For many pet owners, the health and well-being of their furry companions are top priorities. Our pets are a lot like us, they get sick and need medical care. The cost of visiting vets continues to increase though.
To mitigate these expenses and ensure the best care for their pets, many owners turn to pet insurance. One thing you have to keep in mind is that all pet insurance policies have rules about preexisting conditions.
Key Takeaways:
- A preexisting condition is any illness, condition or injury your pet has prior to the start of the insurance policy.
- Majority of insurance providers for pets do not cover preexisting conditions.
- If the preexisting conditions do not show up after a certain period, it might be covered by the pet insurance company.
How Pet Insurance Providers Learn of Preexisting Conditions
All pet insurance providers have measures to determine if a pet has any preexisting condition or not. These conditions refer to any illnesses, injuries, or other health issues that your pet may have had prior to obtaining insurance coverage.
Before your pet is accepted by an insurance company, you will be asked to provide their complete medical history. This encompasses any surgeries, medications, treatments, injuries suffered, diagnosis, vet records and so on. This information helps the insurer assess the overall health of your pet before providing coverage.
Based on the information you provide, the insurance company will review the medical records and determine if any of your pet’s conditions existed or were treated before the policy’s start date.
An assessment will be made. If the insurance determines that your pet has a preexisting condition, any ailments or medical situations that arise due to it will not be covered by the insurance. But bear in mind that insurance companies have differing policies over what constitutes a preexisting condition.
- Waiting Period: The waiting period is the time before the policy takes effect. If your pet develops a medical condition prior to the policy taking effect, then it will not be covered. Any other conditions that come up due to it will also not be covered.
- Look-Back Period: Some insurance companies consider a certain period of time prior to the policy’s start date to determine preexisting conditions. For instance, if the look-back period is six months, any conditions diagnosed or treated within that six-month period will be considered preexisting.
- Exclusions: There are some insurers that might exclude medical conditions because of their nature. For example, if your pet has been diagnosed with a chronic disease like diabetes before obtaining insurance, that condition might be excluded from coverage.
Keep in mind that how pet insurance companies determine preexisting conditions can vary. This is why you have to be very thorough in reviewing a pet insurance plan. So when the time you file a claim, you won’t run into any issues.
To prevent potential issues with preexisting conditions, it is advisable to insure your pet as early as possible, before they develop any significant health concerns. This way, you can have a higher chance of obtaining more comprehensive coverage and ensure that common, costly health issues related to your pet’s breed or age are included in the policy.
What are Temporary and Permanent Exclusions?
Certain pet insurance providers categorize preexisting conditions into two groups: temporary and permanent exclusions.
Temporary Exclusions
If the preexisting condition has been cured or has not manifested over a certain period, the insurance company might offer limited coverage. This period allows coverage for certain conditions once the pet remains symptom-free for a designated time frame. This is only possible if there are no symptoms.
For instance, Fetch pet insurance may cover a condition if any recurrence happens at least 12 months after enrollment, and the pet displays no further symptoms.
Another example is Spot insurance. If there are no symptoms and no treatment for at least 180 days, they no longer regard it as a preexisting condition and will provide coverage. The only exception to this are ligaments and knee injuries.
Some instances when cured preexisting conditions may be covered are vomiting, urinary tract infection, diarrhea, bladder ailments and more.
Permanent Exclusions
On the other hand, incurable preexisting conditions are those that insurance companies consider permanent or ongoing, such as allergies, arthritis, bladder crystals, cancer, diabetes, epilepsy, heart disease, hip dysplasia, kidney disease, orthopedic conditions, and urinary blockages.
These conditions often necessitate frequent vet visits, ongoing medication, and sometimes surgical interventions. If your pet has any of these preexisting conditions, it will almost certainly not be covered by insurance.
It’s important to note that while curable conditions might eventually become eligible for coverage after a waiting period and symptom-free period, incurable preexisting conditions are generally excluded from coverage by most pet insurance policies.
