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Pet Insurance For Pre-Existing Conditions

Matthew Levy
Matthew Levy
After graduating with a Bachelor of Science in Economics from the University of Victoria in 2010, Matthew developed a passion for helping clients meet their financial freedom through strong, risk-adjusted portfolios. Formerly, he was responsible for managing and co-managing over $600MM in cumulative assets for private households and institutions. Matthew also undertook and completed his CFA® charter in 2015, a rigorous professional credential program promoting the highest standards of education, ethics, and professional excellence in the investment profession.

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Table of Contents

Every pet owner knows how expensive veterinary bills can be, which is why some get their pet insured. But what if your pet got sick before you had the chance to buy a pet insurance policy? This article will tell you what you need to know about pet insurance for pre-existing conditions.

Takeaway Points:

  • Pet insurance doesn’t cover all pre-existing conditions. However, there are exceptions. It mainly depends on what individual pet insurers define as a pre-existing condition.
  • Pet insurance companies differentiate between curable and incurable pre-existing conditions. Some pet insurers will cover curable pre-existing conditions if your pet was cured at least six months ago.
  • Hereditary and congenital conditions are covered by some pet insurance policies, but they might require you to pay extra fees, while other companies don’t cover them at all.
  • It’s a good idea to get your pet insured as soon as possible before they exhibit any signs of pre-existing conditions.

What Is Pet Insurance, and How Does It Work?

Pet health insurance is a type of insurance policy pet owners can buy for their pets. Most pet owners get their pets insured, so they don’t have to pay expensive vet bills if their pet gets sick or hurt. Instead of having to pay thousands of dollars for surgery, pet owners just need to set aside money for a monthly policy, which tends to be around $30 to $50 per month.

There are different types of pet insurance policies, the two main ones being accident-only and comprehensive policies.

The first type of insurance only covers surgery expenses and veterinary treatment in case of an accident. For example, if your pet gets hit by a car or eats something poisonous.

The second type of insurance covers the expenses of anything that might happen to your pet from the moment the insurance policy goes into effect. This includes veterinary expenses, checkups, medication, pre-treatment, and post-treatment care.

Comprehensive insurance can either be annual-based, limited to a certain period of time, or a lifetime insurance policy, which is the most comprehensive type of policy.

No matter which insurance policy you get, you’ll have to pay for the veterinary expenses out of pocket. The insurance company will reimburse you afterward. Depending on the type of insurance policy you buy and the pet insurance company, the reimbursement rate can cover 50% to even 100% of your pet’s medical expenses.

Pet insurance policies don’t cover all types of treatment. For example, annual vet exams, vaccinations, dental cleaning, and other types of routine checkups are all omitted from pet insurance policies.

Grooming and cosmetic surgeries (like ear cropping and tail docking) also won’t be covered by any pet insurance policy. Common surgeries, like spaying and neutering, aren’t included in coverage plans either.

Does Pet Insurance Cover Pre-Existing Conditions?

Unfortunately, the majority of pet insurance companies do not cover pre-existing conditions. Even though insurance companies are prohibited from discriminating against people with pre-existing conditions by current laws, animals aren’t as lucky.

The main reason pet insurance companies won’t pay for pre-existing conditions is because a pet with a life-threatening condition will likely have a shortened life.

If they were to cover the medical costs of vet visits, which are even more expensive for serious illnesses, the owner’s monthly payments wouldn’t be able to offset those expenses.

In other words, insurance companies won’t insure your already-sick pet because they are a “risky investment” for the company.

Keep in mind that every pet insurance policy comes with a waiting period. If you take out an accident-only insurance policy, the waiting period is usually a few days. If you buy a comprehensive insurance policy, the waiting period may be longer.

Waiting periods are used to determine whether your pet qualifies for pet insurance. So, if your pet starts showing signs of an illness during the waiting period, it still won’t be covered by the insurance policy.

How Do Pet Insurers Know About Pre-Existing Conditions?

You might be wondering, how would a pet insurance company even know your pet has displayed pre-existing conditions before selling you the insurance policy?

Before you submit a pet insurance claim, your pet must undergo a medical checkup. The details depend on the pet insurance company, but most won’t insure your pet without seeing its medical records first. Most pet insurance policy terms and conditions require proof your pet visited the vet at least 12 months before signing the contract.

Some pet owners might think it’s a good idea to hide their pet’s pre-existing condition to get them insured, but this isn’t a wise move. If the insurance company finds out you lied, you could get into serious legal trouble later.

What Are Pre-Existing Conditions?

Before you get your pet insured, you should know whether it has pre-existing conditions. Pre-existing conditions constitute illnesses or conditions that started before the coverage period. Technically speaking, a pre-existing condition can be any medical condition the animal had displayed signs of before you bought the insurance claim.

For example, if your dog was diagnosed with diabetes before the insurance policy’s effective date, that will be excluded from the insurance policy’s coverage. Think of it as car insurance. If you got in an accident and damaged your vehicle before you got it insured, the insurance policy wouldn’t cover the expenses required to repair it.

The most common pre-existing conditions for dogs are atopic or allergic dermatitis, gastropathy, cystitis or urinary tract infection, otitis externa, pyoderma, tooth infection, degenerative arthritis, and benign skin neoplasia.

For cats, the most common pre-existing conditions include hyperthyroidism, cystitis or urinary tract disease, tooth infection, feline upper respiratory infection, diabetes mellitus, valvular heart disease or murmur, atopic or allergic dermatitis, and renal disease or failure.

