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Published: Feb 28, 2023 13 min read

Medical expenses for pets can add up quickly. For this reason, many pet owners choose to get pet insurance coverage to prepare for inevitable medical costs. But how does pet insurance work if your pet has already been diagnosed with a health condition?

Pet insurance covers some of the costs related to your pet’s healthcare, but the policy comes with standard exclusions and limitations. Read on to learn more about pet insurance, pre-existing conditions and whether your pet’s medical expenses will be covered.

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Will a pet insurance plan cover pre-existing conditions?

Unfortunately, pet insurance doesn’t cover pre-existing conditions. A condition is considered pre-existing if it shows symptoms before you buy a policy or during the waiting period. While most insurance companies have similar definitions and policies surrounding pre-existing conditions, some include or exclude certain conditions.

Generally, pet insurance covers the medical expenses associated with emergency or unexpected veterinary care. For example, if your cat gets hit by a car, pet insurance for cats may cover diagnostic testing, medications, surgery or other types of treatment. In addition, most policies cover long-term conditions that present themselves after you get coverage, such as allergies or cancer.

Below are some types of pre-existing conditions. If your insurance company differentiates between these types of medical conditions, your pet may qualify for coverage.

Curable pre-existing conditions

Some pet health insurance plans will cover curable pre-existing conditions. These are conditions that can be fully cured and do not show symptoms or require any treatment for a certain period of time.

Some curable pre-existing conditions may include:

  • Vomiting, diarrhea and other gastrointestinal issues
  • Ear infections
  • Upper respiratory infections
  • Urinary tract infections (UTIs) and bladder infections

However, if your pet is diagnosed with a chronic condition, such as chronic UTIs or ear infections, it is no longer considered curable and won’t be eligible for coverage.

Some insurance companies require a 24-month waiting period before reviewing coverage for a curable pre-existing condition, but others have shorter wait times.

Embrace will cover curable conditions that show no symptoms for at least 12 months, while the American Society for the Prevention of Cruelty to Animals will cover curable conditions that don’t show symptoms or require treatment for at least 180 days, except knee and ligament conditions.

Incurable pre-existing conditions

Incurable pre-existing conditions are chronic conditions likely to last forever. These issues will show symptoms or require treatment beyond the insurance company’s waiting or review period. Some examples of incurable pre-existing conditions include:

  • Allergies
  • Orthopedic conditions, such as arthritis or hip dysplasia
  • Cancer
  • Diabetes
  • Some skin conditions, such as lipomas
  • Thyroid conditions
  • Urinary blockages and bladder crystals

Congenital and hereditary conditions

Congenital and hereditary conditions are medical conditions that your pet may have inherited from their parents or that are caused by genetics and breed-specific predisposition. They count as pre-existing only if they present symptoms before you get pet insurance coverage. That said, insurers may limit coverage in other ways, like setting per condition payout caps or age limits.

There is a slight difference between congenital and hereditary.

  • Congenital conditions are present at birth or may manifest soon after, while hereditary conditions are passed down from parents and are more likely to manifest later in life. Congenital conditions might include congenital heart disease, hernia, liver disease or hypothyroidism.
  • Hereditary conditions might include hip or elbow dysplasia, as well as intervertebral disc disease (IDD).

Most pet insurance companies will cover congenital or hereditary conditions if they are not pre-existing, which is why it’s advisable to get coverage as early as possible. This is especially important if you buy a policy that limits coverage for congenital and hereditary issues in pets enrolled at an older age.

Bilateral conditions

Bilateral conditions occur on both sides of the body. They often begin on one side of the body, either because it originates that way naturally or as an injury. Some examples of bilateral conditions include:

  • Hip or elbow dysplasia
  • Luxating patella
  • Cruciate ligament conditions
  • Cataracts

Pet insurance plans often consider bilateral conditions as pre-existing conditions, even if the issue has yet to develop on both sides. If your pet develops symptoms of a bilateral illness on one side before you have insurance coverage, the insurance company won’t cover any treatment for the current symptoms or if the condition develops on the other side later on.

Bilateral conditions may be categorized as either curable or incurable conditions. Therefore, if your pet develops a curable bilateral condition, like a non-chronic ear infection, your insurance company may cover future recurrences on either side if your pet hasn’t had symptoms for a certain amount of time.

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Tips for avoiding health issues in pets

One of the best ways to save money on your pets is to invest in their health. If you spend money on preventive care now, your pet is less likely to develop conditions that require expensive treatments.

Read more below on how to keep your pets healthy for as long as possible.

Get pet insurance as soon as possible

While each company will vary on what pet insurance covers, most plans cover unexpected veterinary expenses that you otherwise might not be able to afford. If your pet becomes ill, having pet insurance could be the sole incentive to get the proper treatment, regardless of cost.

Getting pet insurance early on also minimizes the chance of developing pre-existing conditions that won’t be covered. If your pet develops a condition before you get coverage, the insurance company won’t cover the necessary treatment. Or they may require that your pet goes without symptoms for a certain amount of time before they cover it.

