Pet Blog / Pet Insurance: Pre-Existing Conditions

Pet Insurance: Pre-Existing Conditions

Like health insurance for humans, pet insurance can be there to help cover the cost when your dog or cat needs medical care. But does pet insurance cover pre-existing conditions? This is one of the most commonly asked questions about this type of insurance. 

What Does “Pre-Existing Condition” Mean for Pet Insurance? 

A pre-existing condition is any medical problem, such as an illness, infection, or injury, that was affecting your pet before your insurance policy took effect, or before the waiting period on your policy ended. You might have noticed symptoms or your vet might have diagnosed the issue before your insurance was in full effect. 

Here are some examples of pre-existing conditions in pets:

  • If your pet was diagnosed with diabetes before your insurance fully kicked in, the cost of treating this chronic condition may not be covered.

  • If your pet was injured before you signed up for an insurance policy, treatments to heal that injury may not be covered.

  • If your pet was diagnosed with a congenital condition before the insurance was active, it may not be covered. 

Does a pre-existing condition have to be diagnosed?

Not necessarily. Even if your pet hasn’t yet been diagnosed with a medical problem, your insurance might not cover it. It depends on whether the insurer determines that the problem is actually a pre-existing condition rather than a new ailment. For example, if symptoms developed before signing up for the insurance, the treatment to fix the problem might not be covered. 

Let’s say that your dog started having trouble walking, but your vet couldn’t figure out why, before you got pet insurance. If the problem continues, and you return to the vet for a diagnosis and treatment plan, your insurance might consider this a pre-existing condition that isn’t covered. 

How does pet insurance know about pre-existing conditions?

Different pet insurance companies may have different requirements. Some might ask you to answer questions about your pet’s health, while others might require more. For example, you might need to take your pet to the veterinarian to be examined before you enroll in a policy, or you might need to submit copies of your pet’s medical records. This is done to help the insurer figure out if your furry friend has any pre-existing conditions. 

Can you take out pet insurance after a diagnosis or right before surgery?

Yes, you can take out pet insurance whenever you want to do so. But, again, if the insurer determines that treatments, procedures, surgeries, or other types of care are related to a pre-existing condition, they may not be covered.   

Is There Any Pet Insurance That Covers Pre-Existing Conditions?

No, pet insurance generally doesn’t cover pre-existing conditions. This means that you’ll be responsible for paying for everything, from exams and diagnostics to treatments and procedures, for any pre-existing conditions.   

The good news is that pre-existing conditions don’t get in the way of your ability to acquire and retain pet insurance. You can still reap the financial benefits of a high-quality plan when it comes to covering other types of care for your cat or dog. 

Are Pre-Existing Conditions Ever Covered?

There are some cases when certain ailments might not be considered pre-existing conditions anymore. 

Let’s say that your pet dealt with a medical problem in the past. If she was cured and remained symptom-free and treatment-free for a specified length of time, your insurer might provide coverage in the event that the problem recurs. Of course, this depends on the insurance provider and plan you select. 

Curable Pre-Existing Conditions 

Curable pre-existing conditions are those that were already impacting your pet before your insurance coverage took effect, but with the right treatment, these conditions can be cured. Examples include infections and digestive ailments. So, if your pet ends up dealing with the same problem again after a waiting period has passed, your insurer might provide coverage for treatment. 

Let’s say that your pet was diagnosed with an infection before you had insurance. Your insurer may consider that a pre-existing condition. However, if your pet receives treatment and is cured, and later ends up getting the same infection again, your insurer might then cover it because it wouldn’t be considered a pre-existing condition anymore. 

What Pre-Existing Conditions Are Not Covered?

Here are some types of pre-existing conditions that generally aren’t covered by pet insurance:

  • Genetic conditions and breed-specific conditions that were diagnosed prior to enrollment.

  • Incurable or chronic conditions that caused symptoms or were diagnosed prior to enrollment. Examples include allergies, urinary crystals, cancer, hyperthyroidism, and orthopedic problems.   

    Bilateral conditions that developed on one side of the body prior to enrollment. If a pet later develops the same problem on the other side of the body, the insurance might not cover treatment. An example is a cruciate ligament tear. 

Purchase Pet Insurance Early to Avoid Limitations

Because there are so many limitations when it comes to pet insurance and pre-existing conditions, it’s a great idea to invest in this insurance as early on in your pet’s life as possible. That way, if conditions develop, you’ll already be covered. 

Don’t forget: even if you can’t receive coverage for a pre-existing condition, this type of insurance can be super helpful when it comes to covering other types of veterinary care

If you’re ready to sign up for a plan that will give you peace of mind and help you save money, check out the Direct Benefits Marketplace to compare the options available in your area.