What Is a Pre-Existing Condition in the World of Pet Insurance? – American Kennel Club – American Kennel Club

When TV’s Lassie became the first dog to be covered by a pet insurance policy issued in the United States, it was a good thing the famous Collie wasn’t limping. Because when it comes to getting health insurance, dogs, like people, usually can’t obtain coverage for their pre-existing conditions (although some providers do cover pre-existing conditions.)
The number of dog owners insuring their pets is increasing – 20 percent of dog owners have health insurance for their dogs, up from 15 percent in 2018, according to the American Pet Products Association (APPA) 2021-2022 National Pet Owners Survey. In 2020, 3.1 million pets were insured, and approximately 83 percent were dogs, reports the North American Pet Health Insurance Association (NAPHIA).
Veterinarians’ costs are going up as veterinary medicine offers new treatment options and becomes more technologically advanced. Cranial cruciate ligament repair, total hip replacement, chemotherapy, cataract surgery . . . the possibilities for treating our canine pets today are sometimes miraculous and often expensive.
More than 90 percent of APPA survey respondents took their dog for at least one visit to the veterinarian in the last 12 months, with some pet owners saying they made three visits during the year. Consumer spending on veterinary care and medical products has risen every year for the last 20 years.
With dog owners making more visits to the vet, buying more medications, and choosing advanced diagnostics and corrective surgeries, pet insurance sounds like a no-brainer. However, pet insurance is a financial investment, and insurance costs have increased to match the increases in the cost of veterinary care.
The average annual cost for accident and illness coverage was $594 for a dog in 2020, according to NAPHIA. The average annual cost for accident-only coverage was $218. The age and health of your dog, as well as your location and the coverage option you choose will determine the actual cost.
Before you sign up with one of the 20 companies that can insure your pet, the American Veterinary Medical Association recommends that you find out how the provider defines and handles pre-existing conditions, including any diseases and conditions your pet has now or had in the past.
The National Association of Insurance Commissioners explains that most pet insurance companies exclude pre-existing conditions and hereditary or congenital conditions from coverage. However, while other pet insurance brands make distinctions between “curable” and “incurable” conditions, AKC Pet Insurance makes no such distinction and offers the most inclusive pre-existing conditions coverage of any major provider*.
If you research insurance plans, it will help to understand what the following terms mean:
Pre-existing conditions are not usually covered by insurance, and they include any illness or injury that occurred or reoccurred, existed or showed symptoms, whether diagnosed by a veterinarian, prior to enrollment or during the waiting period of the insurance policy.
Medical history reviews are what an insurance company will require before determining what your coverage will cost and whether your dog has any pre-existing conditions that they won’t cover. This usually includes an exam by the veterinarian and a review of records of the dog’s health.
Curable or chronic (incurable) conditions are differentiated by some insurance companies. If a pre-existing condition is curable and was resolved, it is likely to be covered, versus a chronic condition that is incurable and likely to occur again. Again, AKC Pet Insurance offers inclusive coverage for both types of conditions.
Bilateral injuries or conditions can affect both sides of the body. Dogs who experience conditions such as cruciate ligament ruptures of the knee joint are more likely to rupture the ligament in the other knee. Many insurance companies stipulate if your dog has a bilateral condition before insurance takes effect, they will not cover the same injury on the other side of the body, even if it occurs once the insurance policy kicks in.

Please keep in mind that the following examples do not apply to all policies. It’s important to read how any insurance company you’re considering defines pre-existing conditions.
The most common pet health insurance claims for dogs in 2020, as reported by NAPHIA, were for urinary tract infections, ear infections, gastroenteritis, diarrhea, skin conditions, arthritis, allergies, lameness, vomiting, seizures, and eye conditions – and some of these may be pre-existing conditions for your dog. Some plans also don’t cover certain geriatric conditions, offer only partial coverage for visits to specialists, or set maximum reimbursements per incident or per year.
There’s no magic formula that will tell you whether pet health insurance is right for you and your dog, according to the AVMA. It’s best to discuss it with your veterinarian and be sure to ask any insurance company you consider how it defines pre-existing conditions that won’t be covered.
The harsh truth is that most pet insurance providers exclude pre-existing conditions, denying coverage for injuries or illnesses that occur before or during a policy. AKC Pet Insurance offers the most inclusive pre-existing conditions coverage of any major provider. Learn more.
*Not available in all states. Pre-existing condition coverage requires a 12-month waiting period.
AKC is a participant in affiliate advertising programs designed to provide a means for sites to earn advertising fees by advertising and linking to akc.org. If you purchase a product through this article, we may receive a portion of the sale.

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