Does Pet Insurance Cover Pre-Existing Conditions? (2024)

FAQs

Does Pet Insurance Cover Pre-Existing Conditions? ›

No pet insurer covers pre-existing conditions, but you could still get coverage for future illnesses and conditions. That means pet insurance could still be a worthwhile purchase even if it can't cover an immediate issue.

Pet insurers generally don't cover pre-existing conditions. They also may require waiting periods before your pet is eligible for different types of coverages. It's best to get pet insurance early in your pet's life to help ensure any conditions they develop later in life will be covered.

If you are enrolled in a plan since 2010, then your insurer can't legally deny you coverage or charge you higher premiums because you have a pre-existing condition. The Affordable Care Act, passed in 2010, made it illegal for insurers to deny you coverage or charge high rates for pre-existing conditions.

All Marketplace plans must cover treatment for pre-existing medical conditions. No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.

Pre-existing illness or injury - In general, insurers will not cover illness or injury that your pet had or showed signs of having before the policy started. This usually includes illnesses and injuries that can happen again or may appear in different parts of your pet's body.

A pre-existing medical condition (PEMC) is an illness or injury you had before your policy began or was renewed. Examples of pre-existing medical conditions include, diabetes, asthma, high cholesterol or a long-term back condition.

PRE-EXISTING CONDITIONS: In determining which Conditions are Pre-Existing, we look at the 18 months preceding the Policy Effective Date and exclude any Conditions that were Present during that period.

Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

Your insurance company also has the right to reject your claim, and the premium you paid will mean nothing. That's not only what you will face if you do not disclose any pre-existing condition. You might get penalised for providing incomplete or fake information.

Is anxiety a pre-existing condition? ›

In the health insurance world, a pre-existing condition is any injury, sickness or condition that exists before the date an insurance policy takes effect. Examples include asthma, diabetes, anxiety, depression, high blood pressure, high cholesterol and so on.

No. Marketplace health plans are not allowed to charge you more based on your health status or pre-existing condition. However, some plans, such as short-term policies, that are sold off the Marketplace might turn you down or charge you more based on your health status or pre-existing condition.

Acute Onset of Pre-existing Conditions Definition

An acute onset of a pre-existing condition is the very sudden, unexpected recurrence of a condition that you have been treated for in the past, but do not currently suffer from, and requires immediate treatment (within 24 hours of the onset of symptoms).

When working with your pet insurance company, there may be a time when you submit a claim and reimbursem*nt is denied. If this occurs, it is best to look at your claim to double-check that it does not involve a policy exclusion, such as a pre-existing condition.

Wellness exams, treatments and procedures are not covered unless a wellness plan is purchased either individually or as a rider. Such treatments and procedures include, but are not limited to, services such as vaccinations, flea/heartworm prevention and health screens (blood tests).

Cons Explained

Many plans require you to pay upfront and then get reimbursed: Typically, you must pay your vet for services rendered. Then, you can submit the claim to your pet insurance for reimbursem*nt. This can take time. Premiums increase over time: The older your pet gets, the more likely they are to get sick.

No, you can't get retroactive pet insurance (coverage that takes effect on a past date). Insurers will not cover accidents, illnesses or conditions that occur before a policy becomes active or during the applicable waiting periods.

You can get pet insurance before surgery, but that doesn't necessarily mean you should. The condition your pet needs surgery for would be considered a pre-existing condition, which means the surgery would not be covered. Neither would any follow-up care (medication, rehab, etc.) or future recurrences of the condition.

Before choosing a pet insurer and plan, make sure you know exactly how your dog or cat is covered. Insurers will have different coverages, but they typically fall into these categories and may exclude pre-existing conditions: Accidents such as cuts, lacerations, broken legs, ingestions, and swallowed objects.

When you purchase a pet health insurance policy, you agree to let your provider contact current or previous vets on your behalf, and obtain all of your pet's medical records if needed.