Pet Insurance Companies That Cover Preexisting Conditions
Typically, pet insurance providers exclude coverage for incurable preexisting conditions such as cancer, diabetes, and hip dysplasia. However, some companies offer coverage for what they classify as “curable” preexisting conditions, including bladder infections, diarrhea, and ear infections.
Here are examples of pet insurance companies that provide coverage for curable preexisting conditions:
Sonnet Pet Insurance
Exclusions due to preexisting conditions within the policy can undergo review if the pet remains symptom-free and doesn’t require further treatment for a minimum of six months to a year.
Fetch By The Dodo (formerly called Petplan)
Fetch covers curable preexisting conditions moving forward if your pet remains symptom and treatment-free for 12 months from the day of enrollment.
Spot
Spot covers common curable preexisting conditions (except for knee and ligament conditions) if the condition is curable, has been cured, and remains free of symptoms and treatment for 180 days.
OVMA
Policy exclusions due to preexisting conditions can undergo review if the pet remains symptom-free and doesn’t require further treatment for six months to a year.
Pet Plus Us (includes Costco Pet Insurance)
Pet Plus Us adopts a lenient approach in interpreting medical conditions considered as preexisting. They might ignore or consider issues as temporary exclusions if they seem like a one-time event.
Furkin
Furkin distinguishes between permanent exclusions and temporary exclusions, mainly addressing minor, short-term illnesses. If there are no additional episodes throughout the policy year, the preexisting condition becomes eligible for review at the year’s end, provided a veterinarian certifies full recovery.
Peppermint
Similar to OVMA, Peppermint allows a review of exclusions related to preexisting conditions if the pet remains symptom-free and doesn’t require further treatment for six months to a year.
These companies offer varying criteria and timelines for reviewing or covering curable preexisting conditions, emphasizing the importance of understanding individual policy terms before choosing a pet insurance provider.
How Preexisting Conditions Impact Pet Insurance Coverage
When a pet has a preexisting condition, it’s crucial to understand how this affects the insurance policy:
Exclusion from Coverage: Insurance companies often exclude preexisting conditions from coverage. This means that any treatments, medications, or procedures related to the preexisting condition will not be reimbursed.
Waiting Periods: Some insurance providers have waiting periods for specific conditions. During this time, if your pet develops a condition, it might be considered preexisting and not covered.
Coverage for Other Conditions: Even if your pet has a preexisting condition, other illnesses or injuries unrelated to the preexisting issue may still be covered. However, it’s essential to carefully review policy details to understand what is and isn’t covered.
The presence of preexisting conditions can pose challenges for pet owners seeking insurance coverage:
Limited Options: Some insurance companies may refuse coverage altogether if a pet has significant preexisting conditions, leaving owners with limited insurance options.
Higher Premiums: If an insurance company does offer coverage despite preexisting conditions, the premiums might be significantly higher to account for the increased risk. This is often the case, though you might get a lower premium if you opt for a higher deductible.
What to Consider When Purchasing Pet Insurance
When looking for pet insurance, it’s essential to consider the following:
Review policy details carefully to understand coverage limitations, including preexisting condition exclusions.
Be aware of waiting periods for coverage to begin, as any conditions that arise during this time may be considered preexisting.
If your pet has preexisting conditions, explore alternative ways to manage healthcare costs, such as setting up a dedicated savings account for pet expenses or seeking specific disease management programs.
Conclusion
Pet insurance is an effective way to deal with sudden medical costs for your pet. However, pet owners should be aware of the implications of preexisting conditions on coverage. Careful consideration of policy terms and potential exclusions related to preexisting conditions is crucial when selecting a pet insurance plan to ensure the best care for your furry friend.
Remember, each insurance provider and policy varies, so thorough research and understanding of the terms and conditions are essential before making any decisions regarding pet insurance coverage.
