What is a pre-existing condition in the world of pet insurance? – American Kennel Club


When TV’s Lassie became the first dog to be covered by a US-issued pet insurance policy, it was a good thing the famous Collie didn’t have a limp. Because when it comes to getting health insurance, dogs, like people, usually cannot get coverage for their pre-existing conditions (although some providers do cover pre-existing conditions.)

The number of dog owners insuring their pets is growing – 20% of dog owners have health insurance for their dogs, up from 15% in 2018, according to the 2021-2022 National Pet Ownership Survey. the American Pet Products Association (APPA). In 2020, 3.1 million pets were insured, and about 83% were dogs, reports the North American Pet Health Insurance Association (NAPHIA).

Why is interest in pet insurance growing?

Veterinarian costs are rising as veterinary medicine offers new treatment options and becomes more technologically advanced. Cranial cruciate ligament repair, total hip prosthesis, chemotherapy, cataract surgery. . . the treatment options for our canine pets today are sometimes miraculous and often expensive.

More than 90% of respondents to the APPA survey have taken their dog for at least one visit to the vet in the past 12 months, with some pet owners reporting having made three visits in the year. Consumer spending on veterinary care and medical products has increased every year for the past 20 years.

With dog owners making more vet visits, buying more medications, and opting for advanced diagnostics and corrective surgeries, pet insurance seems like a no-brainer. However, pet insurance is a financial investment and insurance costs have risen to match the rising cost of veterinary care.

The average annual cost of accident and illness coverage was $594 for a dog in 2020, according to NAPHIA. The average annual cost for accident-only coverage was $218. Your dog’s age and health, as well as your location and the coverage option you choose will determine the actual cost.

Before signing 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 manages pre-existing conditions, including diseases and conditions your pet currently has or has had in the past. pass.

Pre-existing conditions depend on the provider

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 comprehensive pre-existing condition coverage of all. the main suppliers*.

If you research insurance plans, it will help you understand what the following terms mean:

Pre-existing conditions are generally not covered by insurance and include any illness or injury that has arisen or recurred, exists or is showing symptoms, whether diagnosed by a veterinarian, prior to enrollment or during the policy waiting period. assurance.

Medical history reviews are what an insurance company will require before determining the cost of your coverage and if your dog has any pre-existing conditions that they will not cover. This usually includes an examination by the veterinarian and a review of the dog’s health records.

Curable or chronic (incurable) conditions are differentiated by some insurance companies. If a pre-existing condition is curable and has been resolved, it is likely to be covered, as opposed to a chronic condition that is incurable and likely to recur. Again, AKC Pet Insurance offers inclusive coverage for both types of conditions.

Bilateral injuries or conditions can affect both sides of the body. Dogs that suffer from conditions such as cruciate ligament ruptures in the knee joint are more likely to rupture the ligament in the other knee. Many insurance companies stipulate that if your dog suffers a bilateral condition before the insurance takes effect, they will not cover the same injury on the other side of the body, even if it occurs after the policy insurance comes into effect.

Insurance companies may identify these conditions as pre-existing

Please keep in mind that the following examples do not apply to all policies. It is important to read how any insurance company you are considering defines pre-existing conditions.

  • Your dog constantly licks his paws before politics and is then diagnosed with allergies. Allergies are considered pre-existing and are not covered.
  • Chronic conditions, if already diagnosed, such as arthritis, diabetes, epilepsy, thyroid problems, heart conditions, gastrointestinal conditions, skin and ear conditions, may not not be covered.
  • Degenerative conditions, if already diagnosed, such as deterioration of joints or ligaments, may be excluded from coverage.
  • If your dog was diagnosed with or showed symptoms of the following conditions prior to registration, any associated recurrence can be excluded for 12 months from the date of the last episode: respiratory infections, urinary tract/bladder infections, vomiting, diarrhea and other gastrointestinal disorders, or cancer.
  • If your dog has been diagnosed with a disease of an area of ​​the body whose underlying cause was undetermined, any diagnosis of the same area within 12 months may not be covered.

Most Common Complaints

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 if pet health insurance is right for you and your dog, according to the AVMA. It’s best to discuss this with your veterinarian and be sure to ask any insurance company you consider how they define pre-existing conditions that will not 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 comprehensive pre-existing conditions coverage of any major provider. Learn more.

*Not available in all states. Coverage for pre-existing conditions requires a 12 month waiting period.


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