Does Pet Insurance Cover Pre-Existing Conditions?

Trying to get pet insurance that covers pre-existing conditions? Most policies don’t, but a few plans make exceptions for certain curable conditions.

Written by Alani Asis / December 21, 2021

Quick Bites

  • It’s possible to get some insurance coverage for your pet’s pre-existing condition, depending on what it is.
  • There’s generally a waiting period to make sure the condition doesn’t recur.
  • Currently only California has laws stipulating that insurers be more transparent about what constitutes a pre-existing condition and what exactly is covered.
  • There are some other non-insurance options that can help you pay for treatment of your pet’s pre-existing condition.

If you own a pet, getting pet insurance can be a lifesaver, especially during emergencies.

But if your pet has a pre-existing condition, it can be difficult to find an insurer that will cover it. Typically, you’ll have to pay for treatment of conditions that were present before coverage started. However, some insurance policies make an exception for curable pre-existing conditions.

Here’s what you need to know about getting pet insurance that covers pre-existing conditions, and a look at policies from insurers.

Inside this article

  1. Curable vs. incurable conditions
  2. Who covers pre-existing?
  3. Insurance alternatives

Curable vs. incurable pre-existing conditions

While most insurers won’t cover a pre-existing condition, some insurers make exceptions based on the type of condition. Read the fine print to find out how the insurer you’re considering defines a curable pre-existing condition.

Here’s what you can generally expect.

Curable Pre-Existing Conditions

Curable pre-existing conditions are ailments or injuries that show up before a policy begins and can be completely cured, like fractured ligaments, respiratory infections, ear infections, vomiting or diarrhea.

For something like this to be covered by new insurance, your pet generally must not have recurring symptoms during the policy’s waiting period, usually six months to a year. If symptoms come back within the waiting period, the condition is reviewed as a pre-existing condition and will most likely not be covered by the policy.

Incurable Pre-Existing Conditions

Incurable pre-existing conditions are ailments or injuries that show up before a policy begins and can’t be completely cured, like cancer, diabetes, allergies and other significant injuries and illnesses.

Unlike curable pre-existing conditions, insurers won’t cover any kind of incurable pre-existing conditions.

Which companies cover pre-existing conditions?

Below, we’ve compiled a list of pet insurance companies that offer plans with coverage of some pre-existing conditions with stipulations, including the costs and details you need to know to choose the right plan for your pet.

Some general considerations to make when you shop for pet insurance are:

  • What type of pet insurance you plan to buy—accident-only, accident and illness, or a comprehensive plan with wellness coverage

  • What are considered curable and incurable pre-existing conditions

  • Annual deductible amount

  • Reimbursement amount

  • Annual coverage limit

Pets Best

Pets Best will provide accident-only coverage for pre-existing conditions. It doesn’t cover pre-existing illnesses (such as lymphoma or diabetes).

The plan covers recurring accidents or injuries, like a broken leg. So, if your pet has an accident and breaks a bone before you enroll in the policy, then breaks the same bone after you’ve enrolled in the policy, it’ll be considered a separate condition and is eligible for coverage.

Pet’s Best can be used at any vet clinic, specialized clinic and emergency care center in the U.S. and Canada.[1]

Policy options:

  • Deductible: $50 to $1,000

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $5,000 to unlimited

ASPCA

ASPCA offers accident-only and accident and illness plans. If your pet is cured of its pre-existing conditions and is free of symptoms for 180 days after policy enrollment, it will be eligible for coverage. ASPCA will not cover pre-existing knee and ligament conditions.

ASPCA can be used at any vet clinic, specialized clinic and emergency care center in the U.S. and Canada.[2]

Policy options:

  • Deductible: $100 to $500

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $3,000 to $10,000

Embrace

Embrace offers accident-only and accident and illness plans. Under these plans, as long as symptoms are not recurring and rediagnosed within 12 months of the date of the last visible symptom, then it is classified as a curable pre-existing condition and can be covered by insurance.

Embrace will not cover orthopedic pre-existing conditions, whether an injury happens on the same or opposite side.

Embrace can be used at any vet clinic, specialized clinic and emergency care center across the globe.[3]

Policy options:

  • Deductible: $200 to $1,000

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $5,000 to $30,000

Nationwide

Nationwide offers major medical and whole pet plans, both of which cover accidents and illnesses. Nationwide covers pre-existing curable accidents, injuries or illnesses as long as they have been treated with no recurring symptoms for six months.

Nationwide can be used at any vet clinic, specialized clinic and emergency care center across the globe.[4]

Policy options:

  • Deductible: $250

  • Reimbursement: 50%, 70% or 90%

  • Annual coverage limit: Unlimited

Fetch

Fetch offers only an accident and illness plan. Under this plan, Fetch covers curable pre-existing conditions after the pet has been symptom-free for a year.

A second one-year exclusionary period will apply if the condition recurs within the first year. If the same curable condition recurs within the second exclusionary period, Fetch won’t cover that pre-existing condition.

Fetch can be used at any vet clinic, specialized clinic and emergency care center in the U.S.[5]

Policy options:

  • Deductible: $250 to $500

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $5,000 to unlimited

American Kennel Club

American Kennel Club (AKC) offers an accident and illness plan, and you can choose add-ons. AKC will cover a number of chronic and curable pre-existing conditions after a one-year waiting period.

AKC can be used at any vet clinic, specialized clinic and emergency care center in the U.S.[6]

Policy options:

  • Deductible: $100 to $1,000

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $5,000 to $30,000

Spot

Spot offers an accident-only and an accident and illness plan. Both plans can be used for future coverage if your pet has been cured and free of treatment for pre-existing conditions for 180 days. Spot doesn’t cover pre-existing knee and ligament conditions.

