Pet Insurance That Covers Congenital Conditions

If your pet has a congenital condition and you want help paying for their veterinary care, pet insurance can be a solid investment. Depending on the plan, pet insurance might cover a variety of expenses related to congenital conditions, such as surgery, medication, X-rays, and exams.

To help you find the best pet insurance that covers congenital conditions, we reviewed five top providers based on covered conditions, reimbursement limits, claim handling, waiting periods, and other important factors.

In this guide:

• What are congenital conditions?
• Does pet insurance cover congenital conditions?
• Where to find pet insurance that covers congenital conditions
• How to choose a pet insurance provider for a pet with congenital conditions
• FAQ

What are congenital conditions?

A congenital condition is developed before an animal is born, and it often causes health problems later in life. Congenital conditions are classified by the body system they affect. For example, heart valve dysplasia is a type of congenital heart disease.

Some of the most common congenital conditions that affect dogs include:

• Cleft palate (looks like a hole in the roof of the mouth)
• Overbite/underbite
• Chondrodysplasia (short legs; can lead to premature disc degeneration and increased susceptibility to disc herniation)
• Hernias (internal body part pushes through a weakness in the muscle or body wall)
• Hyperlipidemia (increased cholesterol, triglycerides, or both)
• Liver disease

Here are several common congenital conditions that affect cats:

• Cataracts (cloudy or opaque eye lens)
• Glaucoma (increased pressure in the eye caused by a failure in the eye’s drainage system)
• Hypothyroidism (underactive thyroid gland)
• Renal dysplasia (kidney malformations)
• Aortic stenosis (narrowing of the aortic valve of the heart)
• Pulmonary valve stenosis (heart valve constriction)

When it comes to pet insurance, a congenital condition is not the same as a pre-existing condition. A congenital condition is something your dog or cat is born with, and it may or may not cause health issues as they age. Most pet insurance companies cover congenital conditions if your pet shows no symptoms and is not diagnosed with an associated medical condition before you purchase insurance.

A pre-existing condition is something your pet is diagnosed with prior to being insured. For example, cancer and diabetes are considered pre-existing conditions for pet insurance. Treatment for pre-existing conditions is rarely covered by pet insurance.

However, congenital conditions can also be pre-existing. For instance, if your cat is diagnosed with the congenital condition hypothyroidism before you purchase pet insurance, it would be considered a pre-existing condition and their treatment wouldn’t be covered under your plan. 

On the other hand, if your cat started showing symptoms of hypothyroidism after you purchased pet insurance, their treatment would be covered because it’s a new diagnosis.

	Congenital condition	Pre-existing condition
Timing	Develops before birth	Develops anytime before insurance coverage begins
Coverage	Treatment is covered if your pet shows no symptoms before insurance coverage begins	Treatment is usually not covered

Does pet insurance cover congenital conditions?

Congenital conditions can be expensive to treat. These disorders can affect your pet’s entire body and lead to health problems that require additional treatment. Most congenital conditions aren’t curable, so your pet might need continuous treatment or medication for their lifetime.

Pet insurance covers a range of conditions, including congenital disorders, and your plan can help cover your pet’s medical expenses. For example, let’s say your dog was born with a congenital joint disorder. You purchased pet insurance when she was a year old, and she started showing symptoms of the joint disorder at age three.

Because she didn’t show symptoms of the joint disorder until after you purchased pet insurance, it isn’t considered a pre-existing condition, and her treatment should be covered. However, if you waited to get pet insurance until she was four, after she started showing symptoms of the joint disorder, treatment would not be covered.

Where to find pet insurance that covers congenital conditions

Most pet insurance plans cover congenital conditions, but some plans have limitations. If your pet has congenital conditions, it’s important to choose a provider and a plan that meets your needs. 

We found the five best pet insurance companies that cover congenital conditions as long as the condition hasn’t been detected or is cured prior to obtaining the insurance.

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Tip

When pet insurance companies refer to a condition as “cured,” it means the pet hasn’t received treatment or shown symptoms of the condition in a specified period—often six to 12 months.

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Click the insurer’s name in the table below for more details on the company’s treatment of congenital conditions.

