As a devoted pet owner, you want the best for your furry friend. Pet insurance can be a lifesaver, covering unexpected vet bills. But, it has its own exclusions and limits. Knowing these is key to avoid surprises when filing a claim.

The pet insurance market in the U.S. has grown fast, with over $3 billion in premiums in 2022¹. This growth shows more pet owners see the value of insurance. It keeps their pets healthy and financially safe.

In this article, we’ll look at the top 10 things pet insurance usually doesn’t cover. This will help you choose the right policy for your dog.

Key Takeaways

• Pet insurance policies often exclude pre-existing conditions, pregnancy and birth expenses, and costs related to the death of a pet.
• Certain breeds, bilateral conditions, and preventable diseases may have limited or no coverage.
• Age restrictions and exclusions for elective or cosmetic procedures are common in pet insurance policies.
• Wellness and non-veterinary services, such as grooming and training, are usually not covered unless specified in the policy.
• It’s vital to read the fine print and understand your pet insurance policy’s exclusions and limitations to avoid surprises.

When exploring pet insurance, remember these exclusions. This way, you can find a policy that fits your pet’s needs and your budget. With the right coverage, you can be sure your pet gets the care they need, even for unexpected medical issues.

Understanding Pet Insurance Coverage Types and Limitations

There are many types of pet insurance, each with its own benefits and limits. The main types are accident-only and accident and illness coverage².

Accident-Only Coverage

Accident-only policies cover emergency care and injuries. This includes broken bones, cuts, or swallowing harmful objects. But, they don’t cover illnesses. These plans are cheaper but offer less protection².

Accident and Illness Coverage

Accident and illness plans offer the most coverage. They protect against many conditions, like broken bones and cancer. They also cover alternative therapies and behavioral issues².

But, these plans don’t cover all treatments. They exclude cosmetic procedures, breeding costs, and pre-existing conditions²³⁴.

Wellness Coverage Options

Some plans offer wellness coverage as an extra. This includes routine care like check-ups and vaccinations²³.

The right pet insurance depends on your pet’s needs and your budget. Knowing the different types and their limits helps you choose wisely. This ensures your pet gets the care they need.

Coverage Type	What is Covered	Typical Exclusions
Accident-Only	Emergency care and injuries	Illnesses, pre-existing conditions, preventive care
Accident and Illness	Accidents, illnesses, alternative therapies, behavioral issues	Cosmetic procedures, breeding costs, pre-existing conditions
Wellness	Routine care, vaccinations, preventive medications	Illnesses, injuries, pre-existing conditions

“Understanding the different coverage types and their limitations can help you make an informed decision and ensure your furry friend receives the care they deserve.”

Pre-existing Conditions and Waiting Periods

When looking at pet insurance, it’s key to know about pre-existing conditions and waiting periods. Pre-existing conditions are health issues your pet had before or during the policy start⁵. These can include allergies, heart disease, and more⁵.

Most pet insurance plans don’t cover pre-existing conditions⁵. But, some might cover them if your pet has been symptom-free for about 180 days⁶. Always check the policy details to understand what’s covered and what’s not.

Waiting periods usually last from 10 to 30 days, with no coverage during this time⁶. Conditions that happen then are seen as pre-existing and might not be covered⁶. But, pets with pre-existing conditions can get insurance, and it’s worth considering⁶.

Even if pre-existing conditions aren’t covered, your pet insurance can help with future accidents or illnesses⁶. Make sure to look at the policy’s details, like the deductible, co-insurance, and limits, to see if it fits your budget⁶.

Understanding pre-existing conditions and waiting periods helps you choose the right pet insurance⁵⁶. This way, you can protect your furry friend well⁵⁶.

Breed-Specific Restrictions and Age Limits

Not all pets are the same when it comes to insurance. Some breeds are more likely to get certain health problems. This means insurance companies might not cover them. For example, German Shepherds and Golden Retrievers might not be covered for degenerative myelopathy⁷.

Insurance also has age limits. Most policies won’t cover pets that are too young or too old. This can make it hard to find and afford insurance for older pets⁷.

Common Breed Exclusions

• German Shepherds: Degenerative myelopathy
• Golden Retrievers: Degenerative myelopathy
• Bulldogs: Brachycephalic airway syndrome
• Pugs: Brachycephalic airway syndrome
• Persian Cats: Polycystic kidney disease

Age-Related Coverage Limitations

1. Pets under 8 weeks old may not be eligible for coverage.
2. Senior pets, typically over 14 years of age, often face limited or more expensive coverage options.
3. The cost of pet insurance can increase significantly after a pet reaches 6 years old⁷.

Impact on Premium Costs

Breed exclusions and age limits can really raise the cost of insurance. Purebred pets, like those with inherited health issues, pay more⁷. Older pets also get charged more because they’re more likely to get sick⁷.

