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How Pet Insurance May Cover Pre-Existing Conditions

By Susan Doktor MONEY RESEARCH COLLECTIVE

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Considering pet insurance to help cover the cost of vet bills? Coverage can deliver, but no policy is a panacea. Exclusions always apply.

Before choosing a health insurance plan, then, consider what it will and won’t cover. Let’s look at the most common and complicated pet insurance coverage exclusion: pre-existing conditions. Some of the best pet insurance companies cover certain pre-existing conditions, but the coverage is narrow. It’s smart to know the stipulations, which differ by company.

Table of contents

Do pet insurance policies cover pre-existing conditions?

Nearly all pet insurance policies exclude pre-existing conditions. When choosing a plan, you can select from making many coverage options. Those include whether your policy covers both accidents and illnesses, the amount of your annual deductible, and your reimbursement level. But you don’t have a choice about pre-existing conditions.

The good news is that individual pet insurance companies define these types of medical disorders differently. So there is some leeway built into their policies. Notably, some companies cover curable pre-existing conditions while excluding incurable ones.

Also, pets with pre-existing conditions can still get pet insurance. Such a condition doesn’t mean that you are ineligible for a policy; it just means treatment for that issue likely won’t be covered.

What are pre-existing conditions for pet insurance?

A pre-existing condition to a pet insurance company is a medical illness or injury that your pet had before the date you purchased the policy.

That means that even if the company offers coverage for chronic, hereditary and congenital conditions, it may not extend to your pet. These may not be covered if a veterinarian treated your pet for one of these issues in the past. That care would probably make the problem a pre-existing condition.

To determine whether a medical condition is pre-existing, you’ll need to know your policy’s effective date and consult your pets’ medical records. (Insurers may request these records as part of their approval process.)

Pet insurers typically deny claims if you were aware your pet had the health condition when you applied for coverage. They will have evidence of your foreknowledge if your pet’s medical history indicates that it was diagnosed with or examined for the condition, regardless of whether it ever received treatment.

So let’s say your pet needs treatment for a hereditary condition like hyperthyroidism. The issue may have existed for a long time without your awareness. Perhaps it had never shown any symptoms before. In such a case, your insurer would likely cover treatment after the effective date of your policy under coverage for hereditary conditions.

By contrast, though, consider if your pet was diagnosed with hyperthyroidism before you purchased insurance. Even if the animal had never been treated for it, the disease would be considered pre-existing and not covered.

Which pet insurance companies cover pre-existing conditions?

It’s not a question of which pet insurance companies cover pre-existing disorders. It’s more about how an individual policy defines the term. Some are more lenient and offer more coverage than others.

Many pet insurance companies publish information on their websites about what they cover and exclude. Review the details of each plan you’re considering. If it’s not offered, ask the company for more information.

Does pet insurance cover curable pre-existing conditions?

Some pet insurance providers distinguish pre-existing conditions as curable or incurable and may cover curable ones even if the pet had it before enrolling in the plan under certain guidelines. Some companies limit coverage to the first occurrence of the condition — meaning it may not cover any recurrences in a certain timeframe. They also may only cover conditions if there haven’t been any symptoms of them for a certain period of time — usually 180 days or one year.

Examples of pre-existing conditions sometimes cited as curable  include bladder infections, vomiting and respiratory infections. By contrast, companies consider cancer, allergies, diabetes and other chronic issues to be incurable pre-existing conditions, and therefore don’t cover them.

ASPCA, Spot, Figo, ManyPets and Embrace all offer some form of coverage for curable pre-existing diseases and injuries.

What does pet insurance for pre-existing conditions cost on average?

Pet insurance costs vary based on several factors, including your pet’s age, breed, location, and more. Your policy costs will increase if you seek coverage for preventive care, including vaccinations and tests your vet will perform during wellness visits.

Pet insurance can cost you anywhere from about $15 to over $100 per month for dogs. It’s typically more affordable for cats.

Your options will be limited if you seek a company that will cover your pet’s curable pre-existing condition. Request multiple insurance quotes online to compare the cost and coverage stipulations. Most companies allow policy customization to bring costs in line with your budget. You can reduce your pet insurance premiums by selecting lower coverage limits, higher deductibles and higher co-pays.

Summary of our guide to pet insurance for pre-existing conditions

Pre-existing conditions — injuries or illnesses your pet had before you purchased insurance — are commonly not covered by pet insurance companies. But just as policy costs vary, so do pre-existing conditions clauses.

Some companies allow coverage for pre-existing conditions that are curable, like bladder or respiratory infections. Incurable ones are always excluded, like cancer, allergies and diabetes.

If you’re in the market for pet insurance to help cover the cost of veterinary care, don’t make a decision until you fully understand how insurers define pre-existing conditions. Look for a policy with a short look-back period.

Pet insurance may not be worth it if you want your pet’s pre-existing condition to be covered. However, even if your pet has such a condition, it can still get insurance for coverage of other accidents or illnesses.

Susan Doktor

Susan Doktor is a journalist, business strategist, and veteran homeowner. She writes on a wide range of personal finance topics, including mortgages, real estate, and home improvement. Follow her on Twitter @branddoktor.