Does Pet Insurance Cover Preexisting Conditions?

Small dog using wheelchair on hind legs looks at owner

Roberto Pangiarella / EyeEm

Humans love their four-legged companions, and we often see them as family. So it’s no surprise we get concerned when one of our pets becomes sick. But vet bills, especially for chronic issues, can quickly add up to thousands of dollars. 

Pet insurance can help make costs more manageable. But preexisting conditions may be excluded from coverage. We talk below about what preexisting conditions are, whether your insurer covers them, and alternatives if it doesn't.

Key Takeaways

  • Preexisting conditions are any diagnosed or undiagnosed conditions your pet experienced or received treatment for—before enrolling in pet insurance and up to the end of the policy’s waiting period. 
  • Pet insurers often distinguish curable and incurable conditions to provide coverage if your pet has been cured and symptom-free for a specified time. 
  • Pet insurers typically use your pet’s medical record for information on preexisting conditions. 
  • Pet insurance policies and companies differ among states and providers—ask for details regarding any and all policies you’re considering.

What Are Preexisting Conditions in Pets?

In general, preexisting conditions in pets are any conditions your pet experienced, whether diagnosed or undiagnosed, before enrolling in pet insurance or during a policy’s initial waiting period. (A waiting period of two weeks is typical for accident and illness insurance.) 

Most insurers distinguish between curable and incurable preexisting conditions. They may cover certain curable conditions after enrolling if your pet has been symptom-free for a specified time, such as a 12-month waiting period, since the last episode.

The exact definition of a preexisting condition in pets varies by insurer, as does how far back an insurer will look at medical records to judge whether a condition is preexisting. Typically, you can still purchase a policy if your pet has preexisting conditions. But insurers may exclude recent ailments and certain conditions from coverage. 

Bilateral Conditions

Bilateral conditions are medical issues that can and often do appear on both sides of the body, such as hip dysplasia. Your insurer may not cover a bilateral condition on either side if the first instance is a preexisting condition. In other words, insurers may not cover a bilateral condition that develops on a second side if your pet developed symptoms on the first side before the insurance coverage was in effect or before the waiting period ended. 

For example, say your dog has a preexisting cruciate ligament tear on its right knee. Your pet goes on to develop the condition on its left knee while insured. Pet insurance companies may consider the new cruciate tear as a preexisting condition that’s ineligible for pet insurance coverage.

Common Preexisting Conditions in Pets

Insurers specify in the policy what conditions are considered preexisting, but common ones include cancer, heart disease, and arthritis. Insurers may consider these to be incurable preexisting conditions, along with other common chronic conditions like:

  • Allergies
  • Diabetes
  • Hyperthyroidism and hypothyroidism
  • Urinary or bladder crystals and blockages
  • Bilateral conditions such as hip and elbow dysplasia, cruciate ligament issues, cataracts, and luxating patellas

Your policy’s terms dictate which incurable conditions are permanently excluded from coverage, regardless of how long your pet was symptom-free before a recurrence. 

But some curable preexisting conditions may later be eligible for coverage if there are no symptoms or episodes for the time specified. These include:

  • Ear infections
  • Respiratory infections
  • Urinary tract and bladder infections
  • Diarrhea
  • Vomiting
  • Other gastrointestinal disorders

How Does Your Insurance Provider Evaluate Your Pet?

Pet insurers look at your pet’s medical record to determine preexisting conditions. Medical records include your pet’s:

  • History of vet visits and symptoms examined
  • Wellness tests details
  • Personal details, such as age and breed
  • Vaccination status
  • History of medications
  • Emergency hospital visits
  • Diet and exercise habits

Any diagnoses or symptoms appearing before you enrolled or at any point during the policy’s waiting period are seen as preexisting. Generally, the earlier you get pet insurance, the fewer preexisting conditions will be on your pet’s medical record, making it more likely they’ll be covered when the first symptoms appear. 

Insurers also look at your pet’s breed to determine common breed-specific ailments to exclude from coverage, such as deafness in Dalmatians and cardiomyopathy in Persian cats. It’s crucial to read your policy’s terms before enrolling to ensure you have the coverage you think you do. 

Insurance for Pets With Preexisting Conditions

You’ll have a tough time finding a pet insurance company that provides coverage for a recent or symptomatic preexisting condition as soon as you enroll. But some are more lenient than others with definitions and waiting periods, so it helps to shop around. 

For example, insurers like ASPCA Pet Health Insurance cover curable preexisting conditions after 180 days of no symptoms and treatments, while Embrace requires waiting 12 months.

Many insurers permanently exclude bilateral conditions like knee or ligament issues if first appearing before enrolling or during the waiting period, and waiting periods may last as long as 12 months, depending on the insurer.

To find the best pet insurance company for pets with preexisting conditions, analyze pet insurance policies to determine the following:

  • What constitutes a preexisting condition
  • Fine print exclusions for occurrences or recurrences of specific conditions, even if your pet meets waiting periods 
  • Length of special and general waiting periods
  • Any health coverage exclusions for your pet’s breed

Alternatives to Pet Insurance

If pet insurance doesn’t cover expenses related to your companion’s preexisting condition, there are alternatives to help make treatment costs more affordable. 

Veterinary Discount Plans

Vet discount plans are programs where vets within a network agree to offer discounts on certain procedures. It’s not pet insurance, but it can lower fees for treatments your pet needs. You can join programs online or find discount cards at outlets like drug stores and convenience stores. 

Comparison Shopping

Veterinary procedures don’t all cost the same at every veterinary office. You can save significantly by calling local vets and seeing who has better prices. 

Pet Savings Fund

Having a general emergency fund or one just for your pet can go a long way in relieving the mental and financial stress of unexpected vet bills. While you can do this with a separate savings account at your bank, alternatives like Pawp allow access to a $3,000 fund for emergencies once a year in exchange for a fixed premium of $19 per month.

Credit Financing and Payment Plans 

Vets may partner with credit card companies like CareCredit to offer financing options. Others work with service providers to provide payment plans. Check with your local vet what options are available. 

Financial Assistance Programs

Some foundations and programs help low-income families and other groups afford the cost of vet medical care, such as:

Frequently Asked Questions (FAQs)

What Does Pet Insurance Cover?

There aren’t any standard coverages in the pet insurance industry, so exact plan coverages vary. Plans may offer protection against pet injuries and mishaps, treatments of illnesses, testing, prescription drugs and food, medical procedures, and more.

How Much Is Pet Insurance?

Accident and illness policies cost an annual average of $594.15 for dogs and $341.81 for cats. Accident-only plans cost $218.13 and $133.61 on average for dogs and cats, respectively.

What Pet Insurance Companies Will Accept Preexisting Conditions?

If you’re looking for immediate coverage to treat symptomatic preexisting conditions, you likely won’t find an insurer providing coverage for that. But some companies may cover curable preexisting conditions immediately if enough time has passed since the last incident. Other insurers might cover curable preexisting conditions at a later date if your pet hasn’t shown any symptoms for a specific period.

Article Sources

  1. ASPCA Pet Health Insurance. "Pet Insurance and Pre-existing Conditions."

  2. Embrace Pet Insurance. "Pet Insurance & Pre-existing Conditions."

  3. Pawp. "Pawp Emergency Plan."

  4. CareCredit. "Veterinary Financing."

  5. North American Pet Health Insurance Association. "Section #3: Average Premiums."