Pet insurance offers essential coverage for your pet’s care, yet it also involves exclusions, limitations, and specific conditions that may not be covered based on the policy type. Pre-existing conditions are rarely covered by pet insurance. Certain restrictions apply universally, while others are specific to particular species or breeds.
Key Takeaways
- Coverage exclusions in pet insurance policies differ based on their type.
- The primary types of coverage include wellness, accident, and comprehensive (accident and illness).
- Wellness policies typically cover routine care, such as check-ups and vaccinations, but they don’t include treatment expenses for injuries resulting from accidents.
- Accident and illness policies usually exclude coverage for routine care, such as check-ups and examinations.
Types of Pet Insurance Coverage
There are three main types of pet insurance available, each offering a specific set of coverage. It is crucial to recognize that the coverage provided by one type of policy might not include what another type offers.
For instance, wellness coverage is designed for routine and preventive care such as regular checkups, vaccinations, and certain dental procedures like teeth cleaning. However, it does not provide any coverage for accidents or illnesses.
Similarly, an accident-only policy does not cover wellness or illnesses. On the other hand, comprehensive policies cover both accidents and illnesses, but they rarely include wellness coverage. The policies could differ depending on your location. If you are in Arizona, the cost and coverage may diffe for example.
Expenses Not Covered by Pet Insurance
Before you commit to a pet insurance plan, it’s important to understand what expenses may not be covered. The exclusions list can be found on the insurance company’s website and is worth thoroughly reviewing as it may be longer than the list of covered items.
Pre-existing Conditions
Pet insurance typically excludes coverage for pre-existing conditions, which refers to injuries or illnesses that occurred before your policy started or during a waiting period. As a pet owner, you would be responsible for paying for any treatments related to these conditions out of your own pocket.
It’s worth noting that different pet insurance companies may have various definitions for pre-existing conditions. While some may exclude any condition diagnosed before coverage began, others may consider a certain timeframe and the current state of the situation to determine if coverage is applicable. For instance, if the condition is curable and the pet has been symptom-free for a certain period, it might be considered cured and no longer excluded.
Why do pet insurance companies have exclusions for pre-existing conditions? This is primarily done to minimize the risk of insuring pets with existing health issues. Some pet owners may try to obtain insurance only after their pet has been diagnosed with a chronic condition – this would be financially unsustainable for insurance companies.
Age Restrictions
Many pet insurance policies enforce age restrictions and may not provide coverage for pets below or above certain ages.
The specifics of age limits can vary between providers and policies, but generally, kittens and puppies younger than eight weeks are not covered. Older dogs or cats, typically over 14 years old, may also have limited coverage due to their increased vulnerability to age-related medical conditions.
Routine Care
Your pet health insurance policy does not cover routine or preventative health care by default. However, you have the option to purchase add-on wellness coverage to include these types of care.
Routine and preventative health care encompass several aspects, including dental and oral care, parasite prevention, spaying and neutering, vaccinations, and yearly wellness exams.
Regular visits to the vet are essential in preventing illnesses and identifying health issues early on. This can lead to simpler, less expensive, and less invasive treatments. If you are looking for a pet insurance company that offers preventative and wellness coverage as an additional option, it is recommended.
While adding wellness coverage may increase your monthly expenses, it can save you hundreds of dollars per year on vaccinations and dental cleanings, as well as potentially thousands on preventable illnesses. Therefore, in most cases, opting for wellness coverage is highly beneficial.
Bilateral Conditions
Bilateral conditions are conditions that can occur on both sides of your pet’s body, such as hip dysplasia, cruciate ligament issues, or cataracts. In general, these conditions are covered unless your pet has already experienced the condition on one side of its body. In such cases, it will be excluded from coverage.
Behavioral Issues
Coverage for behavioral problems varies between insurance plans. Some plans include it automatically, while others offer it as an additional option for an extra fee. However, there are some insurance providers that do not offer coverage for behavioral problems at all.
The specific coverage for behavioral issues depends on the provider and the particular problem. Examples of problems that might be covered include excessive chewing and licking, aggression, and separation anxiety.
Preventable Diseases
Pet insurance typically does not cover diseases that can be prevented through vaccinations. Vaccines are seen as a routine part of pet care, so any costs associated with vaccines and illnesses resulting from a lack of vaccinations are not included in coverage.
Instead of specifically listing out the preventable diseases, insurers usually have a set of required vaccinations or follow the guidelines set by organizations like the AAHA and AAFP.
Breed Exclusions
Certain breeds, especially dogs, are more prone to illnesses and accidents due to their lifestyle and physical characteristics. Because of this, some insurers either refuse to provide coverage for these breeds or charge higher rates.
Some of the dog breeds that are more expensive to insure include the American Mastiff, Bull Mastiff, Neapolitan Mastiff, Saint Bernard, English Bulldog, French Bulldog, Great Dane, and Rottweiler.
Administrative Expenses
Insurance companies often charge administration costs for processing insurance forms, verifying customer and patient details, and obtaining a veterinarian’s signature. These administration costs are typically not covered by pet insurance.
Elective Processes
Pet insurance usually does not cover elective procedures, which are considered non-medically necessary. These procedures are often cosmetic and do not fall under the categories of illness or accident.
Examples of elective procedures include cosmetic surgeries like ear cropping, soft tissue surgeries, dew claw removal, tail docking, spaying and neutering, and oral surgeries.
Pregnancy
Complications during pregnancy can be costly, but many pet insurance companies do not cover these expenses, particularly if the complications are related to breeding. However, there are specialized pet insurance companies that cater specifically to breeders.
In addition to pregnancy complications, there are other treatments that are not typically covered by pet insurance policies, including ear cleaning and nail trimming.
Defining Accidents and Illnesses
Pet insurance companies have the authority to specify their own definitions for “illnesses” and “accidents” within their policies. Typically, accidents are classified as unforeseen incidents that cause injury to your pet, such as a fractured bone, a bite mark, or ingesting a sock accidentally.
Conversely, illnesses are regarded as health conditions not resulting from accidents or injuries. They generally encompass issues pertaining to the pet’s bodily well-being, such as bladder infections or liver diseases.
Conclusion
It is important to note that certain situations are explicitly excluded by pet insurance companies. These include expenses for autopsy and cremation, avian flu, quarantine, and injuries resulting from neglect or abuse.
To ensure that your pet is properly insured, it is essential to find a provider that offers a plan tailored to your pet. Carefully read through the exclusions and disclaimers to fully understand your policy.
Different types of pet insurance provide coverage for various costs. It is important to know what is not covered in addition to what is covered when choosing a pet insurance policy. Consider the costs you want covered, such as injuries or routine care, when searching for a policy that suits your needs.
