Pet insurance policies are underwritten by Independence American Insurance Company

Are Pre-Existing Conditions Covered?

Pet Insurance Explained  •   Jodie Otter, MSW  •   Dec 05, 2021

 

If your pet has a recurring medical condition, it’s almost impossible to find a pet insurance company that can help. Pre-existing conditions are a common reason claims are denied, and any illness or accident that predates a policy won’t be eligible for reimbursement.

So, with AKC Pet Insurance, are pre-existing conditions covered?

AKC Pet Insurance Offers Pre-Existing Condition Coverage

We are the first and only major pet insurance company to offer coverage for pre-existing conditions! As long as your pet has had a policy with us for a full policy term (365 days) with continuous coverage, after policy renewal, your pet will have satisfied the waiting period for pre-existing coverage.

Let’s say your dog’s policy began on 1/1/21, and they had shown symptoms of allergies before their policy began. During their first policy term, claims for their allergy treatment would not be eligible because it would be considered pre-existing. However, after you renew your policy for the following year, claims for your dog’s allergy treatments that have a date of service after 1/1/22 may be eligible.

While you can’t submit claims for treatments that occurred during your first policy term due to a waiting period still being in place, claims moving forward for that condition may be considered eligible.

Availability by State

Although this coverage is available in most states as of the date of this blog, not all states have processed filings for this new coverage, so it is not yet available in every state. To put it simply, some states are still working on the paperwork. While plans are being made to make this coverage available in every state, you can check out the sample terms and conditions for your state or speak to a member of our customer care team to confirm availability.

What About Hereditary Conditions?

Hereditary conditions may be eligible as long as you have added HereditaryPlus to your policy at least 2 months prior to your policy’s renewal into the following term. Our HereditaryPlus coverage has a 30-day waiting period, so the sooner you add it to your policy, the better!

Anything Else I Should Know About Pre-Existing Conditions?

Covered conditions with incident limits may not be eligible for additional reimbursement. That means if you had an incident that was denied because it exceeded the incident limit you chose for your policy, it would not be eligible for more reimbursement.

Here’s an example: You chose a $5,000 incident limit for your policy, and your pet develops cancer. During your first policy year, you submit claims for your pet’s cancer treatment. Let’s say their bills add up to $8,000, so you were only reimbursed the max $5,000 and received an explanation of benefits that said additional items related to the cancer treatment were denied because they exceeded the limit.

Suppose, unfortunately, their cancer continues into the next policy year when your pre-existing coverage kicks in. Claims for your pet’s cancer treatment will still be ineligible because the denial was due to the incident limit in your policy rather than an issue with the date when symptoms began.

We can’t guarantee coverage for every unique situation, but with our new policies, your pet may be more likely to get reimbursement for a condition. Find out more about our policies by exploring our quote tool or calling a member of our customer care team at 1-866-725-2747.

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