Pet insurance is designed to give you peace of mind that if something happens to your beloved pet, you will be able to get them the care they need, without having to worry about not being able to pay for the cost of their treatment.
But what if something has already happened? What if they have already been in an accident or diagnosed with a disease? In pet insurance terminology this is known as a pre-existing condition, and the vast majority of pet insurance companies will not cover your pet for this condition.
But how do you know if your pet has a pre-existing condition, and what kind of coverage can you secure for your pet if they do fall into this category?
What Pet Insurance Doesn’t Cover
You have a lot of different options with pet insurance. You can choose to cover them for everything from major illnesses to having their nails trimmed every few months. But you can also be more selective, for example, just covering them in the case of accidents and illnesses, and forgoing the “wellness” coverage for general treatments, which you may feel better able to plan for and budget.
For more information on different types of pet insurance policies, read our comprehensive guide.
But some pet insurance companies, even on their premium policies, won’t cover certain things. For example, a lot of pet insurance companies exclude hereditary conditions. These are conditions that certain breeds of dogs and cats are predisposed to develop. For example, Labradors are genetically very likely to develop hip dysplasia, so a lot of insurance companies just won’t cover this.
A lot of pet insurance companies will not cover hereditary conditions. So, if you have a dog or a cat that is genetically predisposed toward serious medical conditions, it is worth shopping around for a pet insurance company that does.
However, universally, pet insurance companies will not cover pre-existing conditions.
What Are Pre-Existing Conditions?
A pre-existing condition is anything that showed up before you took out the policy. It doesn’t even necessarily need to have been diagnosed. If your pet shows symptoms of it before you take out the policy, and then they are diagnosed after you get the policy, it still counts as a pre-existing condition and they, and you, aren’t covered.
Pre-existing conditions can be illnesses such as arthritis, cancer, or allergies. It can also be injuries from an accident. For example, if they do ligament damage to a knee joint, no treatment for that knee will be covered in the future.
Conditions also don’t have to be chronic to not be covered. For example, if the pre-existing condition is a tooth infection, your pet may not be covered for other tooth infections, as they may be seen as more susceptible to the condition.
Whether pet insurance will cover subsequent instances of an issue depends on the insurance company. For example, some insurance companies will cover the condition as long as your pet has been symptom-free and has not required any treatment for the condition for at least three months.
According to a survey conducted by insurer Nationwide, the most common pre-existing conditions are the following:
- Atopic or allergic dermatitis (average cost to treat $255)
- Otitis externa (average cost to treat $172)
- Benign skin neoplasia (average cost to treat $377)
- Pyoderma (average cost to treat $128)
- Enteropathy (average cost to treat $175)
- Degenerative arthritis
- Periodontitis/tooth infection (average cost to treat $400)
- Cystitis or urinary tract infection
- Anal gland sacculitis/expression
- Cystitis or urinary tract disease (average cost to treat $495)
- Periodontitis/tooth infection (average cost to treat $434)
- Gastropathy (average cost to treat $334)
- Renal disease or failure (average cost to treat $649)
- Enteropathy (average cost to treat $221)
- Feline upper respiratory infection
- Diabetes mellitus (average cost to treat $889)
- Atopic or allergic dermatitis
- Valvular heart disease or murmur
Reporting Pre-Existing Conditions
Some pet insurance companies require a medical exam and/or vet records in order to write a policy for your pet, and this is likely to reveal any pre-existing conditions.
But you may think you can get around this step by taking out insurance with a company that doesn’t require this and just not mentioning any pre-existing conditions.
This is a risky approach. Pet insurance companies have a lot of experience, and there are certain issues that will be red flags for them based on the breed of your pet and the timing of the claim. If they suspect something is a pre-existing condition, they just won’t pay out, unless you can provide definitive proof to the contrary.
Moreover, making a claim on an undeclared pre-existing condition could cause your policy to be canceled. This will see you paying higher premiums for your next policy, even if you take it out with a new provider.
How Do You Insure A Pet With A Pre-Existing Condition?
The pre-existing condition clause is one of the very good reasons to enroll your pet in insurance when they are young, before they are likely to have developed any problems. This can help you ensure they are covered for life.
But if that ship has sailed, you still have options.
First and foremost, you can still cover your pet with a standard insurance policy. It just won’t cover their pre-existing condition.
In this case, you will want to look out for policies that cover non-chronic existing conditions once they are essentially cured. For example, ASPCA Pet Insurance will cover pre-existing conditions it considers cured, which means there have been no symptoms or treatments for 180 days, with the exception of knee and ligament conditions.
However, if your main concern is covering the cost of the treatment of your pet’s pre-existing condition, you may want to try other options.
For example, Pet Assure is not a pet insurance company, but rather a veterinary discount plan. In return for small premiums, you can get up to 25% off treatments at vets within the group, and a similar discount on medications. So, if your pet needs a lot of medical care, this can help make the process more affordable.
You should also ask your vet for advice. They see hundreds of pet parents every week, so they will probably have a good awareness of pet insurance companies and other options that might be able to help you.
Pet Insurance Pre-existing Conditions FAQs
How Do Pet Insurance Companies Know About Pre-Existing Conditions?
Pet insurance will often require a medical exam or vet records to write your policy, which will reveal most pre-existing conditions. If they don’t, you are required to declare any.
However, they also have extensive databases of different types of pets and claims. From this data, they have been able to identify “red flags” that are likely to be a sign of a pre-existing condition. Depending on the breed of your pet and its age, what you are claiming, and when, they have smart systems in place to identify pre-existing conditions.
What Pet Insurance Covers Pre-Existing Conditions?
The definition of insurance is that it covers you for the unexpected, so no pet insurance policies will cover your pet for pre-existing conditions. The best you are likely to find are policies that put a limit on non-chronic pre-existing conditions, rather than declaring them “for life.” This generally means that if your pet has not shown any symptoms or received any treatment for a period of three months, it is no longer considered a pre-existing condition.
Can You Take Out Pet Insurance After A Diagnosis?
You can take out pet insurance after your pet has been diagnosed with a pre-existing condition. However, your insurance will not cover you for expenses related to that pre-existing condition, as it pre-dates the policy. Even if your pet begins showing symptoms just before you take out the policy and only later receives a diagnosis, this will still be considered a pre-existing condition.
Pet insurance helps you ensure that you have the resources needed to cover your pet’s medical expenses should they be in an accident or be diagnosed with an illness.
But if this has already happened and you don’t already have pet insurance, getting pet insurance can’t help you. By definition, insurance exists to cover you for the unknown and unexpected. It will not retroactively cover a pre-existing condition.
Getting your pet insurance after they have been diagnosed with a pre-existing condition can also be problematic, as even curable conditions can be tagged as “pre-existing” because they are seen as more likely to return.
In order to get your pet the best possible coverage for the future, look for policies that put a limit on non-chronic existing conditions, for example 180 days.
But the best thing you can do to protect your pet is to get them covered while they are young, before they are likely to have developed any pre-existing conditions, and therefore make sure they can have coverage for life.