Pre-Existing Conditions

What Is a Pre-Existing Condition?

A pre-existing condition is something that was already affecting your pet’s health before you purchased an insurance policy. It doesn’t matter if your pet has already been diagnosed with something or was only showing signs of an illness, the issue is still considered a pre-existing condition.

When a policy is initiated, most insurance companies have a waiting period to see if any illness develops. If a condition is diagnosed during this waiting period, it’s considered a pre-existing condition and will not be covered by the policy. How long is the waiting period?

While the length varies from one company to the next, it’s not unusual for it to be anywhere from 180 days to as long as a year and, even then, your pet may not be in the clear.

Some insurers may classify something that shows up after the waiting period as a pre-existing condition. For example, cancer is often considered a pre-existing condition even if there weren’t any signs during the waiting period because it often takes a long time to develop.

Do Not Wait to Enroll in Pet Insurance!

Like with human health insurance, pet insurance is the best way to make sure you’re prepared to handle the large vet bills you might face if your dog or cat suffers a serious injury or illness requiring intensive treatment and veterinary care. But what do you do if your pet has a pre-existing condition such as hip dysplasia? Are there any pet insurers that will offer the best coverage options insurance for expensive emergency treatment if your pet already has medical issues?

What Does Pet Insurance Cover?

Pet insurance is designed to help offset the cost of unexpected medical emergencies and the veterinary bills that come with them. For example, if your pet gets hit by a car and needs X-rays and surgery or ingests something poisonous and needs emergency treatment, pet insurance can help significantly lower the cost to you.

In addition to basic pet insurance policies, some insurance companies also offer wellness rewards. This is an insurance policy add-on that covers annual vet exams, routine treatments, and preventative medicine to help keep your pet healthy and catch any problems early.

You might have noticed that neither of these policies mentions anything about pre-existing conditions. If your pet has a prior health concern, you may still be able to get them covered for other problems that might arise in the future. Unfortunately, it’s really difficult to get coverage for pre-existing conditions themselves or the complications that can develop from them.

What Conditions Are Unlikely to Be Covered?

Often, the determining factor as to whether or not your pet can get coverage for a pre-existing condition is whether or not that condition is curable. Again, all companies are different but there are some conditions that can be excluded from coverage for one year from the date of the last episode. If they don’t reoccur, they’re eligible for coverage since the initial condition was cured. Some of these conditions are as follows:

Respiratory infections
Bladder infections
Gastrointestinal disorders

Generally, if your pet’s medical history shows that there were no instances of these things in a year, they’re eligible to be covered for these conditions.

Unsurprisingly, there are some exceptions to this, too. If your pet suffers from a different condition in the same area as the original one and it’s caused by something undetermined in nature, the insurance company could count them as a single disorder even though they may not be directly related. For example, if your pet has a nasty bout of gastritis that clears up and then has problems with colitis a few months later, these two things can be considered the result of a general inflammatory problem which would make both conditions ineligible for coverage.

Moreover, if your pet has what’s considered an incurable pre-existing condition, it will be excluded from the policy regardless of how long it’s been since a flare up. Some of these include:

Orthopedic injuries
Allergies
Cancer
Diabetes
Heart disease
Skin lumps
Hyper and hypothyroidism
Urinary cysts

Is There Any Way to Get Coverage for a Pre-Existing Condition?

Every insurance company is different so you have to do your research. Some insurers may handle pre-existing conditions differently than others but companies that do cover pre-existing conditions usually only do so on a limited basis under their most expensive plans.

You might think it’s unfair that you can’t get coverage for your pet’s pre-existing condition but, remember, pet insurance is designed to protect you from the things that might happen in the future, not problems that you’re currently facing. Insuring pre-existing conditions would be very expensive for everyone and encourage people to delay getting pet insurance until problems started to develop.

What Can I Do to Avoid Problems Getting My Pet Insured?

If your pet has a pre-existing condition they’re still eligible for coverage of any new illnesses and injuries. Make sure you research your options to find out if there are higher premiums or any exclusions from coverage. Each insurance company is different so make sure you shop around to get the coverage your pet needs at the most affordable price.

There have been some promising developments in recent years as pet insurance companies have started to get more and more competitive. For example, it’s becoming more common to find coverage for congenital problems even though they use to be considered a pre-existing condition. While it’s unlikely that incurable pre-existing conditions will be covered any time soon, it’s possible that companies will start to change the length of waiting periods so that curable conditions don’t make it so difficult to get better coverage.

The best thing you can do to make sure your pet is covered for everything is to get them insured when they’re young. In fact, the younger, the better. Premiums will be less expensive for a puppy or kitten than an older dog or car and the coverage will be in place before most chronic conditions start to appear. If you start coverage when they’re young, things that would be considered pre-existing conditions later in life will likely already be covered.

Examples

#1: Your Dog is Limping

Your dog has been limping for a couple of weeks so you decide to sign up for a pet insurance policy on July 1st. You take your dog to the vet on July 3rd and x-rays show he has a broken leg. The broken leg would be considered a pre-existing condition and would not be covered because the injury happened before you enrolled. Outcome – Not Covered

#2: Foreign Body Ingestion

You enroll in a pet insurance plan on December 1st. Then on Christmas Day, December 25th, your dog eats a bunch of wrapping paper. You take him to the vet and find out there is a severe obstruction in his stomach and he needs surgery. Luckily your waiting period has passed so this claim would be covered because it is not a pre-existing condition. Outcome – Covered

#3: Bladder Infection

Two years ago your dog had a bladder infection that required a night in the hospital and some antibiotics. You enroll in a plan March 1st. Eighteen months after you enroll in a pet insurance plan your dog suffers from a bladder infection that requires another night in the hospital and more antibiotics. Some companies, like Embrace Pet Insurance will cover curable health issues like bladder infections as long as they’ve been cured for 12 months after the date of your enrollment. Outcome – Depends

Final Note

As an additional point of clarity, congenital and hereditary disorders are not considered pre-existing conditions.

If you still aren’t sure whether or not your pet has a pre-existing condition you can ask for a free veterinary review prior to enrollment. The review will list any pre-existing conditions and outline what will be covered and what will not.

If you’d like a free veterinary review fill out our quick quote form. One of our licensed agents will reach out and you can ask them you’d like a veterinary review for your pet.

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