How does pet insurance know about pre-existing conditions?

min read
Updated: 23 January 2024
Written by
Cara Carlone
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Key Takeaways

  • Before a pet insurance company covers your pet, they typically require a veterinary examination or medical history review. This is an important step to ensure that your pet’s pre-existing conditions are properly assessed and documented.

  • Just because a condition has not been diagnosed or treated yet does not mean it is automatically eligible for coverage. Some pet insurance policies consider conditions that have not been diagnosed or treated yet as pre-existing conditions.

  • It’s essential to carefully read and understand your pet insurance policy to know what pre-existing conditions are covered and what conditions are not.

How does pet insurance know about pre-existing conditions?

Have you ever wondered how pet insurance companies find out about pre-existing conditions? Well, it’s not as mysterious as you may think.

Many providers will require a thorough examination of your furry friend’s medical history before they will even consider covering them.

This review is done to pinpoint any pre-existing conditions that won’t be covered by the insurance company. It may sound like a headache, but it’s necessary to determine what will be covered under your pet’s policy and what won’t.

But don’t worry, once the review is completed, you’ll have a clear idea of what your pet insurance policy will cover and what it won’t. From there, you can decide whether to enroll your pet or skip out on coverage if you don’t think it’s enough.

Now, not all pet insurance companies require a medical review. Some may simply ask you about any pre-existing conditions. However, honesty is always the best policy, as any deception could lead to cancellation of your policy.

So, how exactly do pet insurance companies review your pet’s medical history? They employ teams of veterinary specialists who are trained to review medical records and determine if your pet has any pre-existing medical conditions.

It’s a meticulous process that ensures your pet receives the appropriate coverage and that you are reimbursed for your medical expenses as soon as possible.

If your pet has never been to a vet, or it’s been a while since their last visit, the insurance company will usually require you to take your pet to a local veterinarian for an exam and provide records from the visit before enrolling your pet in a policy.

It’s just another way to ensure that your pet is healthy and ready for coverage.

Does my pet need to be examined before enrolling?

While not all pet insurance companies require a medical review or veterinary examination, some may ask for proof of a full medical exam or past veterinary records to identify any pre-existing conditions and assess your pet’s overall health.

This ensures that the pet insurance company can provide appropriate coverage and reimburses you for medical expenses as soon as possible.

However, not all pet insurance companies have this requirement. The ASPCA Pet Health Insurance program, for example, does not require a veterinary exam or any medical records for enrollment.

Regardless of the company you choose, it’s important to read the fine print and understand the terms and conditions of your pet’s policy to make an informed decision that provides the best coverage for your furry friend.

What if a condition hasn’t been diagnosed yet?

It’s important to know that even if a condition hasn’t been diagnosed yet, it can still be considered a pre-existing condition. For example, if your furry friend starts limping before you sign up for pet insurance, any future treatments related to that issue won’t be covered under the policy.

So make sure to enroll in pet insurance early to ensure your pet is protected from unexpected health issues!

Can Symptoms Be Considered Pre-Existing Conditions?

Believe it or not, even if your furry friend hasn’t been officially diagnosed with a medical condition, their symptoms could still be considered pre-existing. It all comes down to whether the symptom is part of an incurable or curable condition. Let’s say your pup can’t stop licking their paws, but they haven’t been diagnosed with allergies.

Unfortunately, any claims related to this issue probably won’t be covered because paw licking is often a sign of skin allergies, which is an incurable pre-existing condition. But if your pet is showing signs of an ear infection, like head shaking and ear scratching, there’s a good chance your policy will cover the treatment since ear infections are considered curable.

What if a pre-existing condition is cured?

When it comes to pre-existing conditions, it’s not just about the initial diagnosis, but also the ongoing symptoms and treatments. A condition is considered cured only if it has been resolved without any recurring symptoms or treatment for at least 12 months.

But even then, there are exceptions. Certain states may still provide coverage for curable conditions, so it’s always best to check with customer service to find out what applies to you.

However, some conditions will never be considered cured, like knee or ligament issues, as well as chronic conditions such as allergies, asthma, and cancer. These conditions require ongoing treatment, which is why they fall under the category of incurable pre-existing conditions.

What is considered a pre-existing condition?

In general, many pet insurance plans exclude coverage for pre-existing conditions, but it’s not always cut and dry. The definition of pre-existing varies depending on the insurance company, with some brands distinguishing between curable and incurable conditions.

According to the National Association of Insurance Commissioners, pre-existing and hereditary or congenital conditions are commonly excluded from coverage. However, some companies may have exceptions for certain curable conditions that have been resolved for a specific period of time.

