What Pet Insurance Does & Doesn’t Cover

If getting health insurance for your furry friend has been on your mind, it pays to know what is generally covered and what isn’t.
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Author: Ben Peetermans
Last updated: June 21, 2021

What pet insurance covers

Hereditary and congenital coverage

Hereditary coverages can be important, depending on your pet’s breed. Purebred dogs, especially certain breeds, often have common hereditary conditions like breathing issues for bulldogs and hip dysplasia in German shepherds and other large breeds. Other hereditary conditions include diabetes and cherry eye. You will want to check any pet insurance policy you’re considering to make sure the costs related to these issues will be covered if your pet develops them.

Congenital problems are medical issues your pet has had from birth, like a cleft palate, heart defects, or other problems in their limbs or organs. Many of these conditions don’t show up until years later, so you will want to consider if you need a policy that covers them. For example, if your cat is diagnosed with a heart murmur when she’s ten years old, that would usually be considered a congenital issue and only covered if your policy includes congenital problems.

Pet cancer coverage

Cancer in cats and dogs is sadly very common over age 10. If you have an aging cat or dog, cancer is the number one cause of death as they get older. Treatment can be very costly. Not all policies cover cancer care, so be sure to check any policies you’re considering for details.

Cancer coverage is becoming more important as cancer treatments for dogs and cats improve. New and more advanced treatments are becoming available and can lead to longer lives for your beloved pets. But the cost can run to $10,000 or more for cancer treatments. Pet insurance allows you to afford the treatment your pet needs without breaking the bank.

It’s important to note that cancer is not covered when it’s a pre-existing condition. If your cat or dog is diagnosed with cancer before you buy pet insurance, any further treatments can’t be claimed on your pet insurance no matter what policy you buy.

Vet visits

Pet insurance will cover any certified veterinarian who treats your pet. This means you can have your pet seen by your most trusted vet – you aren’t restricted to a certain area or practice.

But unlike human insurance, with pet insurance, you’ll have to pay any bills upfront. Most vet offices require payment at the time of your visit. This means you will pay all costs out of your pocket at the time of care, and then submit a claim to be reimbursed by your pet insurance after your visit.

What pet insurance doesn’t cover

Pre-existing conditions

Pre-existing conditions are not covered. Maybe your dog was limping before you applied for pet insurance and your vet hasn’t been able to determine the cause. Once you have pet insurance, if the limping happens again any costs related to it will not be covered. If you have an aging cat, kidney failure is a common ailment and can require expensive treatment. But if you purchase pet insurance after your cat has been diagnosed with kidney problems, treatments will not be covered.

How are pre-existing conditions different from hereditary or congenital problems? The main difference is that hereditary and congenital problems are issues your pets may have been born with but have not yet surfaced. Pre-existing conditions are issues they have suffered from in the past and are known to you.

The regulations on pre-existing conditions apply to every pet insurance product on the market. This means that it’s better to purchase pet insurance sooner rather than later, because you’ll need to have coverage before your pet falls ill. If your cat has respiratory issues, for example, you couldn’t sign up for pet insurance to cover her treatments once she’s been diagnosed. You’ll need to plan ahead and insure your pets before anything happens to their health.

Wellness visits

Most pet health insurance plans do not cover wellness visits for your pet. This includes items like annual exams and teeth cleaning. These costs will usually still be out of pocket if you purchase pet insurance. However, this does vary by plan so do check your policy before you purchase.

About the author
Ben Peetermans author
Ben Peetermans
Life Insurance Expert
Ben Peetermans is a life insurance editor. He enjoys blogging about various topics, including finance. He has been writing about insurance since 2015. Ben has been featured in various press outlets including FOX, CBS, and NBC.