Does Pet Insurance Cover Pre-Existing Conditions?

Your pet isn’t just an animal; it's a beloved family member. And as with any family member, ensuring they have the best health coverage is essential. But what if your furry pal already has a known medical issue? Will pet insurance cover it? Here's the scoop on which pet insurance covers pre-existing conditions.

Does pet insurance cover pre-existing conditions?

Most pet insurance companies will not cover costs related to pre-existing conditions. A pre-existing condition refers to any illness or injury that occurred before you bought your pet's policy or during your waiting period. The waiting period is the time between when you buy insurance and when coverage begins.

Insurance companies put this rule in place to prevent you from buying a policy only after your pet gets sick. So if your pet showed symptoms of allergies or an ear infection before your policy started, pet insurance typically won’t pay to treat it.

» MORE: What does pet insurance cover?

Common pre-existing conditions for pets

Just like humans, pets can have a variety of health issues. Some common pre-existing conditions in pets include:

• Allergies.

• Arthritis.

• Cancer.

• Diabetes.

• Ear or eye infections.

Are pre-existing conditions ever covered?

Some pet insurance companies differentiate between curable and incurable pre-existing conditions. While incurable conditions are rarely covered, some insurance companies may cover curable ones after the pet has been symptom-free for a specific period.

Curable vs. incurable pre-existing conditions

Curable pre-existing conditions can heal completely with treatment. Some insurers will cover curable conditions if your pet remains symptom-free for a set amount of time, often six to 12 months.

Examples of curable pre-existing conditions might include:

• Respiratory infections.

• Urinary tract or bladder infections.

• Vomiting and diarrhea (non-chronic).

• Broken bones.

• Cuts and bruises.

• Kennel cough.

Incurable pre-existing conditions are those that your pet will have for a lifetime. These include chronic diseases or conditions with no known cure. Insurance policies typically don’t cover these conditions if they’re present before the policy starts or during a waiting period.

Examples of incurable pre-existing conditions might include:

• Allergies.

• Cancer.

• Diabetes.

• Arthritis.

• Chronic kidney disease.

• Hip dysplasia.

• Epilepsy.

• Heart disease.

» MORE: How much is pet insurance?

Does pet insurance cover bilateral conditions?

A bilateral condition involves body parts that come in pairs, like hips or knees. Pet insurance may not cover bilateral conditions like hip dysplasia if one side was affected before the policy began. If your pet previously had issues with one, insurers often exclude the other side, too, because the condition is likely to recur.

Say your dog tore her right cruciate ligament a year before you bought your policy. If she injured her left cruciate ligament later, after your policy’s effective date, the treatment may not be covered because the insurer considers ligament problems a pre-existing condition.

Does pet insurance cover hereditary and or congenital conditions?

Hereditary conditions are diseases or disorders that your pet inherits from a parent, like Addison’s disease, elbow dysplasia or hypothyroidism. Congenital diseases are ones your pet develops at birth. (Some conditions may be both hereditary and congenital.)

Many pet insurance policies cover hereditary or congenital conditions as long as your pet hasn’t shown symptoms before coverage begins. Others have limitations or extra charges.

» MORE: Does pet insurance cover surgery?

How do insurers determine pre-existing conditions?

Insurers will often ask for your pet's medical history or veterinary records when you apply for a policy. These records provide insight into any pre-existing conditions. In some cases, if the history is unclear, insurers might require a veterinary examination.

To avoid surprises, some insurers allow you to request a medical history review. This review gives you a full breakdown of what will be considered “pre-existing” for your pet. If your insurer differentiates between curable and incurable conditions, it can also tell you which of your pet’s issues might be covered after a symptom-free period.

How to find insurance for pets with pre-existing conditions

Finding pet insurance for pets with pre-existing conditions can be challenging, but it's not impossible. Here’s how to navigate the process.

Look for exceptions. Some insurers may cover a condition they consider curable if your pet has been symptom-free for a specified period, usually six or 12 months. Companies like AKC cover all pre-existing conditions once you’ve had continuous coverage for a year, even if they’re incurable.

Review your pet’s medical history. This will give you a feel for what the insurance company might classify as pre-existing. Your veterinarian may be able to help clarify which conditions might be considered chronic or curable, and if pet insurance is worth it for your pet.

Enroll early. The sooner you sign your pet up for a health plan, the less likely they are to have existing issues.

Self-insure. If you have an older pet with one or more pre-existing conditions, pet insurance might be prohibitively expensive or simply not cover the medical problems your pet has. In these cases, you might be better off setting aside an emergency fund for health care expenses.

Which pet insurance companies cover pre-existing conditions?

To give you a clearer picture, we've researched how a few popular pet insurance companies handle pre-existing conditions.

AKC

AKC pet insurance offers coverage for both curable and incurable pre-existing conditions after your pet has been insured for 365 consecutive days. So if your cat needs medication for a chronic kidney condition, you’ll need to pay for it yourself for the first year of the policy. But after that, AKC will cover it in many states. This is a unique feature, as most other pet insurance companies don’t cover incurable pre-existing conditions at all.

Embrace

Embrace categorizes pre-existing conditions as either curable or incurable. The company may cover curable conditions if your pet remains symptom-free for 12 months. Incurable conditions are never covered.

Figo

Figo doesn't cover pre-existing conditions unless the pet has been cured and symptom-free for at least 12 months. When you enroll in a plan, Figo will check your pet's medical history for the past 12 months to determine if a condition is pre-existing.

MetLife

MetLife may cover curable pre-existing conditions if they recur during your policy term as long as they don’t seem to be evidence of a chronic issue.

MetLife also states that if you’re switching from a group insurance plan, MetLife may cover any pre-existing conditions that were already covered under your previous group insurance plan.

Nationwide

Generally, Nationwide doesn’t cover pre-existing conditions. But you can request a review if your pet hasn’t shown signs of a curable condition for at least six months.

Pets Best

Pets Best doesn’t cover pre-existing conditions unless they’re curable and fully healed. For example, if your dog broke his leg last year and hasn’t had any trouble with it since, it may be covered if he breaks it again.

Spot

Spot pet insurance generally doesn’t cover pre-existing conditions. But if a condition is curable, and your pet has been symptom-free for 180 days, it may be covered. Knee and ligament conditions are an exception — they’re never covered if they occur before your policy’s start date or during a waiting period.

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