7 Pet Insurance Companies that Cover Pre-Existing Conditions

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7 Pet Insurance Companies that Cover Pre-Existing Conditions

Understanding pre-existing conditions is crucial if you’re considering pet insurance for your furry friend. This knowledge can help you choose among the best pet insurance companies and potentially save you from significant financial stress.

A 2023 survey revealed that only 24% of US pet owners have dog or cat insurance. This leaves the majority at risk of their pets developing a condition before they’re insured—possibly facing recurring vet bills for years to come.

In this guide, we’ll explore pet insurance that covers pre-existing conditions and examine how top providers approach these situations. We’ll discuss strategies to protect both your pet and your finances and help you make an informed decision about your pet’s healthcare coverage.

A 2023 survey revealed that only 24% of US pet owners have dog or cat insurance. This leaves the majority at risk of their pets developing a condition before they’re insured—possibly facing recurring vet bills for years to come.

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Our Top Pet Insurance Companies that Cover Pre-Existing Conditions

1. Spot Pet Insurance – Our best pet insurance pick overall

2. ASPCA  – Our best for short insurance activation wait times

3. Embrace- Our best for fast AI-based claims processing

4. Fetch Pet Insurance – Our best for covering 90% of unexpected bills

5. Figo – Our best for 24/7 veterinary telehealth support

6. Pets Best – Our best for integration with CareCredit

7. Healthy Paws – Our best for affordable pet insurance (Learn more about Top Pet Insurance Providers.)

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Does Pet Insurance Cover Pre-Existing Conditions?

Pet insurance typically doesn’t cover pre-existing conditions. Understanding this limitation is crucial for making informed decisions about your pet’s healthcare.

Insurers assess pre-existing conditions by reviewing your pet’s medical history. Their processes vary, so it’s important to read policy details carefully. While most pre-existing conditions aren’t covered, some insurers distinguish between curable and incurable conditions. Curable conditions might become eligible for coverage if your pet remains symptom-free for a specified period, usually six to 12 months. (Learn more about Top Pet Insurance Providers.)

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What Are Pre-Existing Conditions in Pets?

Kristen Lynch, executive director of the North American Pet Health Insurance Association (NAPHIA), explains that pre-existing conditions in pets are generally considered to be any medical condition “that existed before the pet was enrolled for coverage.” It also applies to conditions that develop during the policy waiting period. These can include:

• Acute conditions: Short-term illnesses or injuries

• Chronic diseases: Ongoing health issues like diabetes or arthritis

• Congenital or hereditary conditions: Issues present from birth or due to genetics

Insurers typically categorize pre-existing conditions as either curable or incurable:

• Curable conditions: Minor issues like infections or sprains may become eligible for coverage after a symptom-free period.

• Incurable conditions: Chronic diseases or lifelong conditions are usually permanently excluded from coverage.

When applying for pet insurance, you’ll likely need to provide your pet’s medical history. Be prepared to share details about past treatments, diagnoses, and symptoms. Transparency is key—failing to disclose known conditions could result in denied claims or policy cancellation.

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Spot Pet Insurance

Pricing: From $50/month depending on plan configuration

Reimbursement rates: 70% – 90%

Deductibles: $100 – $1,000

Annual limits: $2,500 – unlimited

Spot Pet Insurance offers comprehensive coverage that includes everything from vet exam fees and diagnostics to surgeries at licensed vets, emergency pet hospital visits, prescription medications, specialized treatments, and even prescription food. It takes a clear stance on pre-existing conditions, defining them as any condition that occurs before coverage begins or during the waiting period.

However, Spot stands out by reconsidering conditions as non-pre-existing if they have been cured, with no symptoms or treatment needed for only 180 days. There is one exception related to knee and ligament complications. If they arise before the coverage starts or during the waiting period, they won’t be covered in the future.

Spot imposes a 14-day waiting period for any diagnosis, treatment, or surgery related to accidents, illnesses, and knee or ligament conditions. This starts from the first effective date of the relevant coverage.

