What Pet Insurance Won’t Cover: Pre-Existing Conditions & More

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Pet insurance can be very helpful for many pet parents and their pets, but it also comes with restrictions and limitations that are important to understand—particularly when you’re seriously considering whether pet insurance is worth it. From pre-existing conditions all the way to age exclusions, understanding these gaps in coverage can help you provide the best care for your companion.

What Doesn’t Pet Insurance Cover?

Pet insurance provides coverage for many different areas of pet health care, but also comes with exclusions and restrictions that apply. While coverage exclusions vary depending on your pet insurance provider, many of them apply across the board.

Pre-existing conditions

One of the most common exclusions in pet insurance policies is coverage for pre-existing conditions—health issues or conditions that your pet had before you started an insurance policy (or during its waiting period). Understanding the waiting periods for pre-existing conditions is crucial, as some policies may never cover them, while others might after a certain waiting period.

For example, Spot Pet Insurance has a “curable” pre-existing condition policy that says a condition may be covered if it shows no symptoms and requires no treatment for a period of six months (this does not apply to orthopedic conditions, like ligament issues).

When considering pet insurance, it may be beneficial to enroll your pet while they’re young and healthy to maximize coverage and prevent pre-existing condition exclusions.

Routine and preventive care

While pet insurance is designed to assist with unexpected medical expenses, it typically doesn’t cover routine and preventive care in a standard accident and illness policy. This type of care includes things like vaccinations, flea and tick prevention, and annual check-ups. Pet parents should be aware that they may need to budget separately for this routine care, or consider if a wellness add-on is worth it to them for an additional monthly cost.

Cosmetic procedures

Cosmetic procedures, such as tail docking or ear cropping, are usually excluded from pet insurance coverage, since insurance policies are designed to address health issues and medical emergencies, not elective procedures that are purely cosmetic.

Behavioral issues

Many pet insurance policies exclude coverage for behavioral issues or training. If your pet develops behavioral problems or needs training sessions, the costs associated with hiring a professional trainer or behaviorist may not be covered.

This isn’t the case for all pet insurance providers, however. Spot, for example, will cover vet-recommended sessions with a certified trainer to help with behavioral issues such as anxiety and aggression. Fetch also offers reimbursement up to $1,000 a year for vet-recommended behavioral therapy to treat pets with these types of problems.

Breeding and pregnancy

Expenses related to breeding and pregnancy are typically not covered by pet insurance. This includes costs associated with pregnancy complications, birthing procedures, and care for newborn pets.

Experimental treatments

Pet insurance policies often exclude coverage for experimental treatments. If your pet requires a cutting-edge procedure or medication that is not widely accepted in veterinary medicine, you may need to take on the full cost.

Grooming and bathing

An important part of pet care is ensuring your pets are regularly bathed and groomed so they stay healthy. These costs are typically excluded from most pet insurance policies.

Age exclusions

Pet insurance providers typically do not cover pets that are younger than 8 weeks old, which is the standard across the board. While there are usually not any breed exclusions, a few providers do not offer coverage for senior pets. For instance, Lemonade will not insure pets older than 14 years of age.

What Does Pet Insurance Usually Cover?

Here’s a quick rundown of what is typically covered by pet insurance, so you have a high-level overview of what to expect. For more detailed information, visit What Does Pet Insurance Cover, and How Does It Work?

Accidents and injuries

Pet insurance shines when it comes to accidents and injuries. Whether your pet gets into a scuffle with another pup at the dog park or sustains a broken bone at home, insurance can help cover veterinary expenses. Accidents and injuries are typically covered under both a standard accident and illness policy as well as an accident-only policy.

Illnesses

Many policies cover the costs of treating illnesses, from common infections to serious conditions, such as cancer. Illnesses are usually covered under a standard accident and illness pet insurance plan.

Surgery

Pet insurance often covers surgeries for your pets, whether it’s a routine procedure or a more serious and complex surgery. Most standard accident and illness policies include surgery coverage, as well as coverage for any diagnostic tools that are used along the way, such as MRIs, X-rays, and CT scans.

Medications

Prescription medications can be expensive, but pet insurance often covers some of these costs. Prescription or diet food may also be covered under some providers’ plans if prescribed by a vet.

Hospitalization for critical care

In the event of serious illness or injury requiring hospitalization, pet insurance may help cover associated costs, including overnight stays and intensive care.

What Isn’t Covered by Pet Insurance?