How Pre-Existing Conditions Impact Pet Insurance Coverage

pre existing conditions pet insurance

Pet insurance is a valuable tool for pet owners to ensure their furry companions receive the necessary veterinary care without breaking the bank. However, when it comes to pre-existing conditions, navigating pet insurance coverage can become a bit more complicated.

In this comprehensive guide, we will explore the impact of pre-existing conditions on pet insurance coverage and provide insights on how to find the best policy for your pet’s needs.


Understanding Pre-Existing Conditions

Before we delve into the intricacies of pet insurance coverage for pre-existing conditions, let’s define what these conditions entail. Pre-existing conditions refer to health issues that were present before purchasing a pet insurance policy. These conditions can be detected through a formal diagnosis or a record of symptoms.

When you apply for pet insurance, the provider will review your pet’s medical records to determine if any pre-existing conditions exist. This evaluation is crucial in determining what conditions will be covered under the policy and what will be excluded.


How Pet Insurance Companies Assess Pre-Existing Conditions

Pet insurance companies employ different methods to assess pre-existing conditions. Some may require a veterinary examination or a thorough review of your pet’s medical history. These assessments aim to identify any pre-existing conditions that the insurance company will not cover. It is essential to be honest and transparent during this process, as providing false information could result in policy cancellation.

Not all pet insurance companies require a medical review, and some may simply ask you about any pre-existing conditions. Regardless of the evaluation method used, it is crucial to familiarize yourself with the specific terms and conditions of the policy to understand what will be covered.

Coverage for Pets with Pre-Existing Conditions

While most pet insurance policies do not cover pre-existing conditions, that does not mean you cannot obtain coverage for your pet if they have a pre-existing condition. It is still possible to find pet insurance policies that cover future unexpected health issues, even if your pet has pre-existing conditions.

For example, if your pet has a curable pre-existing condition such as worms at the time of enrollment, the policy will not cover that specific condition. However, it will provide coverage for new injuries, illnesses, or unrelated medical issues that may arise in the future.


Even if your pet has an incurable condition like allergies or cancer, pet insurance can still be beneficial. The policy will cover medical expenses for new injuries or illnesses that are unrelated to the pre-existing condition. This ensures that your pet’s health is protected in various scenarios.

Factors to Consider When Choosing Pet Insurance for Pet With Pre-Existing Conditions

When selecting pet insurance for a pet with pre-existing conditions, there are several factors to consider to ensure you find the best coverage:

1. Waiting Periods

Waiting periods refer to the time between when your policy goes into effect and when coverage for specific conditions begins. It is crucial to carefully review the waiting period for conditions that your pet has or may be prone to developing. If symptoms or treatments occur during the waiting period, they will not be covered once the waiting period ends.

Look for pet insurance policies with shorter waiting periods, especially for conditions that your pet may already have or is susceptible to based on their breed or medical history. Some insurance providers offer waiting periods as short as 15 days for knee and hip issues, while others may require longer waiting periods.

2. Curable Pre-Existing Conditions

Some pet insurance providers offer coverage for curable pre-existing conditions. These are conditions that were present before the policy’s start date but can be satisfactorily resolved without the expectation of recurrence. It is essential to carefully review the definition of “curable” provided by the insurance company to determine if your pet’s pre-existing condition qualifies for coverage.

3. Bilateral Conditions

Bilateral conditions are medical conditions that can occur on either side of the body, such as knee and hip injuries. Insurance companies often consider bilateral conditions as pre-existing conditions. If your pet had a bilateral condition before obtaining insurance and the same condition presents on the other side later on, it will be treated as a pre-existing condition.

Consider how bilateral conditions may affect your pet’s coverage when selecting a pet insurance policy. Understand the policy’s stance on bilateral conditions and whether they will be covered after the waiting period has passed.

4. Medical History Review

Some pet insurance companies, like Figo, offer the option to request a medical history review or transparency report after enrolling in the policy. This review allows the insurance company to assess your pet’s medical records and inform you upfront about what they consider pre-existing conditions. This information can help you make an informed decision about whether the policy provides adequate coverage for your pet’s needs.

5. Switching Insurance Providers

If you are switching pet insurance providers, it is important to note that your pet’s pre-existing conditions will likely reset. The new insurance company will consider any previous conditions or treatments as pre-existing. Be prepared for potential limitations or exclusions when switching policies and carefully review the terms and conditions of the new policy.

Hereditary and Congenital Conditions

Hereditary conditions are medical disorders that are genetically inherited, while congenital conditions develop in utero and are present from birth. These conditions may not be considered pre-existing if symptoms do not appear before the insurance policy goes into effect.

It is crucial to understand how pet insurance policies handle hereditary and congenital conditions. Some policies may cover these conditions if symptoms do not manifest before the policy start date. Research your pet’s breed and consult with your veterinarian to determine if they are prone to any hereditary or congenital conditions. This information will help you select a policy that offers appropriate coverage.

Premiums and Pre-Existing Conditions

Pre-existing conditions do not directly impact the premiums or the ability to obtain coverage. Insurance providers cannot deny coverage or increase premiums based on pre-existing conditions or the number of claims made. However, it is important to note that premiums may increase as your pet ages due to factors such as rising veterinary costs. Aging pets are typically more expensive to insure.

When considering pet insurance, evaluate the overall cost of coverage, including premiums, deductibles, and potential out-of-pocket expenses. Compare different policies to find the most cost-effective option that provides the necessary coverage for your pet’s needs.

Is Pet Insurance Worth It for Pets with Pre-Existing Conditions?

Determining whether pet insurance is worth it for a pet with pre-existing conditions depends on various factors, including the severity of the pre-existing condition and the potential for future health issues.

For pets with curable pre-existing conditions or conditions that do not significantly impact their quality of life, pet insurance can still provide valuable coverage for unforeseen accidents or unrelated illnesses. In these cases, having insurance can offer peace of mind and financial protection.

On the other hand, for pets with extensive pre-existing conditions or older pets with multiple ailments, the coverage provided by pet insurance may be limited. In such cases, relying on a savings account or considering self-insurance may be a more practical option.

Ultimately, the decision to obtain pet insurance for a pet with pre-existing conditions should be based on your pet’s individual circumstances, your financial situation, and your willingness to assume potential risks.

Finding the Best Pet Insurance for Pre-Existing Conditions

When searching for pet insurance that covers pre-existing conditions, consider the following tips to find the best policy for your pet:

  1. Look for policies with a broad definition of “curable” pre-existing conditions.
  2. Evaluate waiting periods for conditions your pet may be prone to or already has.
  3. Check if the insurance provider offers a medical history review to gain clarity on what will be considered pre-existing.
  4. Consider a higher deductible and lower reimbursement rate to reduce monthly costs while maintaining coverage for major medical expenses.
  5. Compare different pet insurance providers to find the most suitable coverage for your pet’s needs.

To assist you in your search, refer to “The Best Pet Insurance: A Pet Parent’s Guide” for comprehensive reviews of various pet insurance companies and their policies.

In Conclusion

Understanding how pre-existing conditions impact pet insurance coverage is essential for pet owners seeking financial protection for their furry companions. While most pet insurance policies do not cover pre-existing conditions, it is still possible to find coverage for future unexpected health issues.

By considering waiting periods, curable conditions, bilateral conditions, and the policy’s approach to hereditary and congenital conditions, pet owners can make informed decisions when selecting the best pet insurance for their pets with pre-existing conditions.

Remember to carefully review the terms and conditions of each policy and compare different providers to find the most suitable coverage for your pet’s needs.