Spot can be used at any vet clinic, specialized clinic and emergency care center in the U.S.[7]

Policy options:

  • Deductible: $100, $250 or $500

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $100 or $1,000

Hartville

Hartville offers an accident-only and an accident and illness plan. Both plans can be used for future coverage if your pet has been cured and free of treatment for 180 days. Hartville doesn’t cover pre-existing knee and ligament conditions.

Hartville can be used at any vet clinic, specialized clinic and emergency care center in the U.S. or Canada.[8]

Policy options:

  • Deductible: $100 to $500

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $2,500 to unlimited

Pumpkin

Pumpkin offers only an accident and illness policy with an optional preventive-care add-on. This plan can be used to cover curable pre-existing conditions.

Your pet must be free of symptoms and treatment for 180 days to qualify for future coverage. Pumpkin doesn’t cover pre-existing knee and hind-leg ligament conditions.

Pumpkin can be used at any vet clinic, specialized clinic and emergency care center in the U.S. or Canada.[9]

Policy options:

  • Deductible: $100, $250 or $500

  • Reimbursement: 90%

  • Annual coverage limit: $10,000 to $20,000 for dogs; $7,000 to $15,000 for cats

Prudent Pet

Prudent Pet offers an accident-only and an accident and illness plan. Both plans can be used to cover pre-existing conditions if they are a one-time incident and considered cured by a licensed veterinarian.

Prudent Pet can be used at any vet clinic, specialized clinic and emergency care center in the U.S. or Canada.[10]

Policy options:

  • Deductible: $100, $250 or $500

  • Reimbursement: 70%, 80% or 90%

  • Annual coverage limit: $10,000 or unlimited

Pet insurance alternatives

While no pet insurance covers ongoing care for incurable pre-existing conditions, there are some alternatives to get your pet the medical care they need at a reasonable price.

Pawp

At $19 a month, Pawp will cover up to $3,000 in emergency care for up to six pets, even if your pet has a pre-existing condition.

However, Pawp will only cover emergencies that need an immediate response. For instance, if your dog has cancer and collapses as a result or has an immediate reaction, coverage will be provided for the treatment.

The funds cannot be used for planned surgeries and wellness or routine checkups.[11]

Pet Assure

Pet Assure is an employer-sponsored program that shoulders 25% of all vet bills, including care for pre-existing conditions and for exotic pets. Check if your company offers it.

Pet Assure’s prices are based on your location, pet’s weight and the number of pets you need covered. Small pets (rodents, reptiles and cats) start off at $6.58 per month. Larger pets (dogs and farm animals) are priced at $8.25 per month.

Pet Assure can be used at any vet clinic, specialized clinic and emergency care center in the U.S., and it’ll take about 25% off your bill immediately. That means you don’t have to wait for reimbursements from the insurer.[12]

More Regulation on the Horizon

In spring 2021, the National Association of Insurance Commissioners (NAIC) started crafting a model law to uniformly regulate pet insurance while balancing the needs of insurers.

The association is crafting the law as a response to complex policies, premium rates that exceed coverage, the rise of claim denials and the inconsistency in what’s defined as a pre-existing condition.

Prior to this proposal, definitions of pre-existing conditions were inconsistent across insurers and undisclosed. As a result, many customers weren’t able to receive reimbursement for their claims. Under the law, insurers would need to disclose the limitations on pre-existing conditions coverage before the customer signs up for the policy.[13]

The law hasn’t been adopted across the U.S. As of today, California is the only state with specific pet insurance laws.

In California, the law requires that insurance policies must disclose information about reimbursement benefits, pre-existing condition limitations, lifetime policy limits, waiting periods, limitation of coverage and deductibles.

For more on pet insurance, see our stories on deciding whether pet insurance is really worth it, what's generally covered and not covered, and when you should get dog liability insurance.

Article Sources
  1. Pet’s Best Insurance. “Insurance and Pre-Existing Conditions.” https://www.petsbest.com/blog/insurance.
  2. ASPCA Pet Health Insurance. “Pet Insurance and Pre-existing Conditions.” https://www.aspcapetinsurance.com/research-and-compare/pet-insurance-basics/pet-insurance-and-pre-existing-conditions.
  3. Embrace Pet Insurance. “Pre-Existing Conditions & Pet Insurance.” https://www.embracepetinsurance.com/coverage/pre-ex-conditions.
  4. Nationwide. “What’s Not Covered.” https://www.petinsurance.com/whats-not-covered.
  5. Fetch. “Pet health insurance plans terms and conditions.” https://www.fetchpet.com/terms-conditions.
  6. American Kennel Club Pet Insurance. “Frequently Asked Questions.” https://www.akcpetinsurance.com/our-plans/frequently-asked-questions.
  7. Spot Pet Insurance. “Frequently Asked Questions.” https://spotpetins.com/faqs.
  8. Hartville Pet Insurance. “Pet Insurance Plan Information.” https://www.hartvillepetinsurance.com/our-plans.
  9. Pumpkin. “Frequently Asked Questions.” https://www.pumpkin.care/faqs.
  10. Prudent Pet Pet Insurance. “Pre-Existing Conditions.” https://www.prudentpet.com/pet-insurance-101/pre-existing-conditions.
  11. Pawp. “Home Page.” https://pawp.com.
  12. Pet Assure. “Home Page.” https://www.petassure.com.
  13. The National Association of Insurance Commissioners. “A Regulator’s Guide to Pet Insurance.” https://content.naic.org/sites/default/files/publication-pin-op-pet-insurance.pdf.

About the Author

Alani Asis

Alani Asis

Alani Asis is a writer who is on a mission to help young audiences become financially literate and find financial freedom. Her work has appeared in Business Insider, Clever Girl Finance, USDA Loans and more.

Full bio

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