Common Pet Insurance ExclusionsPet Insurance
Nov 2014

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Pet insurance won't cover costs for any condition that your pet showed signs of before the start date of the policy. (Medical records or a vet exam might be required to establish your pet's health). But, pet insurance will cover new conditions and accidents. Also, all the pet insurance plans here will cover conditions that your pet might have been born with but haven't showed up yet. These are called hereditary or congenital conditions. So it's still important to get covered!

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Common Pet Insurance Exclusions

Pet Insurance can provide coverage for many pet health situations, helping you manage the financial stresses incurred when your pet gets sick. However, to make Pet Insurance affordable the insurance companies have to exclude coverage for some treatments. Knowing what these exclusions are can make a huge difference when it comes to finding the right plan for you and your pet. Here’s the top ten exclusions to be aware of when choosing a pet insurance plan:

vet checks the health of a dog1. Pre-existing conditions.
No Pet Insurance policy will provide coverage for uncured conditions that your pet has before the plan takes effect. What many people don’t realize is that this can sometimes include problems noted by your veterinarian in past visits that didn’t require treatment at the time. Some insurers do provide coverage for conditions that are already considered cured, but this is a very limited and should be checked with individual insurance providers.

2. Waiting Period.
When you take out a policy, there will be a waiting period before your pet is covered for accidents, illnesses and orthopedic conditions. Accident coverage varies from a few hours to 15 days, illnesses from 14 to 30 days, and anything up to 12 months for orthopedic issues (including cruciate ligament injury).

3. Bilateral Conditions.
A bilateral condition is a medical problem that can occur on both sides of the body. If your pet has already suffered from a bilateral condition, say for example hip dysplasia in one hip before the policy is taken out, then problems with the second hip would not be covered. In addition, bilateral conditions often share the same payment cap, meaning you might reach the payout limit for the condition and would be liable for more out-of-pocket expenses.

4. Routine/Preventative Care.
Routine care is excluded from Pet Insurance unless you add a wellness plan to your coverage. Routine care includes check-ups, vaccinations, nail trimming and flea/tick/heartworm preventatives, etc.

A picture of a vet brushing dog's teeth5. Dental Treatments.
Dental Cleanings are a common exclusion from Pet Insurance plans. Some companies exclude treatment for periodontal disease, any orthodontic or endodontic procedures, and removal of deciduous teeth. Some insurers do offer add-on dental coverage.

6. Elective Procedures
Pet Insurance will not cover any procedures deemed elective such as tail docking and declawing.

7. Behavioral Therapies.
Any treatment for pet behavioral issues is routinely not covered by many insurers. So it’s highly likely that you’ll need to cover the costs of behavior training out of your own pocket. Some insurers do offer add-on behavioural therapy coverage.

8. Congenital and Hereditary Conditions.
Any condition present at birth, even if it isn’t diagnosed immediately, is considered a congenital condition. Policy coverage varies greatly for congenital issues.
Hereditary Conditions are illnesses that are caused by the pet’s genetic makeup. Most insurance companies have plans that will provide coverage for these conditions, but they are a common exclusion on lower level plans.

9. Preventable Diseases that weren’t vaccinated against.
If you fail to vaccinate your pet against preventable diseases, it’s likely your insurance policy will not provide coverage for the treatment costs. However, if you do vaccinate your pet and maintain the required booster frequency you will be covered for the disease if they do get sick.

10. Hip Dysplasia
Hip dysplasia coverage varies depending on the level of the plan selected and can sometimes be available as an add-on option. Make sure to check that there are no maximum age restrictions at the time of sign up that affect hip dysplasia coverage. And don’t forget hip dysplasia is also considered a bilateral condition.

This list isn’t exhaustive but does include the most common exclusions. Although this can seem like a lot of conditions aren’t covered, it’s really about insurers outlining what their role is in the pet owners life and making coverage affordable. Pet Insurance isn’t there to cover conditions that your pet already has, or to pay for the general care your pet needs; it’s about providing a financial security blanket to cover you for unexpected situations. Ensuring your pet’s vaccinations and routine care procedures are maintained can help you get the most from your Pet Insurance plan throughout the duration of your pet’s life. This leaves you free to enjoy your time with your pet without the worry of large veterinary care bills.