But, there are discounts that can help lower the cost. These include discounts for having multiple pets, spaying/neutering, paying annually, and for military families⁷.

“The cost of pet insurance is influenced by factors such as pet’s age, breed, and location, with significant cost increases after age 6 and limited availability after age 10.”

Pet Insurance Exclusions for Routine and Preventive Care

Pet insurance often doesn’t cover routine and preventive care like annual exams and vaccinations⁸. These services are key to keeping your pet healthy. But, they’re usually not included in basic pet insurance plans.

Some insurers offer wellness coverage plans for extra costs⁹. These plans can cost $10-$25 a month. They help cover the cost of routine care, saving you hundreds of dollars a year⁹. Getting a plan that includes accident, illness, and wellness coverage is a good idea. It ensures your pet gets all the care they need.

Many pet insurance policies won’t cover preventable diseases if your pet isn’t up-to-date on shots or preventive care⁸. Keeping your pet’s care up-to-date is key. It makes sure they’re covered if they get sick or hurt unexpectedly.

Knowing what pet insurance covers and doesn’t cover helps you choose the best plan for your pet. This way, your pet gets the care they need without breaking the bank.

Coverage Type	Typical Monthly Cost	Covered Services	Excluded Services
Accident-Only	$17 (dog), $10 (cat)9	Accidents, emergencies	Illnesses, routine care, preventive treatment
Accident and Illness	$57 (dog), $32 (cat)9	Accidents, illnesses, some preventive care	Routine check-ups, vaccinations, dental cleanings
Comprehensive with Wellness	$10-$25 additional9	Accidents, illnesses, routine care, preventive treatment	Limited exclusions, depending on policy

The type of pet insurance you choose affects how much you’ll pay for care⁹. It’s important to look at policy details and think about your pet’s needs. This helps you find the right balance of coverage and cost.

“Preventable diseases are often excluded if the pet owner fails to follow recommended vaccination schedules or preventive measures.”⁸

By keeping up with your pet’s care and using wellness coverage, you can save money¹⁰. This ensures your pet gets the care they need without costing too much.

Behavioral Issues and Training Expenses

Pet insurance varies in what it covers for behavioral issues and training costs. Some plans include these as standard, while others offer them as extra benefits or don’t cover them at all¹¹. The Complete CoverageSM plan covers behavioral treatments, along with illnesses and accidents¹¹. It includes training for dogs and cats, like counterconditioning and desensitization¹¹.

Only a vet or approved professionals like Applied Animal Behaviorists can treat behavioral problems¹¹.

Types of Excluded Behavioral Treatments

It’s key to check policy details for what’s covered and what’s not¹². About 40% of pet owners deal with behavioral issues in their pets¹². Pumpkin Pet Insurance covers 90% of vet bills for these issues¹². Most plans don’t cover pre-existing conditions.

Alternative Therapy Restrictions

Some treatments like acupuncture or chiropractic care might not be covered or need extra policy add-ons¹¹. The cost of pet insurance depends on several factors, including location and pet’s age¹¹. The Complete CoverageSM plan covers both behavioral and medical issues that cause problems in pets.

¹² Many common behavioral issues in pets are mentioned, affecting many owners¹². Some plans cover behavioral issues as a standard, while others charge extra¹². Pumpkin’s plans include diagnostics, treatment, and Rx medication for covered conditions¹². They offer flexible deductibles and coverage limits.

¹² Issues like aggression and separation anxiety might be covered by insurance¹². Pumpkin also offers a Preventive Essentials package for more wellness care.

¹³ Behavioral therapy is covered in the base plan, no need for the wellness add-on¹³. Some plans cover anxiety medication¹³. Costs depend on reimbursement percentage, deductible, and coverage limit.

“Behavioral issues can significantly impact the well-being of pets and their owners. It’s vital to know the coverage options and limits for behavioral treatments and alternative therapies.”

Pregnancy, Breeding, and Related Costs

Pet insurance often doesn’t cover breeding, pregnancy, and childbirth costs¹⁴. Veterinary bills for these situations are not included in most policies¹⁴. This means surgeries or procedures not linked to a covered condition are also out of pocket¹⁴.

Diagnosing or treating breeding-related issues isn’t covered either¹⁴. Even emergency care for pregnancy problems might not be covered, except in some plans¹⁵. If you plan to breed, check your policy’s exclusions and look into special breeding coverage¹⁵.

Trupanion is the top pet insurance in America, based on a survey¹⁵. Their claims data is based on real members, but it’s just an example¹⁵. Costs can differ a lot between pets and places¹⁵.

Standard pet insurance doesn’t cover prenatal care, delivery, or cesarean sections¹⁴. Costs for cruciate ligament damage or rupture are also excluded¹⁴. Some policies offer limited extra coverage for conditions like hip or elbow dysplasia¹⁴. Always check your policy for what’s not covered.

