Pet Insurance and Pre-Existing Conditions

If your pet has health issues, you may think insurance is out of the question. But did you know there is pet insurance that covers pre-existing conditions? 

Pet insurance can take the financial stress out of caring for your pet. But with a pre-existing illness or injury, coverage may be tricky. 

This guide will walk you through pre-existing conditions, how insurers handle them, and what you need to know to get coverage—even if your pet has existing health problems. 

What is a pre-existing condition?

A pre-existing condition refers to any illness, injury, or health issue your pet showed signs of before their insurance coverage started or during a waiting period. Insurers determine if a condition is pre-existing by reviewing your pet’s medical records.

For example, if your cat was on seasonal allergy medication last spring before your policy started in July, the insurance likely won’t pay for more allergy care. 

Or, if your dog showed signs of limping during the waiting period and then was diagnosed with arthritis, that would also be a pre-existing condition since it occurred before coverage began.

Does pet insurance cover pre-existing conditions?

Pet insurance doesn’t cover pre-existing conditions for one primary reason—it would encourage everyone to delay purchasing insurance until their pet has a medical problem. This would make premiums much higher for pet parents. 

That said, there are a few exceptions. Some insurers will cover pre-existing conditions they deem “curable” if your pet has been symptom-free for a certain period of time, usually six months to a year. 

Curable issues are ones your pet can fully heal from, like skin infections, ear infections, and broken bones. Pet insurance companies almost never cover incurable conditions, which are chronic, lifelong health problems like allergies, cancer, and diabetes. 

Navigate pet insurance with pre-existing conditions

You can do a few things to navigate pet insurance with pre-existing conditions and decide if getting a policy is worth it. 

First, get veterinary records and a health assessment. Most insurers will require your pet to have a veterinary exam within the past year before agreeing to provide coverage. This helps identify pre-existing conditions and establish a baseline for your pet’s health.

Next, understand how pet insurance works. Pet insurance plans typically fall into three categories:

• Accident and illness policy: This is the most comprehensive type, covering vet costs related to injuries like broken bones and cuts and illnesses like arthritis and cancer. 
• Accident-only policy: Lower cost but only covers vet costs related to accidental injuries like bites, broken bones, and swallowed objects. It doesn’t cover illnesses.
• Wellness plan: This is an optional add-on that’s strictly for preventative care like annual exams, vaccines, and flea/heartworm prevention.

Lastly, compare policies and ask questions. Most policies exclude pre-existing conditions, but some will cover curable ones after a certain time frame. Shop around, and don’t hesitate to ask questions about coverage, especially if your pet has pre-existing conditions. 

Alternatives and strategies to pet insurance for pre-existing conditions

Even if your pet has pre-existing conditions, there are ways to get help with their medical bills. 

Find pet insurance that covers pre-existing conditions

Remember, every insurance company handles pre-existing conditions differently. Here’s a rundown of what you can expect from a few of the best pet insurance companies for pre-existing conditions. 

• AKC Pet Insurance is the only major insurer that covers curable and incurable conditions after 365 days of coverage. So if your dog has chronic allergies, AKC would cover it once you have a policy for one full year. 
• Embrace covers curable conditions after a 12-month symptom-free period.
• Figo covers curable conditions after a 12-month symptom-free period.
• Nationwide covers curable conditions after a six-month symptom-free period.
• Pets Best covers curable conditions but doesn’t disclose a time period.
• Spot covers curable conditions after a six-month symptom-free period.

Ask the expert

Erin Kinkade

CFP®

When choosing a pet insurance policy, have the initial vet examination (if not done so already), and identify curable vs. incurable medical issues to understand what could be covered. Shop for insurance providers that match your pet’s medical issues (if any) while factoring in the monthly premium and deductible (out-of-pocket expense). You may also want to factor in the reimbursement/payment process of the insurer. For example, if the insurer pays the vet directly or if you pay the vet and the insurer pays you (reimbursement). If the insurer reimburses you, you will want to know the timeframe it processes these claims.

Become self-insured

Self-insurance is where you set aside money each month into a designated savings account to use for future vet bills or emergencies rather than paying insurance premiums. The goal is to accumulate enough funds to pay for routine care and major expenses if something happens.

Buy a preventive care or wellness plan

Preventive care plans offer an alternative to traditional pet insurance. These wellness policies cover regular checkups, vaccines, dental cleanings and other preventative care without also requiring accident and illness coverage. 

While they don’t pay for pre-existing conditions, wellness plans can help maintain your pet’s overall health and possibly prevent new medical issues from arising down the road. You can get this type of plan as a standalone policy through a pet insurer or often through your local vet. 

FAQ

Are any types of pet insurance more likely to cover pre-existing conditions?

Each pet insurance company has its own policies regarding curable and incurable pre-existing conditions. For example, AKC offers coverage for curable and incurable pre-existing conditions after 365 consecutive days of insurance. 

These companies will often cover curable conditions if your pet has been symptom-free for a certain period: Embrace, Figo, Nationwide, Pets Best, and Spot. 

Is it more expensive to insure a pet with a pre-existing condition?

No, insuring a pet with a pre-existing condition isn’t typically more expensive. Your premium is based on factors like your pet’s age, breed, and where you live. 

But since pre-existing conditions aren’t covered, you may pay more out-of-pocket for treatments related to that condition, which can increase your overall expenses.

Will a pre-existing condition affect my pet’s eligibility for insurance?

You can still get insurance if your pet has pre-existing conditions; that doesn’t affect your eligibility. It just means that costs related to that pre-existing condition won’t be covered.

Can a condition be considered pre-existing if it was never diagnosed by a vet?

Yes, an insurance company can consider a condition pre-existing even if it was never officially diagnosed by a vet. All that matters is if the pet showed signs or symptoms of the condition before coverage started or during your waiting period. A lack of formal diagnosis doesn’t matter.

What should I do if my pet develops a condition while already insured?

Take them to the vet to be examined and receive a diagnosis. Pet insurance will likely cover any new conditions your pet develops as long as they’re not listed as exclusions in your policy. Afterward, file a claim to get reimbursed.

Can I switch pet insurance companies after my cat or dog develops a covered condition?

You can, but be very cautious. Many pet insurance providers will deem any covered conditions by another insurer as pre-existing. This is one of the unfortunate downsides of the pet insurance industry. 

One exception is MetLife—it may cover certain pre-existing conditions if you’re switching from a group plan where those conditions were covered.