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What Pet Insurance Does Doesn't Cover

Find The Best Policy Find The Best Policy Start If getting health insurance for your furry friend has been on your mind, it pays to know what is generally covered and what isn't.

What Pet Insurance Does Doesn't Cover
Brian Greenberg

Written by Brian Greenberg

CEO / Founder & Licensed Insurance Agent

Grant Desselle

Reviewed by Grant Desselle

Licensed Insurance Agent

Last updated: February 2023 | 3 min read

What Pet Insurance Does Doesn't Cover at a glance

  • Understand that pre-existing conditions are not covered by pet insurance.
  • Check for hereditary and congenital coverage based on your pet's breed.
  • Cancer treatments can be costly and may not be covered if pre-existing.
  • Vet visits require upfront payment, with reimbursement from insurance later.
  • Wellness visits, like annual exams, are typically not covered by pet insurance.
  • Purchase pet insurance early to avoid issues with pre-existing conditions.
  • Review policy details to ensure coverage for specific health concerns.

What pet insurance covers

Hereditary and congenital coverage

Hereditary coverages can be important, depending on your pet’s breed. Purebred dogs, especially certain breeds, often have common hereditary conditions like breathing issues for bulldogs and hip dysplasia in German shepherds and other large breeds. Other hereditary conditions include diabetes and cherry eye. You will want to check any pet insurance policy you’re considering to make sure the costs related to these issues will be covered if your pet develops them.

Congenital problems are medical issues your pet has had from birth, like a cleft palate, heart defects, or other problems in their limbs or organs. Many of these conditions don’t show up until years later, so you will want to consider if you need a policy that covers them. For example, if your cat is diagnosed with a heart murmur when she’s ten years old, that would usually be considered a congenital issue and only covered if your policy includes congenital problems.

Pet cancer coverage

Cancer in cats and dogs is sadly very common over age 10. If you have an aging cat or dog, cancer is the number one cause of death as they get older. Treatment can be very costly. Not all policies cover cancer care, so be sure to check any policies you’re considering for details.

Cancer coverage is becoming more important as cancer treatments for dogs and cats improve. New and more advanced treatments are becoming available and can lead to longer lives for your beloved pets. But the cost can run to $10,000 or more for cancer treatments. Pet insurance allows you to afford the treatment your pet needs without breaking the bank.

It’s important to note that cancer is not covered when it’s a pre-existing condition. If your cat or dog is diagnosed with cancer before you buy pet insurance, any further treatments can’t be claimed on your pet insurance no matter what policy you buy.

Vet visits

Pet insurance will cover any certified veterinarian who treats your pet. This means you can have your pet seen by your most trusted vet - you aren’t restricted to a certain area or practice.

But unlike human insurance, with pet insurance, you’ll have to pay any bills upfront. Most vet offices require payment at the time of your visit. This means you will pay all costs out of your pocket at the time of care, and then submit a claim to be reimbursed by your pet insurance after your visit.

What pet insurance doesn’t cover

Pre-existing conditions

Pre-existing conditions are not covered. Maybe your dog was limping before you applied for pet insurance and your vet hasn’t been able to determine the cause. Once you have pet insurance, if the limping happens again any costs related to it will not be covered. If you have an aging cat, kidney failure is a common ailment and can require expensive treatment. But if you purchase pet insurance after your cat has been diagnosed with kidney problems, treatments will not be covered.

How are pre-existing conditions different from hereditary or congenital problems? The main difference is that hereditary and congenital problems are issues your pets may have been born with but have not yet surfaced. Pre-existing conditions are issues they have suffered from in the past and are known to you.

The regulations on pre-existing conditions apply to every pet insurance product on the market. This means that it’s better to purchase pet insurance sooner rather than later, because you’ll need to have coverage before your pet falls ill. If your cat has respiratory issues, for example, you couldn’t sign up for pet insurance to cover her treatments once she’s been diagnosed. You’ll need to plan ahead and insure your pets before anything happens to their health.

Wellness visits

Most pet health insurance plans do not cover wellness visits for your pet. This includes items like annual exams and teeth cleaning. These costs will usually still be out of pocket if you purchase pet insurance. However, this does vary by plan so do check your policy before you purchase.

Frequently asked questions

What are pre-existing conditions in pet insurance?+

Pre-existing conditions are health issues your pet has suffered from in the past and are known to you. These conditions are not covered by any pet insurance policy.

How do hereditary and congenital conditions differ from pre-existing conditions?+

Hereditary and congenital conditions are issues your pets may have been born with but have not yet surfaced. Pre-existing conditions are known issues that have already affected your pet.

Does pet insurance cover cancer treatments?+

Cancer treatments can be very expensive, often exceeding $10,000. However, if your pet is diagnosed with cancer before purchasing insurance, those treatments will not be covered.

Are wellness visits covered by pet insurance?+

Most pet health insurance plans do not cover wellness visits, including annual exams and teeth cleaning. These costs typically remain out of pocket.

Can I choose any vet with pet insurance?+

Pet insurance allows you to visit any certified veterinarian who treats your pet. You are not restricted to a specific area or practice.

What should I do if my pet has a health issue before getting insurance?+

It is crucial to purchase pet insurance before your pet falls ill. If your pet has a known health issue, treatments related to that condition will not be covered.

How does payment work with pet insurance?+

You will need to pay all vet bills upfront at the time of your visit. Afterward, you can submit a claim to be reimbursed by your pet insurance.

Why is it important to check policy details?+

Reviewing policy details ensures you understand what is covered, especially regarding hereditary, congenital, and pre-existing conditions. This helps you avoid unexpected costs.

About the authors

Brian Greenberg

Written by

Brian GreenbergCEO / Founder & Licensed Insurance Agent

Brian is the founder and CEO of Insurancy and carries Life, Health, and Property & Casualty licenses in all 50 U.S. states. Since 2013, Brian has been a member of Million Dollar Round Table, a designation for the top 1% of financial advisors worldwide. Brian has been featured in Yahoo! Finance, Money.com, Entrepreneur.com, Life Happens, Forbes, MSN, and Good Financial Cents. Brian’s goal is to show customers the best products, the quickest answers to their questions, and provide expert advice.

Grant Desselle

Reviewed by

Grant DesselleLicensed Insurance Agent

Grant's past experience includes work as a licensed sales agent for Hagerty Insurance. He has reviewed thousands of existing auto policies across the nation and issued hundreds of new ones on everything ranging from classic cars undergoing restoration to modern exotics and motorcycles.

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