Understanding the basics of pet insurance can ensure you choose a provider who does their best to support the well-being of your pet. While many people have heard the phrase “pre-existing conditions,” not everyone fully understands how such conditions may affect the pet insurance policy’s coverage.
What is a pre-existing condition?
The definition of a pre-existing condition is “any illness or injury that occurred, reoccurred, existed or showed symptoms, whether or not diagnosed by a veterinarian, prior to the pet’s original start date, prior to the coverage period, or during the waiting period of a pet health insurance policy.” Insurance definitions can be confusing, so let’s break that wordy definition down. If your dog is showing symptoms of an injury or illness before you’ve enrolled in a pet insurance policy and the required waiting periods have passed, then the condition will be considered pre-existing. Conditions that are present at birth (congenital conditions) are also considered pre-existing. If your pet has a condition or symptoms that are secondary to a condition that was considered pre-existing by your pet insurance company, those secondary conditions will likely also be considered pre-existing.
Do any pet insurance companies cover pre-existing conditions?
Most providers won’t offer reimbursement for any pre-existing conditions. Policyholders are solely responsible for covering costs associated with injuries and health conditions that show symptoms before a policy takes effect.
Some providers cover curable pre-existing conditions. If your pet is sick with a temporary illness like an ear infection or diarrhea, you won’t be covered until after symptoms subside and a certain period of time elapses.
AKC Pet Insurance (underwritten by Independence American Insurance Company and, in WA, American Pet Insurance Company) covers a variety of eligible chronic and curable pre-existing conditions after a 365-day waiting period. These include, but are not limited to:
- Ear Infections
- GI Issues
- Upper Respiratory Infections
- Heart Disease*
*With optional Hereditary Coverage purchased before pet reaches two (2) years of age.
How are waiting periods and pre-existing conditions related?
Waiting periods are a set time that a pet insurance provider requires after enrolling in a policy before conditions become eligible for coverage. Pet insurance companies require a waiting period to help ensure that new policyholders are not enrolling their pets because the pets are already sick or injured. If your pet becomes ill or injured before enrolling in a pet insurance policy or during the policy’s waiting period for that condition, it may not be eligible for coverage as it is considered pre-existing. When choosing your pet insurance provider, compare waiting periods and pre-exisiting condition coverage to determine which company is right for you and your pet!
Should I still enroll in a policy if my pet has pre-existing conditions?
Yes! Even if your pet has certain pre-existing conditions that aren't covered by any insurance provider, you can still receive coverage for new illnesses or injuries. You can also enroll in wellness coverage to provide reimbursement for preventative care to help keep your dog in top shape.
The best thing to do to reduce conditions that are considered pre-existing is to enroll your dog in a policy as soon as you bring them home. The younger a dog is, the less medical history they will have that might result in a condition being considered pre-existing.
Know your insurance provider’s definition of “pre-existing.”
Every insurance provider has their own definition of exactly what their company will consider to be pre-existing. Read the terms and conditions when you enroll in a pet insurance policy to ensure you avoid surprises. Insurers are also required to make their terms and conditions available on their websites, so you can review them prior to purchasing a policy.
Know your waiting periods.
Every pet insurance provider has different waiting periods. Review the terms and conditions to ensure you know the waiting periods for the conditions you are concerned about before enrolling in a pet insurance policy.
Avoid gaps in coverage.
Don’t allow for gaps in your pet insurance coverage! Often, conditions covered under a previous policy will be considered pre-existing should you have a gap in coverage and start a new policy.
Call Customer Service!
Should you have any questions or uncertainties, contact your pet insurance provider’s customer care team! Customer care representatives are always happy to answer questions to avoid future confusion. Keep in mind, customer care representatives can provide you with helpful information; however, they cannot guarantee whether or not a claim will be paid.