How Does Pet Insurance for a Dog with a Pre-Existing Condition Work? All You Need To Know

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June 30, 2022 / Pet Insurance / By: Melanie Evans0 Comments

Pet insurance for dogs with pre-existing conditions

The term pre-existing condition is controversial, and that is true whether you are using it to talk about humans or their fur family members. As we usually use it when discussing health insurance it can make buying - or even qualifying to buy -pet health insurance a confusing business.

Here we will attempt to clear up some of that confusion to help you understand what pet health insurance options are - and may not be - open to you as a pet parent seeking coverage to help meet the expenses of caring for your pet.

What Is a Pre-Existing Condition?

In the most basic of terms, a pre-existing condition is an illness, or even an injury - that your pet already has at the time you come to attempt to buy pet health insurance for them. These may be smaller problems - a fracture in the process of healing for example - or more serious health problems like cancer or diabetes. Many genetic or hereditary conditions may be classified as pre-existing as well. 

Things are more complicated than that though - you knew they would be didn't you? - and things can become confusing and complicated.


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Common Pre-Existing Conditions

While this is not a fully comprehensive list, all the following are usually considered pre-existing conditions by most pet insurance providers:

  • All forms of cancer
  • Heart disease - no matter what stage it is in.
  • Diabetes
  • Arthritis
  • Joint diseases, including elbow or hip dysplasia, even if it is undiagnosed
  • Kidney disease
  • Diagnosed urinary tract problems
  • Diagnosed allergies
  • Orthopedic conditions

As we mentioned, this is not a complete list, and what one company considers a pre-existing condition it will not provide any coverage for sometimes another may see things slightly differently. To discover how these policies affect your unique pup, don't make blanket assumptions and do a little research and comparison shopping.

Pre-Existing Conditions: Reversible Versus Non-Reversible

Technically, there is not a single pet health insurance company that offers coverage for conditions a pet is suffering from when they issue a policy. That does not, however, mean that they will not cover the pup at all. In most cases it means that while they will provide no coverage for the specific treatment, the insurance company will cover unrelated illnesses and accidents are almost always covered in full as well.

The lines can blur here as well though. Here is an example.

German Shepherd Greta breaks a leg attempting to clear a fence that is just a little too high for her during a boisterous game of chase”

The incident demonstrates to her pet parents just how expensive pet health care can be, and while they are resigned to the fact that this time around they will be 100% rep for all the bills that come along with helping Greta's leg heal, a sign in their vet office waiting room advertising pet health insurance gets them thinking; maybe it is time to purchase some of that.

At the time they contact various health insurance companies Greta's leg is still mending, so, as they expected, even if they begin paying for the policy that very day any remaining bills related to the fence fail will not be considered for reimbursement, but all the other coverages they are entitled to - which will vary according to the plan they chose - will be in effect as soon as any standard waiting periods are over.

A year goes by, Greta's leg heals well and she - and her pet parents - almost forget the incident ever happened. Then, two years after that, Greta gets over-excited again, jumps another obstacle that is too high and fractures the same leg again. Her pet parents are unsure, will her pet health insurance cover this new injury, as it has happened before?

In most cases the answer would be yes. Although Greta began her membership in her current health plan with a broken leg it was considered a reversible condition, it could be completely cured, was for at least 12 months and so when it happened again the expenses related to treating the new injury allowed under the terms of her policy were covered.

Not all pre-existing conditions are considered reversible, and even some that seem to have been resolved will not be covered at any time. The biggest example of that is cancer. If a pup is found to have any form of cancer when they are first insured it will be considered a pre-existing condition. If that pup goes into remission it is an amazing thing for both pet parent and pup, but technically it is not considered cured, no cancer ever is. So, if it recurs a few years later it will still not be covered under the pre-existing condition rules.

What If I Don't Know If My Pet Has a Pre-Existing Condition?

Most pet insurance companies order a medical history review when issuing a pet health insurance. If you pup has been to the vet recently, usually within the last three months, records from that visit will be reviewed. If it has been a while since your pup paid a visit to their doctor you will often be required to schedule one and then allow the pet insurance company to review the notes from that visit.

Not all illnesses and health conditions that will be considered a pre-existing condition that can affect a pup are immediately obvious to pet parents, as some initially only cause very mild symptoms that can be easy to mistake for something else. However, even if you were not aware of the condition if a new medical exam uncovers it, the insurance company will take note, deem it a pre-existing medical condition and not provide coverage for it going forward, although they are still likely to issue a policy, even if it is only basic accident cover.

The Importance of Insuring Your Pet Young

One of the best ways to help ensure that your pet health insurance will provide at least some coverage for serious conditions - cancer, diabetes, hip dysplasia etc. - is to enroll them in a pet health plan early and then keep that coverage intact.

Most pet insurance companies will issue insurance policies to puppies from around the age of 8-12 weeks. Having coverage in place means that you are quite literally ensuring your pup's coverage in the future.

Should your six-year-old pup, for example, develop diabetes, as long as he has been enrolled in his plan for some time (the timing varies but is usually only three to six months) any coverages for the treatment of diabetes that your chosen plan allows for will go into full effect.

Some pet parents do not like to think about any kind of illness or injury befalling their brand new family member when they bring a new puppy home. And that's quite understandable. It's a happy, joyous time for all involved and no one wants to think about bad things.

However, part of becoming a pet parent is understanding that you are taking on the responsibility of ensuring your pup remains happy and healthy for life. Purchasing pet insurance early can be an important step in meeting those commitments.

When in Doubt, Ask

As you shop for pet health insurance and find that there are lots of different options to choose from, making that decision can become an increasingly confusing prospect. This is especially true if you are aware of the fact your fur kid has a pre-existing condition that will affect the levels of healthcare coverage he can get. Some pet parents quickly become so overwhelmed that they give up and 'take their chances', leaving their pup without pet insurance at all. Don't let that be you.

The best advice we can give is that when you are in doubt about what a certain plan has to offer, or how your pet's pre-existing condition will affect their coverage: ask. While pet insurance is easy to buy online - and often that is a wonderful thing for busy pet parents - all companies also offer Customer Service reps you can reach out to to answer any - and all questions before you make any purchasing decisions, so take advantage of that fact and ask everything you need to.

Why Any Pet Parent Should Consider Pet Insurance, No Matter What

Before you dismiss pet insurance as something that is not right for your pup because they have a pre-existing condition, consider the biggest reasons people buy pet health insurance at all: emergency care.

As is the case for a human, an accident can befall a dog at any time. The types of emergency treatment available to pet parents in the 21st century has increased in leaps and bounds over the past few decades and things that were once thought to be almost always fatal can now, with very prompt attention, be effectively treated and the pup saved.

Emergency care can be very expensive though, and having coverage in place that will help offset at least some of those expenses is a great thing, both for your peace of mind and your bank balance. Almost every pet insurance company will issue accident coverage for any pup, no matter what else is wrong with them, and, in many cases, no matter how old they are.

Most of these policies are some of the more inexpensive and it's every pet parent's hope that they will never actually have to make use of them, just like they hope they never crash their car and need to claim on their auto insurance. But having the protection there, just in case, can prove invaluable, and the same is true of pet insurance that covers the unexpected as well.


Melanie Evans

Melanie Evans is a writer and animal advocate based in Scranton, PA, who, enjoys sharing her lifelong knowledge about dogs. When not working, Melanie enjoys playing a wide variety of sports, traveling and hanging out with her energetic boxer dog Bruce.

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