Another benefit of getting pet insurance early is that you may be able to reduce the cost of your policy. Some companies offer lower rates for younger pets since they are less likely to develop conditions associated with aging.

The price of pet insurance varies depending on your pet’s age, breed and location. According to the North American Pet Health Insurance Association, a monthly premium for accident & illness coverage for a dog is just under $50 and about $29 for a cat.

You can get cheap pet insurance to save some money — premium rates can be as low as $20 for dogs and $15 for cats — but you might be sacrificing some coverage benefits. In addition to premiums, pet owners must also budget for routine care expenses such as vaccinations and pet exam fees, which are generally excluded from pet insurance coverage.

Keep your pet’s vaccinations up to date

Pet insurance companies may deny coverage or specific claims if your pet develops a condition that you chose not to vaccinate against such as bordetella, rabies or parvovirus. The same applies to heartworm, tick-borne illnesses and any other ailment for which there is preventive medication.

Maximizing insurance coverage isn’t the only reason to vaccinate your pets. Vaccinations help protect you against illnesses since some of these diseases are transmissible to humans. Your pet can catch diseases from unvaccinated animals, but this is less likely to happen if they have the proper vaccines. If they catch a disease, it should be a mild case, and they may not show symptoms.

Maintain a nutritious diet and active lifestyle

A proper diet and exercise plan are crucial for keeping your pet healthy. Creating a healthy lifestyle for your pet includes preventing obesity, encouraging mental stimulation and providing nutritious food.

A veterinarian can identify the nutritional and exercise needs of your pet, but there are some ground rules that you can follow to get started at home:

  • Set consistent meal times. Feed your pet at least twice a day and monitor their eating.
  • Give your pet the right amount of food. For dogs and cats, the amount of food you give them will depend on factors such as size, breed and lifestyle, so you should consult with a professional to identify their caloric needs.
  • Choose high-quality pet food. Look for brands recommended by veterinarians and approved by the Association of American Feed Control Officials (AAFCO), a label that indicates that the product meets nutritional requirements. We also recommend you consult your veterinarian before adopting grain-free diets since this formulation is being investigated for a potential link to life-threatening heart conditions.
  • Limit human foods. It’s often better to limit human foods so your pet doesn’t develop negative behaviors, exceed their caloric needs or gain access to unsafe foods.
  • Increase your pet’s exercise in small steps. You don’t need to jump in with a rigorous exercise routine. For example, you could start with short walks (or a slightly longer walk if you already walk your dog) or some simple play with a feather toy for cat owners.
  • Make play a part of your exercise routine. Set aside time to play with your pet. Generally, 30 minutes of playtime is enough depending on your pet’s energy levels. If you’re limited on time, consider sending your pet to a doggy daycare or hiring a dog sitter for daily walks or play sessions.

Address symptoms as soon as they emerge

If your pet develops symptoms of an illness or starts displaying unusual behaviors, address them with a veterinarian as soon as possible. Early detection can catch life-threatening illnesses on time and save on treatment costs before further complications arise.

Some symptoms that you may want to look out for include the following:

  • Changes in drinking or eating habits
  • Changes in vision or eye appearance
  • Vomiting, constipation or diarrhea
  • Lethargy
  • Sudden weight loss or gain

You should also bring your pet to the vet for emergencies such as wounds or injuries, seizures, difficulty breathing or possible poisoning.

Getting your pet to the vet immediately can prevent illnesses from worsening, but if complications arise, the best pet insurance companies can offer the financial support necessary to cover the cost of treatment.

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How do pet insurance companies find out about pre-existing conditions?

Pet insurance companies find out about pre-existing conditions by reading your pet’s past medical records, requesting a new medical exam or both.

Companies have veterinary specialists that review an applicant’s medical record and indicate whether the pet has a pre-existing condition. Based on this review, the company will also notify you if additional exclusions apply to your pet.

If your pet has never been to a veterinarian, the pet insurance company will require a basic physical exam to establish medical records and a baseline for your pet’s overall health. This exam typically includes listening to your pet’s heart and lungs and checking eyes, teeth, ears, coat and nails. In some cases, you may also need to update your pet’s vaccinations. You can make an appointment with a local veterinarian if they’re licensed.

Do you need a policy for your pet?

Is pet insurance worth it if your pet has a pre-existing condition? The answer depends on your financial situation and your pet’s healthcare needs.

Even if your pet has pre-existing conditions, a policy is still beneficial to insure against future accidents or illnesses. For example, even if your dog is diagnosed with cataracts and it’s excluded as a pre-existing condition, pet insurance can help cover the cost of treating other expensive medical conditions such as arthritis or cancer.

It’s also worth looking into pet insurance if your pet’s pre-existing condition is considered curable by the companies that make this distinction or if your pet’s predisposed to certain congenital or hereditary conditions that haven’t shown symptoms.