Pros

• 30-day money-back guarantee

• Features a 10% multi-pet insurance discount

• Get up to 90% cash back on eligible vet bills

• Provides a 30-day money-back guarantee on your premium

Cons

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ASPCA Pet Health Insurance

Pricing: From $25/month depending on plan configuration

Reimbursement rates: 70% – 90%

Deductibles: $100 – $500

Annual limits: $2,500 – $10,000

ASPCA Pet Health Insurance plans cover accidents, illnesses, hereditary conditions, alternative therapies, and even behavioral issues. Like most insurers, ASPCA doesn’t cover pre-existing conditions.

However, ASPCA’s policy on curable conditions is pet-owner-friendly. If your pet’s condition is cured and remains symptom-free for 180 days, it’s no longer considered pre-existing (except for knee and ligament issues). Getting your pet insured is straightforward—ASPCA doesn’t require a complete medical exam or veterinary records to start enrollment.

You’ll appreciate ASPCA’s short waiting periods. Preventive care coverage kicks in immediately when your plan starts, while illness and accident coverage have a brief 14-day waiting period. You can choose between an accident-only plan or the Complete Coverage plan. For additional peace of mind, consider adding a wellness care package to cover routine services like dental cleanings and vaccinations.

Pros

• Short waiting times for enrollment
• The mobile app lets you manage your account 24/7
• 30-day money-back guarantee

Cons

• Coverage limits can never exceed $10,000 a year

• Preventative care not included in the base coverage

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Embrace

Pricing: From $28/month depending on plan configuration

Reimbursement rates: 70% – 90%

Deductibles: $100 – $1,000

Annual limits: $5,000 – Unlimited

Embrace Pet Insurance designs policies with pet owners in mind, offering comprehensive coverage for illnesses, accidents, injuries, and dental diseases. While it doesn’t cover pre-existing conditions, Embrace takes a pet-friendly approach by distinguishing between curable and incurable diseases to maximize your coverage options.

If your pet’s curable condition stays symptom-free and treatment-free for 12 months, it may qualify for future coverage. However, incurable pre-existing conditions, like bone and joint issues, cancer, allergies, and diabetes, remain excluded. The same goes for bilateral pre-existing conditions, such as hip dysplasia, unless they develop after the waiting period.

Embrace has your back when it comes to breed-specific conditions. You’re covered if your pet hasn’t shown signs or received treatment before the end of the waiting period. Just remember, if you’re a new enrollee and your pet hasn’t seen a vet in the past year, you’ll need to schedule a full physical exam within 14 days of starting your policy. This includes a complete medical history and vet chart notes with exam findings and test results.

Pros

• Easy and efficient claims process
• The Wellness Rewards add-on offers special discounts and bonuses
• A+ rating on the Best Business Bureau

Cons

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Fetch

Pricing: From $35/month depending on plan configuration

Reimbursement rates: 70% – 90%

Deductibles: $250 – $400

Annual limits: $5,000 – $15,000

Fetch Pet Insurance stands out for covering conditions often excluded by other providers, such as exam fees, emergency visits, breed-specific issues, allergies, behavioral therapy, and cancer treatment. However, like most, Fetch doesn’t cover pre-existing conditions either. It considers pre-existing conditions as any injury or illness you or your vet noticed before enrollment, before the policy’s effective date, or during the 15-day waiting period.

Despite this, Fetch is among the few that cover curable pre-existing conditions after a set period. If your pet remains symptom-free and treatment-free for 12 months, the condition is considered curable and becomes eligible for coverage. Curable conditions include conditions like UTIs, respiratory infections, vomiting, diarrhea, and broken bones.

Fetch also has a six-month waiting period before covering hip and knee injuries. Thankfully, this can be waived if your pet is examined by a vet within 30 days of enrollment and is found to have no relevant pre-existing conditions.

Pros

• Covers up to 90% of unexpected vet bills

• Exam fees are included in sick visit coverage

• Claims can be paid out within two days

Cons

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FIGO

Pricing: From $30/month depending on plan configuration

Reimbursement rates: 70% – 100%

Deductibles: $100 – $750

Annual limits: $5,000 – unlimited

Figo Pet Insurance offers comprehensive coverage with flexible options to suit your pet’s needs. With an average monthly cost of $22, it’s a budget-friendly choice for many pet owners. Figo’s plans cover various health issues, including accidents, illnesses, and hereditary conditions, without imposing caps on claim payments by condition.