So, what does this mean for your pet’s coverage? Well, it ultimately depends on the specific condition and its history. To help clarify, here are some common examples of pre-existing conditions and how they may impact coverage.

Hereditary and Congenital Conditions

Pet owners want to ensure that their furry friends are covered, but what happens if a congenital or hereditary condition arises? The good news is that some pet insurance companies have got you covered!

These providers may offer coverage for these types of conditions, but only if your pet hasn’t shown any signs or been diagnosed before the coverage starts. In fact, some companies even have special policies that exclusively cover hereditary and congenital conditions!

Common examples of hereditary conditions include hip dysplasia, elbow dysplasia, allergies, thyroid disease, and even some types of cancer. These conditions can often be passed down from parents to offspring, especially in purebred animals.

Congenital conditions are conditions that your pet is born with, but may not always be immediately apparent. Some examples of congenital conditions include hernias, certain liver diseases, and nervous system issues.

It’s important to know that even if a pet insurance policy covers congenital or hereditary conditions, it’s best to read the fine print to understand the extent of the coverage provided.

Curable Pre-Existing Conditions

If your furry friend has been treated for a medical condition and shows no symptoms for a certain period of time, it may be considered cured and eligible for coverage by some pet insurance companies.

The required symptom-free period varies, with some providers requiring 180 days and others a full year. Treatable conditions like ear infections, urinary tract infections, upper respiratory infections, and non-chronic vomiting or diarrhea are examples of curable conditions that may be covered by your pet insurance policy.

Incurable Pre-Existing Conditions

Managing your pet’s health can be tough, especially when dealing with incurable conditions. Unfortunately, most pet insurance plans won’t cover any pre-existing conditions that can’t be cured, like arthritis, certain types of cancer, and allergies.

Other examples include diabetes, hip dysplasia, many heart diseases, torn cruciate ligaments, epilepsy, disc disease, and urinary blockages or cystitis. While it may be discouraging to hear, knowing what’s covered and what isn’t can help you make informed decisions about your pet’s health and well-being.

Bilateral Conditions

Bilateral health conditions affect both sides of your pet’s body, and they can be quite common. For instance, hip dysplasia is a bilateral condition that can occur in one or both hips. Insurance policies typically exclude coverage for pre-existing bilateral conditions that were diagnosed before the effective date of the policy.

If your pet was diagnosed with a bilateral condition like hip dysplasia on one side, there’s a higher chance they’ll develop the condition on the other side too, which is why insurance companies often exclude such conditions from coverage.

However, not all bilateral conditions are excluded. If a condition is curable and your pet had no symptoms of the condition for a certain period of time, then it might be covered.

For instance, if your dog had an ear infection on one side before the policy started but developed one on the other side later, the insurance company might cover the second ear infection if the first infection was treated and your dog was symptom-free for a specified period.

As always, it’s important to check the fine print and talk to your insurance provider about bilateral conditions.

Can you provide examples of pre-existing conditions?

It’s always a bummer when you enroll your furry friend in a pet insurance policy and later find out that a health issue isn’t eligible for coverage. But how do you know if a condition is pre-existing or not?

Unfortunately, there’s no way to determine eligibility until you file a claim. However, we can shed some light on a few scenarios to give you an idea of what to expect.

For instance, let’s say your pup was constantly licking their paws before you enrolled them in a policy, and they later developed allergies. Would those allergies be covered?

Unfortunately, they wouldn’t. The pre-policy paw-licking is a telltale sign of the pre-existing condition.

Or, what if your cat developed a sarcoma mass on their back before your policy’s effective date, but you didn’t notice until after enrolling them? Sorry to say, the sarcoma would also be considered pre-existing and not covered.

But, here’s some good news. Say your dog sprained their knee pre-policy, but later developed hip dysplasia after enrollment. In this case, the hip dysplasia would be covered.

Our claims specialists could determine that there is no medical connection between the knee injury and the hip dysplasia, so it wouldn’t be considered a pre-existing condition.

Remember, every situation is different, and eligibility is determined on a case-by-case basis. It’s always best to read the fine print and ask your insurance provider about any specific concerns you may have.

How can I avoid a pre-existing condition?

Enrolling in a pet insurance plan early can help mitigate the risk of pre-existing conditions. Pets, being curious, energetic, and playful, can become injured unexpectedly or fall ill without warning.

Delaying enrollment in a pet insurance plan could increase the chances of your pet suffering an injury or illness, which would then be classified as a pre-existing condition, rendering it ineligible for coverage.

