Pet Insurance Coverage Exclusions and Limits

Pet insurance is a great and worthy investment if your dog, cat or even bird gets sick or has an injury.

As we all know, the costs of treating our pets can become expensive and that is why pet insurance is such a life-saver, sometimes literally and usually financially!

There are many decisions you need to make when signing up with a new policy: the company, what type of coverage you want as well as pricing.

Our quick primer on how pet insurance works can give you an overall idea of what to look for in coverage and how to make the most of a pet insurance plan.

There are also many things that are not included in a pet insurance policy and are usually found under “exclusions”.

Each pet insurance company is different in what they exclude so it’s important to read the fine print carefully.

The Typical Coverage Exclusions are the following:

Pre-Existing Conditions

All pet insurance companies will not cover any pre-existing condition or illness that your pet has developed prior to signing up with the new company.

Any condition or illness that is on your dog or cat’s medical record will be excluded from coverage.

The reason pet insurance companies exclude sickness or conditions is to help keep the insurance prices down.  If all pets that signed up were pets were sick or injured the prices would be astronomical.

The waiting period when signing up for a policy is just for this purpose…to make sure that all conditions that are pre-existing are disclosed.

Because pre-existing conditions are always excluded, it’s best to insure your dog or cat when they are young.

Routine Procedures

Any preventative care procedures are not included in a typical pet insurance plan.

They typically include the following:

  • Annual Checkups
  • Vaccinations
  • Teeth Cleaning
  • Flea & Tick Control
  • Spaying and Neutering
  • Heartworm
  • Microchipping
  • Ear cleaning

However, there are some pet insurance companies that offer a wellness plan that will cover a certain amount of these costs at an additional fee.  Wellness plans are added on to a pet insurance policy.

These routine procedures are easily paid out of pocket and not worth the additional costs.

Office Visits and Exam Fees

Some pet insurance plans exclude the vet office fee visit when you take your dog or cat in for an exam.

Yet, most will pay for the diagnostic testing that accompanies the exam.

Most that have a payout limit will include the exam fee, while other plans that have unlimited benefit limits won’t pay the fee.

For example, Figo, if you choose the benefit limit level that has a maximum of $15,000, it includes the exam fee.

And, Healthy Paws, which has unlimited annual and lifetime benefits does not include the exam fee.  Which makes sense because they are paying for all other unexpected and big expenses.

Age Limits

Some pet insurance companies have limits on the age when you can enroll your dog or cat (usually up to 10 years) while others have no upper age limits.

However, most companies will not deny your pet coverage at any age once enrolled.

Deliberate Injuries

Any deliberate injury to your dog, cat or even turtle is not covered.  These will usually include injuries that are inflicted at home and injuries and illnesses after a fight as well as injuries resulting from cruelty and neglect.

Injuries that are a result of dogfighting or racing are also not included and for good reason!

Injuries due to an accident, however, are covered.

Treatments That Haven’t Been Approved by the Vet

Most pet insurance companies will not cover treatments that aren’t prescribed by the vet.

Prescriptive Food

Some pet insurance companies will not cover prescriptive food.  There are some that will pay half of the prescriptive food if the food is for an illness and not merely being overweight.

Pet food, vitamins and supplements are not covered.

However, all pet insurance companies will cover prescription medicine from your vet.

Boarding Costs

Most pet insurance companies won’t cover boarding costs while you travel.

Breeding

Breeding, or anything related to pregnancy, is not covered.

Cosmetic or Elective Procedures

Elective procedures such as ear cropping, tail docking, nail trimming or claw removal aren’t covered.

DNA Testing/Organ Transplant

DNA testing, stem cell therapy or Organ transplants.

Grooming Costs

Anything related to the grooming of your pets which includes bathing, hair trimming, removal of anal glands, or anal sacculitis.

Parasites

Flea, tick or any parasite prevention or treatment even including any illness that is transmitted by parasites

Dental

Unless covered by a dental plan, orthodontics, endodontics and/or the removal of the deciduous teeth.

Behavioral Training

Most plans will not cover behavioral training, while there are some that cover behavioral therapy that is a result of an accident or illness. Or considered as a treatment of both.

Avian Flu

Most pet insurance plans, even those for birds will not cover Avian Flu.

Final Thoughts on Pet Insurance Exclusions

While it seems like there are many exclusions, there are also many, much more expensive veterinary expenses and treatment that are covered when you insure your pet.

Before signing up with any pet insurance company, make sure you understand what is included AND excluded in the policy.

Our top 10 pet insurance companies are all very reputable, honest companies that can tell you what is covered in your policy.

We will be happy to hear your thoughts

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