Understanding
Your Pet Insurance
Coverage
Pet insurance not only provides a financial safety net, it gives us peace of mind that we can provide for pets when they need us most.
That said, figuring out what your policy does and does not cover can be difficult. Although pet insurance carriers offer similar types of plans, they're all different. Some might cover your dog's bad-breath dental cleaning under a wellness package, others under their accident and illness plan, or simply not at all.
To understand your pet insurance coverage, we've created a general guide to walk you through the three types of plans available, what they cover, and what they don't cover.
Pre-Existing Conditions
Pet insurance carriers don't pay for pre-existing conditions, i.e., any illness or injury your pet has prior to you buying pet insurance.
The reason is simple: if people could sign up for pet insurance when they arrived at the emergency vet clinic, and then ditch the policy once their pet was healthy, the pet insurance industry would go bankrupt paying for everyone's emergency visits.
Some pet insurance companies do differentiate between curable and incurable pre-existing conditions:
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Curable pre-existing conditions:
an illness or injury that your pet currently has, but it's getting better, and it's not expected to need treatment for it again. Think broken bone, kennel cough, or a non-chronic ear infection.
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Incurable pre-existing conditions:
an illness or injury that is going to require ongoing or lifelong treatment, like cancer, diabetes, arthritis, or hip dysplasia.
Only AKC offers coverage for incurable pre-existing conditions. For curable pre-existing conditions, your pet will still need to be "cured" of that condition for a certain length of time (usually six months to one year) before your pet insurance carrier would consider covering it.
Waiting Periods
Signing up for pet insurance at the emergency vet clinic doesn't sound like that bad an idea... except that every pet insurance company has waiting periods before their policies kick in.
It's for the same principle that they don't cover pre-existing conditions; they can't force people to keep paying for a plan once the emergency is over, and if they paid for every emergency, the pet insurance company would quickly be out of money.
There are three types waiting periods to look out for:
- Accident coverage: 24 hours to 14 days, depending on the carrier and plan.
- Illness coverage: usually between 14 and 31 days.
- Orthopedic and cruciate ligament coverage: usually 6 months to 1 year.
What if I "don't know" that my pet has a pre-existing condition? In addition to the waiting period, your pet insurance carrier might require a clean bill of health from the veterinarian before coverage starts.
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Health Future Today!
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Deductibles and Coinsurances
Like most human health insurance plans, you're not totally off the hook when it's time to pay the vet, even with pet insurance. We dive into more detail in our "How Does Pet Insurance Work" article, but here's the essentials.
When you have a pet insurance plan, you're responsible for paying:
- The premiums: this is the fee you pay every month to have pet insurance.
- The deductible: your annual deductible is what you've agreed to pay before pet insurance starts paying for the costs of certain treatments and procedures.
- The reimbursement rate: The percentage your pet insurance company has agreed to pay for any treatment or procedure. If it's not set at 100% (the insurer pays for everything), you're responsible for the gap.
- Anything over the coverage limit: Your pet insurance plan has a maximum dollar amount they're willing to pay per year (and sometimes per pet). If your pet's expenses go over that, you'll have to make up the difference.
Only AKC offers coverage for incurable pre-existing conditions. For curable pre-existing conditions, your pet will still need to be "cured" of that condition for a certain length of time (usually six months to one year) before your pet insurance carrier would consider covering it.
What (Often) Isn't Covered?
Pet insurance plans do cover a lot of injuries and illnesses that may happen to your pet, but there are some exceptions to what your pet insurance company will help pay for.
These conditions or treatments often aren't covered by pet insurance companies, but make sure to check your specific policy.
Sometimes Covered, Sometimes Not Covered:
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Prescription food and supplements
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Dental treatments, such as exams and routine cleanings
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Behavioral therapy for veterinarian-diagnosed issues like aggression (pet insurance plans don't cover puppy training or obedience lessons)
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Chronic or hereditary conditions such as heart disease, eye disorders, and hip dysplasia
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Alternative treatments like acupuncture, chiropractic care, hydrotherapy, naturopathy, and homeopathy
Usually Not Covered:
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Pre-existing conditions, as we talked about earlier.
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Bilateral conditions if your pet has a pre-existing condition with one eye or one leg and later develops a (related) problem on the other side.
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Breed-specific exclusions Some breeds of dogs and cats are more prone to certain (expensive) conditions, and pet insurers won't cover treatment in these cases.
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Elective procedures, like declawing, ear cropping, and tail docking.
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Pregnancy and birth care.
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Boarding and grooming.
Choosing The Right Pet Insurance Policy
If it feels like deciding the right policy is a lot, here are five questions to help you
1. What type of pet insurance plan do you need: accident-only, or accident and illness?
2. Do you want to add a wellness package to cover routine and preventive care?
3. Do you want routine dental care to be covered?
4. Is your pet prone to any hereditary or breed-related conditions?
5. Are there any treatments that are "sometimes/usually not covered" that you want to have available to your pet?
Knowing the answers to these questions will help you avoid policies that don't give your pet adequate protection, ensuring you get the coverage you need.
Want us to review a policy for missing coverage gaps? Submit it to our review tool (it's free!) and we'll identify any weak points in your plan.
Secure Your Pet's
Health Future Today!
Inadequate coverage could cost you tens of thousands of dollars.
Review your pet
insurance policy and
identify any coverage
gaps for free