Pet Insurance Limitations and Pre-Existing Health Conditions

by Andrew Rombach

Pet insurance is a rapidly growing industry. In 2017 the pet insurance industry was worth more than $1 billion, and that’s expected to double to $2 billion by 2022, based on data forecasts from the market research firm Packaged Facts.

pet insurance

The estimates indicate pet insurance will grow by more than 14 percent annually, largely because consumers are becoming increasingly aware of these offerings and the benefits available if their pet gets sick or injured.

Increasing consumer awareness is coupled with the fear many pet owners have that they couldn’t afford medical bills if something unexpected were to happen. An Associated Press survey showed 41 percent of pet owners are extremely or somewhat worried they wouldn’t be able to afford the medical bills for a sick dog or cat.

Some pet owners feel the peace of mind and the potential protection of pet insurance is worth the additional cost, but as with health insurance for people, there are limitations including pre-existing conditions.

What Is a Pre-Existing Condition?

In terms of insurance, a pre-existing condition is simply a health problem that exists before enrolling in an insurance program. If you have a pet with a serious pre-existing condition, then you may have to disclose this to the insurance company. To receive coverage, it may be required that your pet is examined by a veterinarian. Companies will have their own set of conditions that are considered pre-existing.

Examples of pre-existing conditions for pets include cancer, allergies, diabetes, arthritis, and heart disease.

Insurance companies see pre-existing conditions as costly and likely expensive investments. Pre-existing conditions can also lead to a host of other medical complications in the future, which the insurance company doesn’t want to pay for.

Many insurance companies will also consider something that comes up or is diagnosed during the insurance waiting period as a pre-existing condition. The waiting period for pet insurance can be as long as a year after signing up. A waiting period is the time you have to wait before coverage begins. Every company has different guidelines for waiting periods, and some make a distinction between illness and injury waiting periods.

How Are Pre-Existing Conditions Covered by Pet Insurance?

Typically, pet insurance companies will refuse to insure an animal’s pre-existing condition. Even if your pet didn’t show symptoms of a condition during the waiting period, or you didn’t know about the condition before you signed up, it’s still possible for the insurer to refuse or limit coverage.

As an example, most pet insurance companies consider cancer a pre-existing condition no matter when it’s diagnosed since it develops slowly.

There are a few examples where you may be able to find coverage even with certain pre-existing conditions. First, if the condition is curable, an insurance company may provide coverage. The specifics will vary depending on the company and the policy, but as an example, if the animal was unwell because of the condition but now hasn’t shown any symptoms of the condition for at least six months to a year, they may receive coverage.

If the condition is considered a hereditary disorder, the insurance company may cover the pet as well.

Some insurance companies may have a list of pre-existing conditions they will cover such as urinary tract infections and gastrointestinal disorders.

An animal with an incurable pre-existing condition is not likely to be eligible for coverage. For example, incurable disorders can include diabetes, cancer, and arthritis.

Pet owners tend to have questions about coverage for bilateral conditions. Bilateral conditions affect both sides of an animal’s body, and one of the most common is hip dysplasia. Some insurance companies will not cover this condition and some will, so you’ll have to check with the specific insurance company.


While it’s very unlikely a pet with a serious or incurable pre-existing condition will be covered by an insurance company, there are other options. One option is to enroll in a veterinary discount plan.

Veterinary discount plans offer discounts on the cost of veterinary care for pets, and pre-existing conditions are irrelevant. All pets are covered under most of these programs, and there isn’t the need to submit vet records or show proof of a healthy pet.

Another option is using a medical financing company geared toward healthcare and more specifically, pet health care.

It can be scary to think about your pet needing care that you aren’t able to afford, but insurance comes with limitations. One of the most significant limitations are pre-existing conditions, and in most cases, with a pre-existing condition, you will have to find other options to cover the costs of your pet’s care.

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About Simba's Mom

I was born and raised in California, lived in Pennsylvania for several years, and have recently moved to Delaware. I have gone from being a teacher for 20 years to a blogger and now back to teaching but still blogging. I have a great dog named Simba. Simba is a German Shorthaired Pointer. Life with Simba is an adventure every day. I have had dogs my entire life but I have learned most about dogs living with Simba. German Shorthaired Pointers really do become your best friend. They become extremely attached and that is why they say they have the Velcro phenomenon. Simba now has a sister 8 years younger and her name is Gypsy.
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