How to Navigate Pet Insurance with a Pre-Existing Condition

Marcela OteroMar 29, 2017

Does pet insurance cover pre-existing conditions?

Pet Insurance companies do not cover pre-existing conditions, but each company’s definition of said conditions may vary. If you and your veterinarian weren’t aware of a condition before obtaining the policy, chances are it will be insured, unless it manifests itself prior to the commencement of coverage. Your best bet is to obtain insurance as soon as possible.

Why don’t pet insurance companies cover pre-existing conditions?

A pre-existing condition is usually defined as an illness or injury that happened either before the insurance policy waiting period or before even getting coverage at all. Since insurance is designed to cover emergencies and the unexpected, most companies won’t cover anything that’s already affecting your pet. For example, a ruptured cruciate ligament on one side of your pet’s body might be considered a bilateral condition, and if it develops on the other side as well, it won’t be covered. Additionally, plans with a 12-month cover will reset pre-existing conditions upon policy renewal, in order to exclude any ongoing, recurring or chronic illness.

What pre-existing conditions can be covered, if any?

If the illness or condition your pet was suffering from is curable, most companies will cover it if your pet has since recovered, and hasn’t shown symptoms for at least six months to a year—companies will have different policies regarding this period. This only applies to diseases that are actually curable, not to ones that may lie dormant, only to flare up in the future.

Some conditions that might be covered by your policy after twelve months are: respiratory, ear or urinary tract infections, common gastrointestinal upsets, vomiting, diarrhea, dermatitis and some types of skin rashes. Most companies will also cover pets that were diagnosed and treated for cancer prior to purchasing the policy. Generally, though, if there are complications from the treatment, or cancer appears on another part of the body, this won’t be covered.

If my pet has a pre-existing condition, should I still get pet insurance?

Even if your pet has a pre-existing condition, this shouldn’t discourage you from obtaining insurance. Though the policy won’t cover your pet’s pre-existing condition, depending on the gravity of the illness or injury, this may not make much of a difference. For instance, say the issue is that it contracted a disease which may remain dormant, even if insurance won’t pay for treating a recurrence of the illness, it will still provide coverage for any different new problem that may arise, as well as emergency care. And there may not even be another flare-up of the disease. On the other hand, maybe your pet has been relatively healthy, barring a few minor problems, but is getting on in years. Insurance can help mitigate the costs of future illnesses or conditions. You can also get insurance just for emergencies, which tend to be the higher-cost treatments anyhow. Emergency-only policies are considerably more affordable than those with more complete coverage, and can help pay for surgeries, medication and rehabilitation for your pet.

Are there alternatives to pet insurance?

An alternative to pet insurance could be A credit card geared toward medical expenses. CareCredit, for example, offers financing options for 6,12,18, or 24 months, with zero interest on payments less than $200, provided you make the minimum monthly payments and clear the balance at the end of the promotional period.

A similar alternative is Pet Assure, a veterinary discount plan that gives you a 25% discount on all medical care provided by your vet, including wellness visits, dental care, spaying/neutering, and emergency care. Think of it like a membership to a big box mart -- The more you use the membership, the more it pays for itself. This can be a good option for owners of multiple pets who can’t necessarily afford the premiums on four cats and two dogs, for example. Pet Assure reviews are positive across the board when used for pre-existing conditions that insurance won’t cover. The only issue is that not all vets are participating members of the program, but that can be solved easily by checking if there’s an office near you before enrolling.

United PetCare works in much the same way as Pet Assure, but is a membership savings program rather than a credit card. Members receive reductions for regular visits, vaccinations, procedures, surgeries and medications. The bill is discounted at the time of service, and you can expect it reduced 20-50%, for a monthly cost of between $10.60 to $13.90. These last options all enter into effect immediately, and have zero waiting period. One issue is that United PetCare only works in California, Arizona, Nevada, Texas and Colorado. United PetCare Reviews also present a recurring problem with customer service and difficulties in cancelling the program.

Should I just open a Pet Health Savings Account?

Some people recommend that you open a pet health savings account instead of paying monthly premiums, arguing that most policies aren’t worth the cost over a long period of time, especially when you have a generally healthy animal. Though it’s true that most pet owners won’t get back in benefits what they’ve paid in premiums, this is actually a good thing, since it means your pet was healthy. The idea behind pet insurance is to help defray the costs for emergency treatments that you’d have trouble paying for out-of-pocket, and a savings account may not actually be enough to do so.

Most pet owners adopt a three-pronged strategy for financing their pet’s needs, and opt for some insurance for emergencies and unexpected situations, a savings account for wellness care, and either a regular credit card or something like CareCredit for deductibles. This means they’ve covered all the bases, and can rest assured that life-and-death decisions for their pet won’t be determined by an immediate lack of funds.

Whatever decision you make, bear in mind that since most insurance policies don’t offer coverage for pre-existing conditions, it behooves you to insure your animal friend as soon as possible. That way, if any condition does develop, it will happen after it’s already covered. For more information on Pet Insurance policies, a good place to start is our best of the year list.

(Cover image: Austin Community College)