If you are a pet owner, you probably have questions about pet insurance and pre-existing conditions. What does pet insurance cover? Are there any limits to the illnesses or injuries it covers? And does it cover any pre-existing conditions? The answers can vary, so we’re here to help you understand the basics.
The good news is that medical issues that occur prior to purchasing pet insurance are not always considered to be pre-existing conditions that won't be covered depending on the pet insurance provider. For instance, 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, for example, would extend coverage for this second condition as long as there was no relationship between both infections.
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 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.), and pet insurance covers your pet’s future unknown and unexpected events and conditions. Any illnesses or accidents that manifest during your waiting period are also pre-existing conditions. Some pet insurance providers may have specific nuances in how they define pre-existing conditions so it’s important to read the policy of any pet insurance you are considered thoroughly prior to enrolling.
Like humans, pets have body systems that operate independently but affect each other, such as allergies. Any condition occurring in one body system (itchy paws due to allergies) can cause related problems in another (ear infections due to 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, 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 the policy remains 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.
Why are they excluded?
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. This would cause premium costs to go up for all other responsible pet parents.
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 usually contact the care or sales team of any pet insurance provider you’re considering to chat through your pet’s unique history and how it might impact coverage.
What Are Bilateral Exclusions?
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.
That also means that 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 had insurance coverage (after any applicable waiting periods), as then this condition and all future related claims, regardless of which limb, would be covered.
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. This is why we encourage pet parents to enroll their pets after they turn 7 weeks old or as early 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?
If you have a new puppy or kitten, it’s okay if they have no medical history. If you have a pet that is older and has never been to a veterinarian, you may need to take your pet for a medical exam as many pet insurance providers require a veterinary exam within a certain window of enrollment. Regular veterinary visits help you stay informed about what is going on, and they can provide the vital records needed to determine your eligibility for pet health insurance.
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, you would not receive reimbursement for any claims related to these pre-existing conditions. For example, if your vet diagnosed your pet with a protruding disc before your policy start date, they wouldn't be covered for other associated protruding discs, even if they occurred in a different place on the spine. But they would be covered for all other accidents or injuries as long as they were not directly related to the pre-existing condition. With a Furkin Pet Insurance policy, hereditary and congenital conditions are covered as long as such conditions are not pre-existing.
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. 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 and pre-existing conditions, you can call our Care Team at 1-888-453-1088. We would jump at the chance to help in any way we can!