What does pet insurance cover?

Pet insurance is a way to ensure your pet’s health if they ever get injured or have an accident. If you are a pet owner considering a pet insurance plan, pinpointing exactly what different pet insurance providers cover can seem like an impossible task.    

As with most insurance policies, pet owners can choose the level of coverage they want for their pet.  
The varying levels of coverage most commonly offer accident-only, accident and illness, and wellness plans. Many companies provide a variety of endorsements or riders. These endorsements allow you to broaden your coverage to include specific conditions such as cancer, hereditary illnesses, and other ailments that would otherwise not be covered by the commonly offered insurance plans.  

Pet Insurance Policies

Accident Only (AO) – This policy type covers unexpected physical injuries caused by an accident or emergencies related to accidents. It does not include any illness-related, chronic conditions, cancer, congenital conditions, or wellness-related costs. Only 0.3% of all written policies in 2020 were accident-only, and they usually cover older pets who have aged out of the accident and illness coverage.  

This policy covers injuries such as:  

  • Torn ligaments
  • Broken bones
  • Bloat
  • Flesh wounds and cuts
  • Snake bites
  • Swallowed objects
  • Toxic ingestions
  • Sprains
  • Bee stings
  • Eye injuries

Accident & Illness (A&I) – This is a more comprehensive insurance plan that reimburses both accident and illness care. It is the most common written insurance policy for 2020 as 93.4% of all written policies were combined insurance of accident and illness with embedded wellness. In addition to the coverage listed above, accident and illness policies cover diagnosis and treatment for minor and major illnesses such as:  

This type of plan does not cover accidents, common injuries, or emergency treatments for illnesses. 

  • Cancer
  • Infections
  • Digestive issues
  • Allergies
  • Arthritis
  • Hypothyroidism
  • Ear infections
  • Urinary tract infections
  • Hereditary conditions
  • Congenital conditions

Note: It does not include routine vet visits, flea and heartworm prevention, or vaccinations.  

Wellness plans – Most plans provide add-on or standalone wellness plans. These policies cover expenses related to various routine care expenses. Wellness coverage is usually not subject to any waiting periods. Preventive care covers things such as:  

  • Routine vet visits
  • Vaccines
  • Microchipping
  • Spaying/neutering
  • Annual vet exams
  • Flea and tick control
  • Heartworm prevention
  • Teeth cleaning

This type of plan does not cover accidents, common injuries, or emergency treatments for illnesses. 

What are Hereditary, Congenital, and Pre-Existing Conditions?

Hereditary and genetic illnesses

Hereditary or genetic conditions are illnesses your pet’s breed is prone to inheriting. These conditions affect both purebred and mixed breed dogs and are often transferred to pets from their parents. They are costly to detect and treat. If your pet is prone to these disorders, it is important to look for pet insurance covering hereditary conditions. Some providers only offer this coverage as an optional add-on for hereditary illnesses.  

Common genetic disorders in cats and dogs are:   

  • Elbow and hip dysplasia
  • Diabetes
  • Upper respiratory infections
  • Thyroid disease
  • Cancer
  • Allergies
  • Patellar luxation
  • Intervertebral disc disease (IVDD)

Congenital conditions

Congenital diseases are diseases that a pet is born with but usually stay undetected and dormant without any symptoms until provoked later in life. Some insurance providers do not cover them or require pet owners to pay extra. Common congenital conditions in cats and dogs are:  

  • Heart-disease
  • Nervous system issues
  • Cataracts
  • Liver disease
  • Hernia
  • Hypothyroidism 

Pre-existing conditions

Pet insurance providers usually define and handle pre-existing conditions differently. However, most of them do not offer coverage for pre-existing conditions. Anything that your pet has been diagnosed with before enrollment and during the waiting period is considered a pre-existing condition and will not be covered by the insurance company.   

Certain providers may no longer consider it as a pre-existing condition if your pet has not shown any symptoms for longer than 180 days or a year or is considered cured of the disease.  

The sooner you enroll your pet for a policy, the better your chances of avoiding a situation where your animal has a pre-existing condition. 

What Does Pet Insurance Cover?

Pet insurance coverage varies, but it can include the following treatments:

  • General vet fees if a pet is in an accident or injured
  • Surgery, hospitalization, nursing and technician care
  • Common illnesses, such as allergies and vomiting
  • Chemotherapy treatment for cancer
  • Heart disease treatment
  • Diagnostic testing and imaging (X-rays, MRIs, CT scans, ultrasounds, etc.)
  • Treatment of chronic illnesses such as allergies, arthritis, and diabetes
  • Treatments of hereditary and congenital conditions
  • Dental care if it is related to illness or injury and not for cosmetic purposes

As with most insurance policies, to avoid fraud, there is a waiting period of approximately 30 days before a claim can be filed for a pet. Some providers may request past vet records or require your pet to be fully examined before enrolling them for insurance. Some policies will not cover pets younger than eight weeks or older than seventonine years at the time of application.  

Note: Exceptions may occur; displayed above are most commonly offered coverages across multiple insurance providers.  

It is important to check and compare policies before you enroll your pet to ensure it includes the coverage you need for your pet and the common illnesses related to its breed.    

Top 10 Most Common Conditions in Dogs Covered by Insurance  

Many pet owners are not aware of the high cost of veterinary services. When bills for certain conditions are exceeding thousands of dollars, it could leave many dog owners in a tough spot regarding the care of their beloved pals.  

To better understand the costs related to dogs and the most common claims in 2019, we have listed below the most common conditions, and the highest claim paid out for their treatment.  

Pet insurance for dogs is designed to help cover the cost and give pet owners peace of mind against unexpected vet bills.   

Top 10 Most Common Conditions in Cats Covered by Insurance

Pet insurance for cats is generally cheaper than pet insurance for dogs. That does not mean the vet bills will not leave a dent in the pet owner’s wallet. Listed below, we have gathered the top claims made for cats in 2019 and the highest claims paid out for those conditions.   

In comparison to the prices of treatments, the cost of pet insurance is relatively low. As the cost of veterinary services has been on the rise these last two decades and is expected to continue rising, investing in your pet’s future and their wellbeing is a must. Most pet owners ask whether pet insurance is cost-effective, which we have covered more in another article.   

What is Not Covered by Pet Insurance? 

The coverage of pet insurance policies varies, but most companies will not cover routine vet visits and non-essential treatments. Every pet insurance provider has exclusions or conditions that they will not cover.  

It is important that pet owners check this list and look for a provider that keeps these exclusions to a minimum.  Pet insurance policies generally do not cover:  

  • Pre-existing conditions
  • Microchipping
  • Behavioral problems (pet obedience training)
  • Pregnancy or breeding care
  • Grooming and other cosmetic treatments (baths, shampoos, and nail trims)
  • Food and diet products and services, nutritional supplements
  • Spaying and neutering
  • Elective procedures (tail docking, ear cropping, and claw removal)
  • Vaccinations and boosters
  • Dental care (if dental damage occurs in an accident, it is covered by the AO and A&I plan)
  • Preventive care (flea and tick control, heartworm medication, de-worming)
  • International costs acquired while taking your pet abroad
  • Euthanasia or other expenses related to putting your pet to sleep
  • Non-veterinary charges (waste disposal services, license or certification such as dog registration)

Every pet is unique and has different needs. However, it is unavoidable that all of them will get injured and sick as they age. With various policies available and their coverages, take the time to find a policy that best suits your budget and your pet’s needs.