Do Any Pet Insurance Policies Cover Pre-Existing Conditions?
In general, it’s hard to find a pet insurance that covers pre-existing conditions, since most pre-existing conditions are not covered by most pet insurance plans, but there are exceptions. This goes back to what the insurance company defines as pre-existing.
Here are some of the most common types of illnesses and conditions, when they are considered to be pre-existing, and how that affects whether they’re covered or not.
Hereditary and Congenital Conditions
Many companies cover congenital and hereditary conditions as long as your pet hasn’t shown any signs or been diagnosed with one before coverage starts. Some companies even have separate “hereditary and congenital coverage” policies.
Hereditary (genetic) conditions are common, especially in purebred animals, and are inherited from a pet’s parents. Some examples include:
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Hip dysplasia
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Elbow dysplasia
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Cherry eye (entropion)
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Patellar luxation
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Intervertebral disc disease (IVDD)
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Allergies
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Some types of cancer
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Thyroid disease
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Diabetes
A congenital condition is one that your pet is born with, although they might not show any signs right away. Examples include:
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Hernia
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Congenital heart disease
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Some liver diseases, such as portosystemic shunts and copper-associated hepatopathy
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Nervous system issues
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Brachycephalic airway syndrome
Curable Pre-Existing Conditions
Curable conditions are defined as any medical condition/illness that your pet has been treated for and cured of. Most insurance companies require 180 symptom-free days to consider a condition cured, while some require a whole year. Some examples of curable conditions are:
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Ear infections
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Urinary tract infections
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Upper respiratory infection
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Vomiting/diarrhea not related to a chronic illness
Incurable Pre-Existing Conditions
These are conditions that cannot be cured; instead, they must be managed. Most pet insurance plans will not cover incurable pre-existing conditions that were diagnosed before the policy’s effective date. Some examples of incurable conditions are:
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Arthritis
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Some types of cancer
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Allergies
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Diabetes
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Hip dysplasia
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Many types of heart disease
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Torn cruciate ligament
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Epilepsy
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Disc disease
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Urinary blockages, crystals, or idiopathic cystitis
Bilateral Conditions
A bilateral condition is a health condition that can happen to both sides of a pet. An example is hip dysplasia, which can occur in either the left or right hip, or often both.
Most insurance policies will not cover a bilateral health condition if the issue was diagnosed before the coverage date, just like any average pre-existing condition. For example, if your pet was diagnosed with hip dysplasia on their left side before enrollment, and years later developed hip dysplasia on their right side, your policy will not cover either.
Some other types of bilateral conditions are:
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Torn cruciate ligaments
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Glaucoma
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Uveitis
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Patellar luxation
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Cataracts
Insurance companies exclude bilateral conditions because there is a good chance that a condition that occurs on one side of your pet’s body will develop on the other side. For example, a dog with left hip dysplasia will tend to shift their weight to their right side to avoid discomfort.
As a result, they are at higher risk of developing hip dysplasia on their right side as well. The underlying genetics that predispose pets to many bilateral conditions also, obviously, affects both sides of the body.
Hip dysplasia is also incurable, so it can be excluded for that reason if your pet had shown any signs before coverage. However, some bilateral conditions may be considered curable and will be covered.
For example, let’s say your dog was diagnosed with an ear infection in the right ear before enrollment but develops an ear infection in the left ear after the policy kicks in. The insurance company will likely cover the left ear infection as long as your dog had been symptom-free for 180 days (or maybe longer) after the first ear infection. Be sure to read the fine print and ask your insurance company about bilateral conditions.