Most common pre existing conditions

In 2020, the most frequent insurance claims for dog health were for a range of conditions, including urinary tract infections, ear infections, gastroenteritis, diarrhea, skin issues, arthritis, allergies, lameness, vomiting, seizures, and eye conditions.

However, some of these conditions may be considered pre-existing for your dog, depending on your insurance policy’s terms. Additionally, some insurance plans may exclude certain geriatric conditions, provide limited coverage for specialist visits, or set a maximum amount for reimbursement per incident or annually.

Should I cover a pet with a pre-existing condition?

Consider enrolling your pet in a pet insurance policy despite any pre-existing conditions they may have. Although the pre-existing condition may not be covered, the policy can still provide coverage for other things, such as accidents or new illnesses.

The insurance plan may cover any future unrelated conditions diagnosed, depending on the type of policy purchased.

Can a pre-existing condition be covered in the future?

Don’t let your furry friend’s pre-existing condition get you down! Every pet insurance provider handles these differently, so it really depends on the plan.

Why aren’t they covered?

If you’re scratching your head wondering why pet insurance companies don’t cover pre-existing conditions, the answer is pretty simple. Insurance is designed to help you prepare for future incidents, not to pay for past ones.

Think about it: if you bought car insurance after you’ve already been in an accident, you wouldn’t expect the insurance company to pay for the damages from the wreck, right? The same principle applies to pet insurance.

Can you get pet insurance with a pre-existing condition?

Even if your furry friend has pre-existing conditions, you can still safeguard their health with pet insurance. Let’s say your pet has a curable condition like worms when you enroll them. While it won’t be covered at first, after a certain amount of time, your pet will be eligible for coverage.

And even if your pet has an incurable condition like allergies or cancer, pet insurance can still be a valuable asset when it comes to new health issues that arise unexpectedly, such as an injury or unrelated illness.

Don’t let pre-existing conditions prevent you from protecting your pet’s health and wellbeing with the peace of mind that pet insurance can provide.

Tips for insuring a pet with pre-existing conditions

Purchase when your pet is young and healthy

Enrolling your pet in a pet insurance policy while they’re young is one of the smartest decisions you can make to ensure their well-being in the long run.

Since younger animals are generally healthier and have fewer pre-existing conditions, you’ll save a ton of money in the future by having coverage for any new health issues that may arise as your pet ages.

Don’t wait until it’s too late – take the first step towards securing your furry friend’s future today!

Visit the vet regularly

As a loving pet owner, you want to ensure that your furry friend is healthy and happy. Scheduling regular check-ups with your vet is a crucial step to achieving that.

Not only does it help catch health issues early on, but it can also prevent your pet from getting sick by keeping up with necessary vaccinations.

When your pet does fall ill, taking them in for care as soon as possible is vital to prevent the condition from worsening and causing unnecessary suffering for your animal.

Remember, proactive measures like these can keep your pet healthy and make a huge difference in the long run.

Prioritize their health

Healthy eating and regular exercise are key to keeping your furry friend in tip-top shape. Just like humans, pets need nutritious meals to stay healthy. For dogs, incorporate fruits, veggies, and proteins that are loaded with nutrients into their diet.

Opt for safe foods like carrots, green beans, sweet potatoes, apples, bananas, and blueberries. Regular exercise is also important, as it can help prevent obesity and manage pre-existing conditions like diabetes.

Cats can enjoy many of the same healthy human foods as dogs, such as cooked vegetables like carrots and broccoli, whole grains, and proteins like eggs and fish. Even if your cat seems content lounging around all day, playtime is still important to keep them fit.

Break out their favorite toys and engage in some fun playtime to keep your kitty active and entertained. Remember to switch up their toys to avoid boredom.

By ensuring your pets stay active and well-fed, you can help prevent costly health issues down the line and keep your pet insurance premiums low.

FAQs

Can you still get pet insurance after diagnosis?

Pet insurance can be a game-changer for protecting your furry friend’s health and well-being, even if they have pre-existing conditions.

While any pre-existing conditions may not be covered by your policy, rest assured that any new injuries or illnesses will be covered, depending on the coverage type.

So, don’t hesitate to invest in pet insurance and ensure your pet’s future is secured!

Can I get pet insurance for a dog with pre-existing conditions?

Don’t let your pet’s pre-existing condition discourage you from seeking pet insurance coverage. While no pet insurance company covers pre-existing conditions, having a pre-existing condition won’t stop you from getting pet insurance coverage.

The type of coverage you can receive for your pet’s pre-existing condition will depend on whether it’s curable or not.

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