4 min read

Pet Insurance Coverage: Explaining the Pre-existing Condition


By hannah hollinger

Published: 04/11/2017, edited: 09/07/2022

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For those of us who love our pets like family, pet insurance seems like an attractive way to ensure the future pet health care & wellness of our furry companions. But looking over the many policies available can be a daunting task. What stops many pet parents from continuing to research pet insurance companies is the exclusion of pre-existing conditions.

Pet insurance, while it is the best way to provide quality care for accidents and illnesses that we just don’t expect, may not appear to be the best solution for animals that have already had health problems. There are no pet insurance providers that cover pre-existing conditions, but knowing what a company defines as a pre-existing condition can not only help you decide between policies, but it can also tell you when to get one.

How is a pre-existing condition defined?

The definition of just what constitutes a pre-existing condition can vary from company to company. It is important to find out what the company you are researching considers a pre-existing condition, as you may be able to be covered under certain circumstances.

Most companies consider a pre-existing condition as an illness or injury that was present before the policy begins, or before the end of the waiting period. The waiting period is a feature included in all insurance policies that is intended to prevent fraud, and designates a time frame from the beginning of coverage that any illnesses, accidents or other conditions that may appear will not be covered. There is a tremendous amount of variation in these waiting periods, from a day to 2 weeks for accidents, up to a month for illnesses, and even up to a year for conditions such as hip dysplasia.

Some policies extend this time frame for pre-existing conditions to before your date of enrollment. One policy considers any signs of illness, internal injuries, symptoms, or irregularities within 18 months prior to your enrollment in a policy as evidence of a pre-existing condition.

Another tricky part of defining a pre-existing condition is the fact that an illness or injury can be considered pre-existing even if it has not been diagnosed prior to the beginning of your policy or during the waiting period. An example of this would be if your dog was limping, but your veterinarian wasn’t sure of the cause, and administered no treatment. After you begin a policy for your dog, you again visit your veterinarian for the limp, and he then diagnoses it. Your insurance policy will likely not cover this problem because it began previous to your enrollment. This type of exclusion can even include conditions that may have begun earlier but were never seen by your veterinarian. In these cases, the insurance company often confers with your veterinarian when you make the claim to find out how long your pet has likely been sick or injured.

What are specific kinds of pre-existing conditions?

Pre-existing conditions can cover/include a wide range of illnesses and injuries in pets.

What's included:

  • Respiratory infections
  • Gastrointestinal disorders
  • Heart disease
  • Arthritis
  • Urinary tract infections, crystals or blockages
  • Orthopedic conditions such as luxating patellas, hip dysplasia, and elbow dysplasia
  • Allergies
  • Cancer
  • Diabetes
  • Lipomas or skin lumps
  • Hyperthyroidism or hypothyroidism
  • Complications from previous accidents or trauma
  • Chronic conditions requiring continuous care

If any of these conditions were present before you were enrolled in your insurance policy, and they were treated, any further treatment or related complications will not be covered. This includes any further appearances of cancer in a recovered cancer patient. Any bilateral conditions will not be covered if one side had a problem previous to enrollment, such as a luxating patella that was treated in the left leg, then appears in the right leg after your policy begins.

What is a curable versus incurable condition?

There is another distinction that insurance companies often make when trying to decide if a condition can be covered. A curable condition is one that can be successfully treated, resulting in a full recovery that leads to a healthy state in your animal. An incurable condition, on the other hand, is often going to result in a chronic problem needing continuous care.
There are no cures for these health conditions, and some companies will not only exclude them from coverage, but many even refuse to insure your pet altogether if he is suffering from one.

What's excluded (often):

  • some cancers
  • orthopedic problems
  • heart disease
  • diabetes
  • arthritis
  • and more

When can a pre-existing condition still be covered?

It may seem bleak, as most animals experience some type of illness or injury before their pet parents seek insurance. But there are exceptions to these pre-existing condition rules.

For conditions that are considered curable, many pet insurance providers require that your pet has recovered from the condition and has not shown any further signs, or required treatment, within six months of the beginning of the policy. These can include various infections, skin problems, and digestive system issues.

There are even some policies that will cover a previous cancer patient and hereditary conditions. It is important that you read the policies carefully to distinguish between each companies’ rules, and to find the one that allows for the condition your pet may have encountered or be at risk for.

Ensuring the health of the ones we love is important, but it can be tough to navigate through the many providers that are out there. To be sure that you are receiving the best pet insurance a pet insurance policy can provide, do your research and find the right company that can cover what you and your pets need most.

To find the best pet insurance for your furry friends, check out our pet insurance comparison tool at our Wellness page. 

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