Can a Pet Insurer Deny Coverage Due to a Pre-Existing Condition?

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  • Pet insurance pays for medical care that our animal companions need.
  • Some animals develop pre-existing conditions before their owners buy pet insurance.
  • Pet insurers can deny coverage for pre-existing conditions, unlike human insurers.

A pre-existing condition could cause lots of problems when trying to get a pet covered. 

Pet insurance provides protection for injuries or illnesses that affect animal companions. Owners of dogs, cats, and even some exotic animals can buy a policy that pays the vet's bills when their furry friend needs veterinary care.

But, it's generally important for owners to get insurance early on in their pet's life before the animal develops any medical problems. 

Owners should know the rules for pet insurance and pre-existing conditions in order to understand why getting covered early is so important -- and what happens if they don't do that and a medical issue develops before insurance is in place.

Here are the rules for pet insurance and pre-existing conditions

Pet insurance has different rules for pre-existing conditions than human insurance. The Affordable Care Act (also known as Obamacare) made it illegal for human health insurers to deny coverage for a pre-existing medical issue. This means a person can buy insurance after they are sick and the insurer will pay for their bills -- even for the illness that existed before they got covered.

There's no such rule for pet insurers, though. As a result, no pet insurance company is going to provide protection for pre-existing conditions. Insurers will ask about a pet's medical history, and will typically request veterinary records or that the pet undergo a medical exam before a policy is purchased. If the animal has a pre-existing medical problem, the insurer will know about it and won't cover it. 

This doesn't necessarily mean the pet will be denied insurance entirely, though. In many cases, the pet insurer will provide coverage for other issues the pet has but not pay for anything related to the medical problem the animal had before coverage was purchased. 

For example, if a pet had been diagnosed with a heart murmur before insurance was purchased, then the insurance would not cover any medical issues that were related to the animal's heart. But if the owner bought coverage after the heart condition was diagnosed and then the pet developed cancer, the insurance would pay for bills related to this unrelated medical issue.

Some insurers also distinguish between curable and incurable conditions. So, if a pet had a condition such as a urinary tract infection that can be cured, the insurer might refuse to cover any expenses related to the infection for 12 months but after a year was up, would provide protection for future urinary tract infections. But an incurable condition such as diabetes, on the other hand, wouldn't ever be covered throughout the pet's life. 

How to make sure pets are covered

If a pet owner wants to make sure any medical issues their animal develops are covered, the owner should make certain they buy insurance as soon as possible while the pet is still young and healthy.

Buying insurance before a pre-existing condition develops ensures that there should be no major exclusions from the policy. Whenever the animal gets sick, insurance will be there to pay the bills so there will be no question that a beloved pet gets the very best medical care without regard to price.

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