How Pet Insurance Handles Pre-Conditions
Pet insurance can be a useful financial protection when your dog or cat needs medical care. But coverage is not limited, and policyholders often don’t realize what’s excluded until their claim is denied.
This often comes from the well-documented pre-existing conditions — like finding out your cat’s allergy medication isn’t covered because the vet treated it for a skin rash years ago, or learning that your dog’s knee surgery won’t be reimbursed because the phrase “intermittent lameness” appears somewhere in his medical records.
Here is a quick explanation of how this release works.
Key Takeaways
- A pre-existing condition is any health problem your pet has shown symptoms of before your insurance starts, including during the waiting period.
- Most pet insurance plans do not cover pre-existing conditions, but some will cover future occurrences of treatable conditions, such as ear or respiratory infections, after a period without symptoms.
- The easiest way to avoid pre-existing condition restrictions is to register your dog or cat while they are young and healthy.
Important as a pre-existing condition in pet insurance
Any symptoms, behavior or diagnosis before having pet insurance has the potential to be a pre-existing condition, from something as simple as a rash or stomach ache, to more complex issues like asthma or cancer.
An actual diagnosis is not necessary. According to the National Association of Insurance Commissioners (NAIC), a medical condition may be pre-existing if:
- Your vet has given you previous advice on this problem, such as consulting them about your dog’s lameness.
- The pet received treatment for the condition, such as an injection to eliminate the skin rash
- The pet showed early symptoms. This can be as simple as a medical note saying “Max seems strong” during a routine exam.
Pet insurance companies identify this as:
- Using wait times: The waiting period is an insurance hedge against pet owners who only buy insurance after their pet is sick. Once registered, policyholders must wait a certain number of days or months before they can file the first claim. Anything that appears during this time counts as pre-existing matter.
- Medical footnote: Most insurers require you to take your dog or cat to the vet for a full check-up at the time of registration or shortly thereafter. Any problems noted by the vet will be labeled as a pre-existing condition.
- To review your pet’s health records: When you file a claim, the insurer may ask for a complete history of your dog or cat from the last 12 months (or more). They will review physical exam notes, past treatments, lab results, and prescription history.
Because insurance providers rely heavily on your pet’s medical history, getting help early can help prevent future problems from being labeled as present. The sooner you register – preferably while your pet is young and healthy – the better.
Pre-existing ‘curable’ conditions may be an exception
Most pet insurance policies do not cover pre-existing conditions, but companies may make exceptions for medical issues that can be treated if your dog or cat remains symptom-free for a set period of time – usually six months to a year.
Say your dog has a bad respiratory infection during the waiting period of the policy. If your dog makes a full recovery and shows no further symptoms, a future respiratory infection may be eligible for coverage, depending on the insurance.
How to pay for veterinary care if your pet has a pre-existing condition
If your pet’s condition is not covered by your insurance plan, you still have options to manage the cost of veterinary care:
Open a dedicated savings account
Setting up automatic transfers to a savings account designated for pet care builds a cushion over time — even if it’s just $20 a month. As with any emergency fund, it’s best to keep the account separate from your regular savings so it can’t be spent on other important things.
Sign up for pet discount programs
Pet discount programs can help reduce the cost of care at participating clinics. For a low monthly fee, members receive discounts — often 20% to 30% — on many animal services, including treatment for conditions that pet insurance may not cover. Fees and discounts vary by provider and clinic.
Use credit strategically
You may not have enough money in your savings or checking account to pay off a large, unexpected vet bill. If so, a credit card can help bridge the gap — even if you have pet insurance.
If you have strong credit, you may qualify for a card with a 0% APR offer, which allows you to spread the cost over an interest-free period. This method only makes sense if you are sure that you can pay off the balance before the end of the promotional period. Otherwise, interest charges can turn a one-time vet bill into a much larger expense.
FAQ
Can you get pet insurance if your pet is already sick?
Although you can purchase a policy for a sick pet, the care of your pet for that disease or condition will not be included in the coverage because it is a pre-existing condition. Pet insurance will cover future treatment for some emergencies.
Are allergies considered a pre-existing condition for pet insurance?
In most cases, yes. Because allergies are a lifelong problem, insurance brokers see any allergy as a pre-existing condition – even if the symptom is that your dog often licks its paws.
When should I buy pet insurance?
The more recently you purchased pet insurance for your dog or cat, the better. When they are young, healthy, and free of major problems, you can ensure that your pet’s future care is covered. Older pets may still be eligible for coverage, but there may be some exclusions.
More from Mali:
How to Choose the Right Pet Insurance Plan
What To Do If Your Pet Insurance Claim Is Denied
How to File a Pet Insurance Claim: A Step-by-Step Guide
