If you’re researching pet insurance options, you may notice that you see the phrase, “pre-existing conditions aren’t covered,” everywhere you look. Although most of us know what pre-existing conditions mean in the human health insurance world, you may be wondering if it means the same thing for pets and their medical status.
In this piece, we’ll examine what pet insurance companies mean by “pre-existing conditions” and cover the pet insurance providers that consider conditions before deciding if the company will or will not cover your pet’s health issues.
What are pre-existing conditions?
The National Association of Insurance Commissioners (NAIC) defines a pet pre-existing condition as the following:
“[A] pre-existing condition means any condition for which a veterinarian provided medical advice, the pet received treatment, or the pet displayed signs or symptoms consistent with the stated condition prior to the effective date of a pet insurance policy or during any waiting period.”
Pre-existing condition language to watch out for
According to the NAIC, some pet insurance policies may “exclude coverage in renewal policies for conditions diagnosed or treated in prior coverage periods.” Some policies won’t cover congenital (something a pet is born with) or heredity (breed-specific issues) conditions. The NAIC adds that some common conditions that aren’t covered are “hip dysplasia, heart defects, cataracts, and diabetes.”
For example, when I researched pet health insurance policies (you can read the whole piece here), I discovered that some pet insurance policies would cover hip dysplasia after a lengthy waiting period, others allowed pet owners to fill out a form for a shorter waiting period, and one (Spot) had a totally different take on hip dysplasia coverage. At Spot, pets who are enrolled after age six are not eligible for hip dysplasia coverage altogether.
Pet insurance policies that consider some pre-existing conditions
Embrace’s pre-existing conditions policy is unique for a few reasons.
1. Embrace will review your pet’s medical records for free
Pet owners can get a free Medical History Review after they enroll. The company’s “claims team will review your pet’s medical records to determine if anything would be considered pre-existing and for how long.”
2. Embrace will consider some conditions
“Embrace distinguishes between curable and incurable pre-existing conditions and covers curable conditions if pets remain symptom- and treatment-free for 12 consecutive months”.
Pumpkin will consider coverage for “curable” pre-existing conditions after a certain amount of time has passed.
“ … Pumpkin’s plan will be able to cover curable pre-existing conditions that have been free of symptoms and treatment for 180 days and occur again in the future.”
However, there is an exception: knee and hind leg ligament conditions.
“If a knee or hind leg ligament condition occurs before your coverage starts or during the waiting period, any future ones will not be covered.”
If you have questions about certain pre-existing conditions and if your pet can or can’t get coverage, call the pet insurance provider for clarification.