Insurance company	Waiting period for coverage for cured congenital conditions	Best for	Editorial rating
Lemonade	12 months	Fast claims	4.7 out of 5
Fetch	12 months	Coverage	4.9 out of 5
Spot	6 months	Variety of terms	4.5 out of 5
Embrace	12 months	Quick coverage	4.7 out of 5
Trupanion	12 months	Direct vet payments	4.4 out of 5

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Lemonade – Best for fast claims

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Editorial rating: 4.7 out of 5

• Easy to file a claim and get reimbursed
• Cured congenital conditions are covered after 12 months
• Deductibles ranging from $100 to $750

Like the other pet insurance companies we profiled, Lemonade’s pet insurance plans cover congenital conditions, but only if they’re cured. 

Out of the five pet insurance companies we reviewed, Lemonade stands out for its fast claim handling. Lemonade uses an AI-powered digital claim system that allows the company to process and payout claims quickly. You can file claims right on Lemonade’s mobile app. 

• Eligible pets: Dogs and cats
• Annual coverage: $5,000 – $100,000
• Reimbursement: 70%, 80%, or 90%
• Deductible: $100 – $750
• Waiting period: 12 months for cured pre-existing conditions

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Fetch – Best coverage

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Editorial rating: 4.9 out of 5

• Robust coverage with all plans
• Coverage for breed-specific conditions
• Up to 90% reimbursement for vet bills

Fetch’s accident and illness plan provides comprehensive coverage for many of your pet’s medical needs, including cured or undetected congenital conditions. Fetch also covers breed-specific health issues, such as hip dysplasia in certain dogs. After purchasing a plan, you must wait six months before you can use your benefits to cover hip and knee injuries.

Based on our review, Fetch provides the best coverage compared to the other pet insurance companies we evaluated. In addition to standard accident and illness coverage, Fetch also covers sick visit exam fees, and boarding fees when a pet owner is hospitalized.

• Eligible pets: Dogs and cats
• Annual coverage: $5,000 – $15,000
• Reimbursement: 70%, 80%, or 90%
• Deductible: $300 – $700
• Waiting period: 12 months for cured pre-existing conditions

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Spot – Best variety of terms

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Editorial rating: 4.5 out of 5

• Excellent selection of deductibles and reimbursement rates
• Offers unlimited annual coverage option
• Most congenital conditions are covered

Spot’s accident and illness plan covers congenital conditions, including heart disease, eye disorders, and joint conditions. It will cover most of your pet’s vet expenses, such as medications, X-rays, diagnostic testing, acupuncture, surgery, and hospitalization. If your dog or cat has a pre-existing congenital condition, Spot will cover their treatment after they’ve been symptom-free and treatment-free for six months.

Spot stands out for its wide variety of terms. It has the largest combination of deductibles, reimbursement rates, and annual coverage limits out of the providers we reviewed. You can also choose unlimited annual coverage for the most financial assistance with vet bills.

• Eligible pets: Dogs and cats
• Annual coverage: $2,500 – unlimited
• Reimbursement: 70%, 80%, or 90%
• Deductible: $100 – $1,000
• Waiting period: 6 months for cured pre-existing conditions

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Embrace – Best for quick coverage

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Editorial rating: 4.7 out of 5

• Short waiting period for accidents
• Option for unlimited annual coverage
• 12-month waiting period for cured congenital conditions

Embrace insures dogs and cats with congenital conditions, but only after your pet is diagnosed or shows symptoms of a congenital disorder. Congenital conditions that occur before you purchase pet insurance aren’t covered. The only exception is for cured pre-existing congenital conditions, which require a 12-month waiting period.

One reason we like Embrace is its short waiting periods. The waiting period for accidents is 48 hours, and the waiting period for illnesses is 14 days. For dogs, Embrace has a six-month waiting period for orthopedic conditions, but you can bypass this with an orthopedic exam from a licensed vet.

• Eligible pets: Dogs and cats
• Annual coverage: $5,000 – unlimited
• Reimbursement: 70%, 80%, or 90%
• Deductible: $100 – $1,000
• Waiting period: 12 months for cured pre-existing conditions

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Trupanion – Best for direct vet payments

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Editorial rating: 4.4 out of 5

• Trupanion can pay your vet directly for treatment and services
• Plans cover a variety of expenses, including prosthetics and physical therapy
• Live chat for customer service

A Trupanion pet insurance policy will cover your dog or cat’s treatment for congenital conditions that were undetected or have been cured for 12 months from when you opened the policy. The company covers a variety of vet expenses, including medication, alternative therapies, prosthetics, orthotics, and physical therapy.

If your vet accepts Trupanion Vet Direct Pay, Trupanion will pay its portion of the vet bill before you leave the animal hospital or clinic. For example, if your vet bill was $2,000, Trupanion would pay the vet $1,800 (90% reimbursement), and you would pay the remaining 10% ($200) out of pocket to the vet. Unlike some other pet insurance companies, there’s no need to pay the full amount up-front and wait for reimbursement.