Curable vs. Incurable Pre-Existing Conditions

Pet insurance companies usually differentiate between curable and incurable pre-existing conditions. Each may have different rules for curable and incurable pre-existing conditions.

As the name implies, curable pre-existing conditions can be cured, which is why pets with these types of conditions have a better chance of getting insured.

Curable pre-existing conditions include:

  • Ear infections
  • Vomiting (if not related to a chronic illness)
  • Diarrhea (if not related to a chronic illness)
  • Upper respiratory infection
  • Urinary tract infections
  • Bladder infections
  • Other curable conditions

Some pet insurance companies allow coverage for curable pre-existing conditions. However, your pet must be healthy for at least six months after being cured of the pre-existing condition. Some insurance companies even require a clean bill of health for an entire year.

Incurable pre-existing conditions are otherwise known as chronic conditions. They’re the type of illnesses and conditions that will affect the pet throughout its entire life. Incurable pre-existing conditions include the following:

  • Diabetes
  • Cancer
  • Eye cataracts
  • Skin diseases
  • Allergies
  • Kidney disease
  • Epilepsy
  • Heart disease
  • Hyperthyroidism and hypothyroidism
  • Disc disease
  • Arthritis
  • Hip dysplasia

Hereditary vs. Congenital Conditions

It’s also important to mention hereditary and congenital diseases because pet insurance companies have special terms and conditions for these types of illnesses. This is usually called hereditary and congenital coverage, and it’s typically separate from the standard terms and conditions of an insurance policy.

Hereditary conditions are illnesses and disorders pets inherit through genetics. They’re quite common for purebred dogs and cats. Even though hereditary conditions can appear very early in your pet’s life, the problems may not start manifesting until much later.

Common hereditary conditions include hip dysplasia, elbow dysplasia, patellar luxation, and intervertebral disc disease. Whether hereditary conditions are covered by insurance plans depends on the pet insurance company.

Congenital conditions are an illness or a disorder that your pet is born with. Some congenital conditions are visible from early on, while others can remain dormant for years.

They’re usually revealed when your pet gets another illness or some sort of accident. Congenital conditions usually include hernia, congenital heart disease, nervous system issues, and liver disease.

Just like hereditary conditions, congenital conditions may or may not be covered by pet insurance policies, depending on the insurance company you choose.

What About Bilateral Conditions?

If you want to get informed on pet insurance policies and their coverage, it’s important to know about bilateral conditions.

A bilateral condition is an illness or a disease that affects both sides of your pet’s body. Bilateral conditions can occur to the pet’s eyes, limbs, and ears. The reason it’s important to mention them is that if a pet has a pre-existing bilateral condition on one side of the body, it will probably happen to the other side as well.

Most pet insurance companies won’t cover the condition on the other side. However, if your pet is diagnosed with one bilateral condition after you paid for the insurance policy, the insurance should then cover the condition on both sides of the body.

Bilateral conditions include:

  • Glaucoma
  • Cataracts
  • Patellar luxation
  • Torn cruciate ligaments
  • Uveitis

Pet Insurance for Pets With Pre-Existing Conditions

If your pet is already diagnosed with a pre-existing condition, you may be wondering if buying a pet insurance policy is even worth it.

Just because your pet shows signs of pre-existing conditions or if it’s diagnosed with a chronic illness or disability, you can still get them insured. Your pet may get in an accident that has nothing to do with its chronic illness. Pet insurance will still cover the costs of the treatment and vet care.

Similarly, your pet’s current illness can lead to another illness. That’s why it’s better to be prepared and get your pet insured.

Should You Get Pet Insurance?

There are many reasons you should insure your pet, regardless of its current condition.

Even though your pet might not show signs of pre-existing conditions, some breeds tend to have more hereditary illnesses than others. For instance, dogs with flat faces, like pugs and bulldogs, are more prone to respiratory issues. Larger dogs, like German shepherds and Labrador retrievers, are more prone to hip dysplasia than smaller breeds.

When it comes to your feline friends, some breeds are also more likely to contract an illness than others. For example, Persian cats can have cystitis and urinary calculi, both of which are expensive to treat. If you’re uncertain whether your pet’s breed has common health issues, you can always ask your vet.

The cost of pet insurance policy depends on several factors. This includes your pet’s age, gender, breed, species, and current health.

To be more precise, older pets cost more to insure than younger pets. Similarly, larger pets require more expensive insurance policies since they’re more prone to hereditary diseases and generally live for a shorter amount of time.

Of course, your pet may never get sick or hurt. But as your pet gets older, they are more likely to need medical care. For instance, nearly 90% of dogs are likely to get periodontal disease as they get older.

Treating periodontal disease can cost up to $1,000, but if your dog is insured, the insurance company may reimburse you for the medical bills.

Your pet’s insurance may cover many other types of expenses. For example, if someone were to steal your pet, or if, in the worst-case scenario, your pet passes away due to an illness or injury, the insurance company may still be required to pay you.

Be Informed About Your Options

Most pet insurance policies do not cover pre-existing conditions. If the pre-existing condition in question is curable, hereditary, or congenital, you might have a chance of getting insurance coverage for your pet.

Pet insurance is a great investment regardless of your pet’s health history and current condition. Even if your pet has pre-existing conditions, an insurance policy can help you financially overcome any new medical expenses that may arise, or cover the expense of an accident.

No matter the case, it’s important for you to be honest about your pet’s medical history when applying for pet insurance and filing an insurance claim.

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