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Comprehensive Guide on Pet Insurance Pre-Existing Conditions

Dr. Chip Coombs, DVM | Sep 14, 2022

If you are a pet owner, you probably have questions about pet insurance and pre-existing conditions. Are there any limits to the illnesses or injuries it covers? Does it cover any pre-existing conditions? The short answer is: pre-existing conditions are generally excluded. However, there are some exceptions, so we’re here to help you understand the basics.

Why Aren't Pre-Existing Conditions Covered?

Most pre-existing conditions are known events (e.g., your pet has gotten ear infections in the past, they’ve already been diagnosed with diabetes, etc.). With pet insurance, you’re paying a monthly premium to get protection from any large unexpected veterinary expenses so you know you’ll be able to give your pet the best available care when needed. If pet insurance companies didn’t exclude pre-existing conditions, it would be easy for some people to wait until their pet developed expensive conditions before enrolling and starting to pay for insurance. Therefore, causing affordable premium costs to go up for all other responsible pet parents.

Note: The information in this article is based off the Furkin Pet Insurance policy. Some pet insurance providers may exclude more and/or have specific nuances in how they define pre-existing conditions so it’s important to read the policy of any pet insurance provider you are considering thoroughly prior to enrolling.

What Are Pre-Existing Conditions?

A pre-existing condition refers to any condition that occurred or showed signs or symptoms before an effective policy date, including any respective waiting periods. Most conditions that are pre-existing with your pet before you enroll in insurance will be excluded from coverage. For example, let’s say your pet was itching their paws last year and got diagnosed with allergies. When you enroll in coverage today, allergies would be pre-existing and any future claims related to allergies would be excluded from your coverage. However, the rest of your pet insurance coverage would remain the same.

When discussing pre-existing conditions, it’s important to mention two key terms: Associated Conditions and Bilateral Conditions.

Associated Conditions

Like humans, pets have body systems that operate independently but affect each other, such as allergies. A condition occurring in one body system (itchy paws due to allergies) can have related problems in another (ear infections due to allergies). In this case, allergies would be considered the primary condition and any future conditions that arise due to allergies would be considered “associated conditions” to those allergies. If your pet has a primary condition that is eligible for coverage, any associated conditions will also be covered. On the other hand, associated conditions related to a primary condition that was deemed pre-existing may not be covered.

Let’s use Furkin Pet Insurance coverage and allergies as an example.

Not Covered: If your veterinarian diagnosed your pet with allergies before taking out a policy, then skin allergies and any associated conditions to these allergies (e.g., ear infections) would be considered pre-existing and not eligible for coverage.

Covered: However, the above example only applies because the allergies were a pre-existing condition before you enrolled in coverage. If your pet developed skin allergies while insured, then all treatment for the allergies and related conditions would be eligible for coverage for as long as you keep the policy in force.

Associated condition coverage may vary between pet insurance providers so, as always, be sure to review the policy and coverage details before enrolling.

Bilateral Conditions

When something is bilateral, it has two sides: two ears, two eyes, two front legs, and so on. Bilateral injuries mean that something that happens to one side can happen to the other, such as ear infections, hip dysplasia, or kidney infections.

Generally, if a pet experiences an injury or illness on one side of their body, there's often a greater chance they'll also experience it on the other side. So if your dog shows signs of hip dysplasia on the left side of the body before activating your coverage, many pet insurance companies will consider this a pre-existing condition for both hips.

However, this does not apply if the condition manifested or occurred once you already had insurance coverage (after any applicable waiting periods), as then this condition and all future related claims, regardless of which limb, would be covered.

What Are The Exceptions?

There is some good news. Depending on the insurance provider, some medical issues that occur prior to purchasing pet insurance may not be considered to be pre-existing conditions.

For example, if your dog had a bladder infection that occurred prior to your policy start date and then has another bladder infection years later after purchasing insurance, Furkin Pet Insurance would extend coverage for this second condition as long as there was no relationship between both infections.

How Do I Know if My Pet Has a Pre-Existing Condition?

Conditions, symptoms, and causes can be confusing, so it’s important to talk to your veterinarian. They can review your pet’s complete medical records, outlining any conditions your pet has experienced to date. It’s essential to consider any previous veterinarians or specialists your pet has seen, as those medical records will also help you understand what is pre-existing for your fur baby. Even without a diagnosis, a symptom of a condition can still count as a pre-existing condition if known before your pet's insurance policy begins.

After you’ve spoken with your veterinarian, you can contact a Furkin Care Member to chat through your pet’s unique history and how it might impact coverage.

Do I Need to Provide Medical Records to a Pet Insurance Company?

Yes, your pet’s medical records are typically retrieved after you submit your first claim, but you can always send this information proactively beforehand. Processing these records is how pet insurance companies know about your pet's past health history. At Furkin, we have experienced veterinary specialists that will review your pet's medical records to determine whether your furry family member has any pre-existing conditions and to ensure they receive the best possible coverage.

We want to be there for ALL of your pet’s needs so we encourage pet parents to enroll their pets as soon as possible to avoid having any pre-existing conditions excluded from coverage.

What if My Pet is New and Has Never Been to the Vet?

Some pet insurance providers may require a veterinary exam within a certain window of your enrollment. If you have a new puppy or kitten, it’s likely okay if they have no medical history prior to enrollment. But even if not required, regular veterinary visits are recommended to help you stay informed about your pets health and for early detection of any potential problems.

Can I Still Get Pet Insurance if My Pet Has a Pre-Existing Condition?

Most pet insurance providers will still provide coverage if your pet has pre-existing conditions. However, as mentioned above, you would not receive reimbursement for any claims related to these pre-existing conditions. With a Furkin Pet Insurance policy, hereditary and congenital conditions are covered as long as such conditions did not begin to manifest prior to your enrollment.

Pet insurance policies are an essential part of your pet's health and veterinary care. As your pet gets older, there's an increased possibility of an accident or illness, which can be expensive to treat and take a toll emotionally and financially. You’ll want to have pet insurance before any issues arise so you are fully protected when the time comes. It’s not always easy to make decisions about your pet's medical care and quality of life, especially when the costs of veterinary care can be high. To learn more about Furkin Pet Insurance or pre-existing conditions, you can call our Care Team at 1-888-453-1088. We will jump at the chance to help in any way we can!