Figo takes a nuanced approach to pre-existing conditions. If your pet has been symptom-free from a curable condition for 12 months after treatment, you might find that future occurrences are covered. This policy can be particularly helpful for temporary issues like skin problems or digestive upsets. Remember that your vet’s assessment is crucial in determining coverage for new symptoms.

You can choose from three main plans—Higher Coverage, Popular, and Value Plus—and add wellness options if desired. While Figo doesn’t require a pre-enrollment vet exam, you’ll need to provide a list of your pet’s veterinary visits from the past year.

Pros

• Most claims payout in less than three business days

• Free 24/7 live chat access to veterinary professionals

• Features a 100% reimbursement option with no copay necessary

Cons

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Pets Best

Pricing: From $40 depending on plan configuration

Reimbursement rates: 70% – 90%

Deductibles: $50 – $1,000

Annual limits: $5,000 – unlimited

Pets Best, founded by Dr. Jack Stephens, the “father” of pet insurance in North America, has been a trusted name in the industry since 2005. The company offers comprehensive coverage for accidents, illnesses, hereditary conditions, and even routine care. With average monthly costs ranging from $36-$58 for dogs and $22-$34 for cats, Pets Best provides flexible options to fit your budget. You even get fixed-rate accident-only plans starting at $9 for dogs and $6 for cats monthly.

Like other insurers, Pets Best doesn’t cover pre-existing conditions, but its approach to curable issues sets it apart. Many conditions that occur before your policy starts aren’t permanently excluded. If issues like broken legs, kennel cough, or sprains heal and remain symptom-free, Pets Best may cover them if they recur. However, incurable conditions such as cancer or diabetes that appear before your policy starts will remain excluded.

If your pet has pre-existing conditions, Pets Best offers a smart solution. Combining its policy with a CareCredit card can create a comprehensive financial plan for your pet’s healthcare. This approach gives you the flexibility to manage covered and non-covered expenses, ensuring your furry friend gets the care it needs throughout life.

Pros

• Pet record hub lets you manage all health records online or through the app

• Provides 24/7 access to expert veterinary advice

• Offer full coverage even when pets are not spayed/neutered

Cons

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HealthyPaws

Pricing: From $15/month depending on your plan configuration

Reimbursement rates: 50% to 80%

Deductibles: $100 to $1,000

Annual limits: There are no limits

Healthy Paws offers a stand-out pet insurance plan that covers a wide range of needs. You’re protected from illnesses and accidents to hereditary and chronic conditions without any maximum limits on claim payouts. What sets Healthy Paws apart is its commitment to reimburse you based on your actual vet bill costs, not predetermined estimates for specific treatments.

The enrollment process is straightforward, with a 15-day waiting period for most conditions and 12 months for hip dysplasia-related illnesses. While pre-existing conditions aren’t covered, Healthy Paws takes a pet-friendly approach to acute, non-chronic issues. For example, if your furry friend experiences ear infections or gastrointestinal upsets more than a year apart, they’re typically considered new conditions and covered.

Claiming your reimbursement is a breeze with Healthy Paws. Simply visit any US-licensed vet, snap a photo of your bill, and submit it through their mobile app or website. Most claims are processed within two days, quickly getting money back in your pocket. With average monthly premiums of $63 for dogs and $29 for cats, Healthy Paws offers peace of mind at a competitive price.

Pros

• No maximum annual or lifetime payouts

• A+ accreditation from BBB

• 30-day money-back guarantee

Cons

• Doesn’t cover examination fees

• Elective procedures, boarding, and behavioral correction are not insured

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Methodology

Our review team carefully examined how each pet insurance service handles pre-existing conditions. We scrutinized their coverage limits, exclusion criteria, and any flexibility they offer for curable conditions. We also compared their features, waiting periods, and pricing plans to understand how these factors impact overall coverage.

To add another layer of insight, we analyzed customer feedback on Trustpilot and the Better Business Bureau (BBB), focusing on how real users perceive the handling of pre-existing conditions.

