Understanding Pre-Existing Conditions

Four Minutes Jun 11, 2022

A common exclusion for pet insurance claims is pre-existing conditions. Naturally, many pet owners frequently ask how pet insurance and pre-existing conditions work with each other.

At MetLife Pet Insurance1, we understand that it can be confusing. We believe it’s important to educate all pet parents about one of the most common  pet insurance exclusions from the very beginning.

What Is a Pre-Existing Condition for a Pet?

MetLife Pet Insurance, like all other pet insurers, defines a pre-existing condition as any injury or illness contracted, manifested, or incurred prior to the policy effective date. This means conditions that affect your pet prior to the policy effective date (regardless of medical notation, diagnosis, or treatment) are excluded from coverage.

Does pet insurance cover pre-existing conditions?

Not usually. There’s generally no pet insurance that covers pre-existing conditions.

Like any insurance policy, pet insurance is intended to protect your pet from medical conditions that may happen in the future, not the past, so there’s no specific pet insurance for pre-existing conditions.

How Does Pet Insurance and Pre-Existing Conditions Work?

Pre-existing conditions can make it complicated to understand how pet insurance works.

In general, pet insurance plans may not cover conditions or illnesses that occur before the policy begins, but that doesn’t mean pets with pre-existing conditions are always ineligible for pet insurance.

Typically, pet insurance claims could help cover vet bills for accidents, illness, and hospitalizations, among other things. Pre-existing conditions make the process less straightforward.

It can get even more confusing when policies mention curable and incurable pre-existing conditions. Many pet insurance companies account for these two kinds of pre-existing conditions differently.

Curable pre-existing conditions

A curable pre-existing condition is an illness or injury a pet experienced at one point but has been symptom-free for a period of time. Some pet insurance companies may cover curable pre-existing conditions after there are no symptoms for a certain period of time, like 180 days or 12 months. This timeframe could also be subject to a waiting period.

Examples of curable pre-existing conditions could include:

●      Bladder infections

●      Ear infections

●      Diarrhea

●      Respiratory infections

●      Urinary tract infections

●      Vomiting

Incurable pre-existing conditions

Incurable pre-existing conditions are illness or injuries your pet will have for the remainder of their life. Many of these conditions often require frequent vet visits and medication. Incurable pre-existing conditions are not covered by pet insurance companies.

Examples of incurable pre-existing conditions could include:

●      Allergies

●      Arthritis

●      Bladder crystals

●      Cancer

●      Diabetes

●      Epilepsy

●      Heart disease

●      Hip dysplasia

●      Kidney disease

●      Orthopedic conditions

●      Urinary blockages

Remember, these conditions are not covered as pre-existing conditions, but many could be covered if they are diagnosed after your pet insurance begins. The sooner your pet is covered, the better.

Does Pet Insurance Cover Bilateral Conditions?

A bilateral condition is an illness or injury that affects both sides of the body. A bilateral injury or illness could be pre-existing conditions but not always.

Provided all terms of the policy are met, MetLife Pet Insurance may cover bilateral conditions that are diagnosed after policy coverage begins.

Are Pre-Existing Conditions Covered When Switching Pet Insurance Providers?

While MetLife Pet Insurance may not cover all pre-existing conditions, we may be able to provide coverage for pre-existing conditions that were covered by a previous insurance provider. If you’re looking to switch providers, your pet may still be eligible for the care it needs.

Don’t Let Pre-Existing Conditions Dictate Your Decision

If your pet had an accident or is diagnosed with an illness before you get pet insurance, you may be subject to pre-existing conditions. But remember, even if your policy cannot cover a pre-existing incident, pet insurance may still be worth it. Investing in dog insurance or cat insurance covers your pet’s future and the health of your furry family member for years to come.2

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1 Pet Insurance offered by MetLife Pet Insurance Solutions LLC is underwritten by Independence American Insurance Company (“IAIC”), a Delaware insurance company, headquartered at 485 Madison Avenue, NY, NY 10022, and Metropolitan General Insurance Company (“MetGen”), a Rhode Island insurance company, headquartered at 700 Quaker Lane, Warwick, RI 02886, in those states where MetGen’s policies are available. MetLife Pet Insurance Solutions LLC is the policy administrator authorized by IAIC and MetGen to offer and administer pet insurance policies. MetLife Pet Insurance Solutions LLC was previously known as PetFirst Healthcare, LLC and in some states continues to operate under that name pending approval of its application for a name change. The entity may operate under an alternate, assumed, and/or fictitious name in certain jurisdictions as approved, including MetLife Pet Insurance Services LLC (New York and Minnesota), MetLife Pet Insurance Solutions Agency LLC (Illinois), and such other alternate, assumed, or fictitious names approved by certain jurisdictions.

2 Provided all terms of the policy are met. Application is subject to underwriting review and approval. Like most insurance policies, insurance policies issued by IAIC and MetGen contain certain deductibles, co-insurance, exclusions, exceptions, reductions, limitations, and terms for keeping them in force. For costs, complete details of coverage and exclusions, and a listing of approved states, please contact MetLife Pet Insurance Solutions LLC.