Most pet insurance policies are straightforward in their coverage; generally, you can get coverage and reimbursement for accidents, illnesses, and chronic conditions. Other kinds of coverage — like that for pre-existing conditions, routine and wellness care, and liability — aren’t as common, though sometimes you can purchase them as policy riders.
What Pet Health Insurance Covers
Many pet insurance policies provide some variation of the following kinds of coverage. Often, you can get additional coverage when you purchase policy riders (see below).
Accidents and Illness
Most pet insurance companies cover accidental injuries and unexpected illnesses. Talk with an agent about the related procedures the policy covers, as well as any situations that aren’t covered.
Chronic Conditions
Chronic conditions such as asthma, arthritis, diabetes, and cancer are common among older pets and can cost thousands of dollars a year to treat.
Find out which chronic conditions the policy you’re considering covers, as well as any reimbursement limits. For example, a policy might treat a single cancer treatment as a single incident, and if you have a per-incident policy this could mean your policy will cover only one cancer treatment. Ideally, the policy will provide treatment coverage on a continual basis.
What Pet Health Insurance Doesn’t Cover
Most pet insurance providers don’t offer the following kinds of coverage. Again, this varies by insurance company, and some insurance companies might offer these types of coverage as policy riders (see below).
Routine and Wellness Care
Usually, pet insurance policies offer coverage for unexpected situations and not routine care such as annual checkups and vaccinations, dental cleanings, and spaying or neutering. However, some providers do offer add-on coverage for this kind of care and many vet offices offer wellness plans to supplement your main pet insurance policy.
>>MORE: Finding the Best Pet Dental Insurance
Liability Coverage
This is another kind of coverage you might be able to get as a policy rider, but typically not as a standard coverage.
Pet insurance covers your pet — not the damage your pet causes to another person’s body or property. Check with your homeowners insurance policy to see if it covers pet-related liability.
Pre-Existing Conditions
Not an ideal situation, but basically if insurance companies offered coverage for pre-existing conditions it would put them out of business. Some companies do distinguish between curable and incurable conditions, though, and might provide coverage for curable conditions after a certain amount of time has passed.
Learn more about pet insurance and pre-existing conditions.
Bilateral Conditions
Think of bilateral conditions as cousins to pre-existing conditions.
Let’s say that prior to your purchasing pet insurance, your dog has a problem with his left hip and must have surgery. Now, years later and after you have pet insurance policy in place, your dog develops the same problem in his right hip. That’s a bilateral condition, and most pet insurance providers also will label it a pre-existing condition.
Elective Procedures
It’s unlikely your plan will provide coverage for elective or cosmetic procedures like ear cropping, tail docking, and declawing unless the veterinarian determines the procedure is medically necessary.
>>MORE: Pet Insurance that Covers Preventative Care
Additional Kinds of Pet Insurance Coverage
These might act as riders or add-on coverage, or they might already be in the plan you choose — it depends on the insurance company.
- Prescription medication.
- Liability coverage for bodily harm or property damage your pet causes.
- Alternative treatments (e.g. homeopathic, herbal, etc.).
- Obedience training or behavioral therapy.
- Treatment during out-of-country traveling.
- Boarding or other caregiving costs if you’re hospitalized.
- Costs to advertise a reward for your lost or stolen pet; possibly a certain amount of the reward.
Pet Health Coverage Exclusions
Aside from pre-existing conditions, which are the most common coverage exclusions, you need to look out for policies that limit or exclude coverage based on:
- Species and Breed: Make sure your pet’s species and breed are covered. Some companies have special coverage lines for pets that aren’t dogs or cats (such as birds and reptiles), and don’t cover — or charge more to cover — purebreds and pedigrees than mixed breeds.
- Age: Many companies implement a minimum and maximum age for coverage. Find out how old your pet be for the policy to kick in and at what age your pet will no longer be eligible for coverage.
- Congenital and Hereditary: Hereditary conditions are those linked to genetics; congenital conditions are those that develop in utero. Some companies cover them and others don’t. Even if you think your pet doesn’t have either condition (it can take years for them to manifest), it’s smart to see if the provider offers coverage or a policy rider.
Not All Pet Insurance Is Created Equal
Again, the above examples are just that — examples. Just because it’s not the norm for a pet insurance policy to cover preventative care or provide liability coverage doesn’t mean that none of them do, and that’s just one more reason it’s crucial to shop around for the policy that meets your pet’s and budget’s needs. For example:
- ASPCA pet health insurance doesn’t cover preventative care, but you can tack it on to your plan for an additional cost.
- Progressive has an entire wellness routine care plan that covers vaccinations, teeth cleaning, and more.
- Trupanion doesn’t cover wellness or preventative care but does provide add-on coverage for liability for third-party property damage and even holiday vacation cancellation costs.
Unfortunately, it’s almost impossible to find coverage for pre-existing conditions, at least at first. Some companies do differentiate between curable and incurable pre-existing conditions and will offer some kind of coverage if your pet’s condition is considered curable.
Final Thoughts
Although there are some kinds of coverage most pet health insurance companies offer (or don’t offer), everything still depends on your exact provider and policy.
Before you commit to a pet insurance policy, talk with an agent about the specific types of coverage the policy does and doesn’t offer. Ask questions and get the answers in writing. Unlike human health insurance plans, most pet insurance plans work by reimbursing you, which means if you pay for care that isn’t covered, the company isn’t going to reimburse your claim. You’re out that cost.