Here’s what we focused on:

• Curable pre-existing conditions coverage: We evaluated how each service handles them and whether they offer coverage after a certain period.

• Types of conditions and treatments covered: We assessed each plan’s range of conditions and treatments to ensure comprehensive care.

• Plan flexibility: We examined each plan’s flexibility, including options for customization to fit different needs and budgets.

• Vet exam requirement: We reviewed whether a veterinary exam is required before enrollment, as this can impact eligibility for coverage.

• Cost: We compared the cost of each plan, balancing premiums with the level of coverage provided.

• Waiting periods: We analyzed the waiting periods for different types of coverage, as these can significantly affect when your pet can start receiving benefits.

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Common Exclusions in Pet Insurance

Pet insurance has many common exclusions. Policies generally don’t cover expenses related to breeding, grooming, or elective procedures. Likewise, coverage for pre-existing conditions is relatively rare, and it’s not just diseases that are often exempt from coverage.

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Understanding Pre-Existing Conditions

For example, if your dog was diagnosed with a torn ligament before you purchased pet insurance, you couldn’t file a claim for any medical treatments. The exclusion of pre-existing conditions also applies to your policy’s waiting period. For instance, if your cat gets diagnosed with diabetes during that time, treatments like dialysis won’t be covered. Insurers impose a waiting period to prevent pet owners from signing up for coverage when they already know of (or suspect) a medical concern.

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The Role of Waiting Periods

Pet insurance policies come with waiting periods before your coverage starts. These periods vary:

While these timeframes might seem clear-cut, there’s more to consider. Dr. Lynch offers this insight:

“This is not as straightforward as it might seem because our pets can’t speak to us, and even in human health, we often have the precursors of medical conditions long before they manifest and are diagnosed and treated.”

Think about it: your pet can’t tell you when they’re feeling off. Just like in humans, some health issues develop slowly and silently. Even if your pet doesn’t have a medical history, it doesn’t mean they’re completely healthy. Insurance companies use these waiting periods to ensure they’re not covering pre-existing conditions.

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Disclosure of Symptoms

Moreover, in the eyes of insurers, your pet doesn’t even need to be seen by a vet to have a pre-existing condition. If you observe symptoms in your cat or dog, you must disclose them when purchasing coverage. The insurance company will decide whether or not your pet has an excluded pre-existing condition.

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Example Scenario

Kristen Lynch offered an example of a common scenario to help explain the issue of pre-existing conditions: “Your 3-year-old dog develops a limp. You decide not to conduct many medical tests as they’ve never limped before. Your vet advises to rest the leg for a few weeks, and [they] prescribe some anti-inflammatory meds,” Lynch says. “Over the next few weeks, your pet’s condition improves. Then, six months later, Max plays rambunctiously at doggy daycare and comes home limping. Again, you think he’s just aggravated it, so you treat it like the last time. Max’s occurrences continue with increasing frequency and include longer recovery periods, more medication, and increasingly complex diagnostic tests until he is ultimately diagnosed with ligament disease and needs surgery.”

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Coverage Implications

Would this scenario be covered? If Max was already enrolled in coverage, Lynch says, the answer is yes. “However, if you enrolled Max at some point along the way before he was fully diagnosed, he had a pre-existing condition which would be excluded from coverage (and ineligible to claim for),” she adds.

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Types of Pre-Existing Conditions

There are two types of pre-existing conditions: curable and incurable. Here’s how they compare:

If you’re considering getting pet insurance, you should also be aware of bilateral conditions, which can impact both sides of the body. A common bilateral condition is hip dysplasia.

If your pup is diagnosed with dysplasia on its left side before you purchase pet insurance or during the waiting period, typically, neither hip would be covered even if the right hip displayed no signs of dysplasia when the policy was purchased.

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Pet Insurance Enrollment Requirements

Every pet insurance company has its own enrollment criteria your pet must meet to be eligible for coverage. However, you can generally expect to encounter requirements such as:

• Species restrictions. Most pet insurance policies only cover cats or dogs.