For vets that don’t use direct pay, the company pays most claims within 24 hours. Trupanion will reimburse you for 90% of your pet’s medical expenses with no annual cap.

• Eligible pets: Dogs and cats
• Annual coverage: Unlimited
• Reimbursement: 90%
• Deductible: $0 – $1,000
• Waiting period: 12 months for cured pre-existing conditions

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If you have a pet with a congenital condition and are unsure whether purchasing pet insurance still makes sense, CFP® Erin Kinkade thinks it’s worth considering: “I believe the pet owner should still obtain pet insurance to cover other vet costs not associated with the congenital condition. Ideally, those costs are mitigated, and the pet owner can budget more toward the treatment costs of the congenital condition.”

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How to choose a pet insurance provider for a pet with congenital conditions

If you’re purchasing pet insurance that covers congenital conditions, here are several questions to ask yourself as you’re comparing plans:

1. What congenital conditions are covered? Most pet insurance companies cover congenital conditions, but every plan is different, and every company has exclusions. Check to see what congenital conditions are covered before you purchase a plan. For example, if your dog has hip dysplasia on one side, some insurers won’t cover their treatment if they start showing symptoms on the other side.
2. What is the waiting period? If your pet has a pre-existing condition related to a congenital disorder, but they are symptom-free and treatment-free, a waiting period of six to 12 months often applies before future treatment is covered. 
3. How much will the plan cover? Many plans will reimburse up to 90% for your vet’s medical bills, and some offer unlimited annual coverage. However, plans with more coverage generally have higher premiums. 
4. How much value do I get for the money? The cost of pet insurance depends on a variety of factors, including your pet’s age and breed. However, your plan preferences, such as your deductible and reimbursement amount, will also affect your rate. It’s wise to get quotes from several pet insurance companies to see which one can offer the most value for the lowest price.

Erin Kinkade, CFP®, recommends getting pet insurance quotes as early as possible: “The ideal situation for pet insurance occurs when the owner acquires the pet at a young age and applies for a policy right away—before any symptoms occur or after the condition is considered cured based on the waiting period.”

FAQ

What’s the difference between congenital and hereditary conditions?

A congenital condition is a disorder your pet is born with, such as a heart defect. A hereditary condition is a disorder your pet inherits from a parent. Hereditary conditions include epilepsy, allergies, and certain kidney diseases.  

How do I know if my pet has a congenital condition?

If your dog or cat has a congenital condition, your veterinarian will notify you when they notice it—sometimes early in your pet’s life. However, other congenital conditions aren’t discovered until they start causing health issues. In either case, a vet can let you know whether a symptom or disorder is likely congenital.

Does pet insurance for congenital conditions also cover routine vet checkups?

Some pet insurance companies cover routine veterinary care, but others don’t. Many pet insurance companies that cover routine vet care sell an optional preventive care plan you can add to your accident and illness or accident-only plan. This add-on is sometimes called a wellness plan. 

Do insurance providers require a vet’s diagnosis to confirm a congenital condition?

When you purchase a pet insurance policy, many companies require you to submit your pet’s medical records from the last year. The records should note what congenital conditions they’ve been diagnosed with or have shown symptoms of. The pet insurance company uses this information to identify pre-existing conditions.

Can I get coverage for congenital conditions if I adopt an older pet?

Yes, pet insurance policies might cover congenital conditions in pets of all ages. However, some pet insurance companies, such as Trupanion and Embrace, only cover dogs and cats up to a certain age. And if your pet already has health issues resulting from congenital conditions before you buy insurance, it’s considered a pre-existing condition, and their treatment won’t be covered.

Will pet insurance cover surgeries for congenital conditions?

Yes, pet insurance will cover the cost of surgery if your pet is insured before they get diagnosed with a congenital condition. For example, if you insure your puppy at 12 weeks old, and they start showing signs of an atrial septal defect several years later, surgical treatment is often covered. However, pet insurance doesn’t cover surgery for congenital conditions your pet shows symptoms of before you purchase insurance.

Are prescription medications for congenital conditions covered?

Most pet insurance plans cover prescription medications for a variety of conditions, including congenital disorders. Keep in mind: Your dog or cat’s medication is only covered if they start showing signs of the condition after you purchase insurance. Medication for pre-existing conditions isn’t covered.