If My Dog Was Sick Before I Got Insurance, is He Covered?

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Veterinary care for your dog can be expensive, even prohibitively so. For most dog owners, their furry companion is like a family member, and having to face a medical crisis without the means to cover veterinary costs and treatment is a nightmarish situation. Nobody wants to face the decision, if care can not be afforded, of what to do: go in debt beyond your means or consider euthanasia.
Many pet owners obtain medical insurance for their dogs in the expectation they will not have to face such a difficult decision. But is it that simple? Does pet health insurance cover pre-existing conditions? As with human health insurance, pet health insurance is limited, and often does not cover pre-existing conditions--and a variety of other situations you may be unaware of. For a better understanding of what pet health insurance covers, what it does not, and some notable exceptions, read on.


What is a Pre-Existing Condition?

A pre-existing health condition is a medical condition, disease, or disorder your dog suffered from prior to your obtaining health insurance. The vast majority of pet health insurance plans do not cover medical expenses to address pre-existing conditions--and there is more. Most insurance plans also have a waiting period after you begin your policy. The waiting period may be several weeks or months, during which time any medical condition that manifests is considered to have been pre-existing, and is not covered by your newly obtained insurance. This waiting period is implemented because medical conditions that manifest slowly could exist prior to coverage being obtained, but not discovered until weeks or months later. Your new coverage does not apply to medical conditions that were believed present but undetected prior to coverage being obtained.


Bilateral Conditions

Also, newly developed bilateral conditions may not be covered. For example, if your dog was previously diagnosed as having hip dysplasia in one hip, that is a pre-existing condition not covered by newly obtained insurance. If the other hip later develops dysplasia, even though it did not have it before, because of the dysplasia in the previous hip, the new hip is classified as a pre-existing condition! Limitations like this are something for pet owners to be aware of when they take out health insurance for their dog if their dog has experienced orthopedic conditions or disease on one side and not the other.


Previous Symptoms
Also, symptoms that have manifested before coverage that were not diagnosed or treated in your dog, or symptoms in one area of the body that manifest again in the same region, may be ruled as pre-existing, and medical expenses not covered under an insurance policy. For example, an injury to your dog's shoulder that later results in orthopedic strain in the same limb later, or a gastrointestinal symptom that is dismissed as resolved without treatment, and later your dog develops into a gastrointestinal disorder that the previous symptom is linked to, may be considered as indication of pre-existing disorder and not covered.

Other Conditions

Other conditions that are generally not covered by pet health insurance include:

■ Regular vet check-ups
■ Expenses around breeding and having puppies, as this is considered an optional decision
■ Injury caused by your abuse, altercations with other animal or people in your home, or neglect on your part are considered your responsibility
■ Injury caused by strenuous activities you choose to partake in with your dog, such as racing, or sporting competitions
■ Cosmetic procedures


Exceptions?

Some companies will cover a pre-existing condition if it was “curable” and was successfully resolved prior to insurance being obtained. In this case, if the condition occurs again, it may be covered. An example might be an eye infection that was successfully treated and resolved. After insurance has been obtained, and an appropriate time period has gone by, if your dog gets another eye infection, it may be covered and treated as a separate incident not a pre-existing one. You will need to carefully examine the policy you are purchasing to determine if this is the case and if this is a concern for you and your dog.


Timing

As our dogs age, more and more conditions will become classified as pre-existing, so getting coverage earlier, rather than later, may be advisable. Some plans cover routine medical care, while some are for accidental injury or illness only. The cost of these plans varies. What is and isn't covered varies between companies and plans, so doing research on what coverage best suites you and your pets needs is recommended.

Some insurance plans do or do not cover the following conditions:

■ Serious disorders with poor prognosis such as cancer or heart conditions
■ Orthopedic conditions and arthritis
■ Allergies
■ Diabetes and other endocrine conditions
■ Hereditary disorders

Understand what you and your pet’s needs are, and what conditions your pet has, that may or may not be considered as pre-existing and not covered by pet health insurance plans. Completely research the pet insurance policy before purchasing, to make sure it fits you and your dog’s needs. Make sure you understand what your pet insurance plan covers so that you will not be taken off guard at a stressful time when your pet is suffering a medical crisis and you are faced with difficult decisions and veterinary costs.