• Age limitations. Insurers often won’t cover animals if they’re under 8 weeks or over 14 years old.

• Health status checks. Typically, you’ll need to submit veterinary records or have your pet undergo a medical exam to identify pre-existing conditions.

“Some companies may necessitate an initial and subsequent annual health exam, while others may only require medical records from the past 12 months,” says Raman Singh, certified financial planner and pet insurance advocate. “Alternatively, certain insurers may not mandate any exams or pet records, but their rates are typically higher than those with enrollment requirements.”

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How to Choose the Right Pet Insurance for Pre-Existing Conditions

1. Review your pet’s medical history: Carefully examine your pet’s records to identify any potential pre-existing conditions. This thorough review will help you anticipate possible exclusions from insurers and avoid surprises when you receive their list of coverage limitations.

2. Evaluate plans for curable pre-existing conditions: Look for plans that include coverage for curable conditions. Pay close attention to waiting periods—check how long your pet must be symptom-free before coverage for these conditions begins.

3. Analyze costs: Compare premiums across different plans to get a sense of the market. Don’t forget to consider deductibles and co-insurance rates as well. Assess the overall value of each plan by weighing the benefits offered against the costs involved.

4. Investigate the claims process: Research how quickly each insurer pays out on claims. Look for companies with a reputation for straightforward filing procedures. A smooth claims process can make a significant difference when using your insurance.

5. Assess customer service: Test how easily you can reach customer service representatives. Evaluate their knowledge and friendliness. Good customer service can be invaluable when you need help understanding your policy or filing a claim.

6. Research company reputation: Read online reviews from sources like Trustpilot or the Best Business Bureau (BBB) to get a sense of real-world experiences. Also, check if the company has faced any legal issues or sanctions, as this could indicate potential problems down the line.

7. Enroll early: Enrolling your pet in insurance early reduces the risk of exclusions for conditions that may develop later. This strategy allows you to transfer potential financial risks to the insurer sooner rather than later.

8. Seek personal recommendations: Ask friends and family about their experiences with pet insurance. Pay special attention to those who have pets with pre-existing conditions when they enroll. Their insights can provide valuable real-world perspectives to help you make the best decision for your pet’s coverage.

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Medical History Review Process

Insurance companies typically request your pet’s records from your current veterinarian, considering factors such as the pet’s age and breed type. These records may span up to two years in history. This practice enables insurers to assess the probability of claims and accurately calculate your monthly premium based on the evaluated risks.

As noted, if your pet has pre-existing conditions, your insurer may exclude them from your policy, especially if they’re incurable. The insurance company may also charge you a higher rate for coverage if your pet is older or is a breed that often develops expensive medical issues.

Finally, note that some insurers require a medical history review before you enroll in coverage, while others need it before you file your first claim.

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Alternatives to Traditional Pet Insurance

It’s recommended that all pet owners plan for costly health issues their dog or cat might need to experience in the future. This is especially true if owners don’t plan to pay for pet insurance or if doing so is not an option.

While no one knows about a pre-existing condition before it shows up, preparing for one is never a bad idea. Here are some ways you can plan for future costly veterinary treatment:

• Plan ahead for the cost. “Consider setting aside monthly savings, akin to how you might save for your child’s college education fund,” says Singh.

• Research low-cost clinics or medical non-profit organizations. You can secure discounted veterinary care.

• Ask for help online. Community pools or crowdfunding platforms provide newer alternatives to consider.

While these alternatives may have fewer restrictions on pre-existing conditions, their benefits are typically limited or capped at a certain dollar amount. Combining savings, pet insurance, or community funding sources offers the most comprehensive approach.

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Bottom Line

Finding the right pet insurance for pre-existing conditions can be complex, making you navigate many exclusions and requirements. While some insurers offer coverage for curable pre-existing conditions, incurable ones are generally not covered.

Understanding your pet’s medical history and carefully reviewing policy details before enrolling is crucial. Planning ahead, researching low-cost care options, and considering alternative funding can help manage costs. By taking these steps, you can provide the best possible care for your pet, regardless of its medical history.

This article originally appeared on BestMoney.com and was syndicated by MediaFeed.org.

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