Mix, Spicy.