Excluded Costs	Potential Coverage
Routine prenatal care	Emergency care for pregnancy complications
Delivery costs	Limited coverage for certain breeding-related conditions
Cesarean sections	Specialized breeding insurance policies

“Veterinary expenses related to breeding or pregnancy are not covered by the pet insurance policies.”

Bilateral and Hereditary Conditions

Understanding pet insurance for bilateral and hereditary conditions is key. Bilateral conditions affect both sides of the body and may not be fully covered¹⁶. Insurers might not cover them if diagnosed before the policy starts¹⁶. Even after coverage begins, some plans might not cover it if the same issue has shown up on the other side¹⁶.

Hereditary and genetic disorders can also be challenging. Some policies might cover these, but others might not, mainly for certain breeds¹⁷. Insurers often have a waiting period before coverage starts. They might also have age limits or limits on coverage for these diseases¹⁷.

Common Bilateral Conditions

• Hip dysplasia
• Cruciate ligament issues
• Glaucoma

Genetic and Hereditary Disease Coverage

It’s vital to know how your pet insurance covers bilateral, hereditary, and genetic conditions. These issues can lead to high healthcare costs over time. Coverage can vary a lot between insurers¹⁷. Make sure to check your policy’s exclusions and limits to protect your pet¹⁷.

Condition	Coverage Likelihood	Key Considerations
Hip Dysplasia	Low	Often considered a pre-existing condition if diagnosed before policy start
Cruciate Ligament Issues	Low	May be excluded if one side is affected before coverage begins
Glaucoma	Moderate	Curable if diagnosed years after affecting one side, as long as pet was symptom-free
Hereditary Conditions	Varies	Coverage depends on policy terms, including waiting periods and breed-specific exclusions

Knowing the details of your pet insurance policy is important for coverage of bilateral, hereditary, and genetic conditions. By carefully reviewing exclusions and limits, you can protect your pet from unexpected costs¹⁸.

“Bilateral conditions, affecting both sides of the body (e.g., hip dysplasia, cruciate ligament issues), are often subject to specific exclusions. If one side is affected before policy inception, the other side may be excluded from future coverage.”

Elective and Cosmetic Procedures

Pet owners should know that pet insurance often doesn’t cover elective procedures or cosmetic surgeries¹⁹. It rarely covers surgeries for pre-existing conditions or things like tail docking or dew claw removal¹⁹. Cosmetic or elective surgeries like ear cropping, tail docking, or microchipping are usually not covered¹⁹.

Pet insurance may cover necessary medical treatments but not non-essential or purely aesthetic ones¹⁹. Procedures related to breeding, such as cesarean sections or spaying, are also not covered¹⁹. Owners need to pay for these procedures themselves or look into specialized coverage if they want them done.

Common Elective and Cosmetic Procedures Not Covered by Pet Insurance
Ear cropping
Tail docking
Declawing
Dew claw removal
Spaying/neutering
Cesarean sections

Pet owners should carefully read their insurance policy to know what’s not covered²⁰. Each company and policy has its own rules, so it’s key to understand what’s included and what’s not²⁰. Knowing the limits of pet insurance helps owners make better choices for their pets’ health and budget.

Non-Veterinary and Alternative Services

Pet insurance has its limits and exclusions. It often doesn’t cover non-veterinary services like grooming and boarding²¹. While it covers many health needs, it might not include these extra services.

Also, pet insurance may not cover alternative or experimental treatments well. Some policies might cover alternative treatments like acupuncture if a vet prescribes it²². But, treatments not widely accepted in vet medicine might not be covered.

Grooming and Boarding Exclusions

Most pet insurance doesn’t cover routine grooming like baths and nail clippings²¹. Boarding costs while you’re away might also not be covered, even for medical reasons. Always check your policy for these exclusions.

Experimental Treatment Limitations

If you’re looking into alternative or experimental treatments for your pet, know the insurance limits²². Some policies might offer some coverage, but it’s key to review the details. This includes any vet prescriptions needed.

Coverage Type	Typical Monthly Premium Range	Deductible Range	Reimbursement Level
Accident-Only	$10 – $40	$50 – $500	70% – 90%
Accident and Illness	$30 – $100+	$100 – $750+	70% – 90%
Wellness	$10 – $50	$0 – $250	50% – 100%

Knowing what your pet insurance covers helps you make better choices for your pet’s care²¹²². You can look into other options for non-veterinary services and experimental treatments if needed.

“Navigating the complexities of pet insurance can be challenging, but being aware of the exclusions and limitations can help you make the best choices for your furry family member.”

²¹²²

Conclusion

Knowing about pet insurance exclusions is key to good pet care²³. Pet insurance helps a lot, but you must know what it doesn’t cover²³. This includes pre-existing conditions, certain breeds, and routine care²³.

By reading your policy carefully, you can plan for unexpected costs²⁴. This way, you can pick the best pet insurance policy for your pet’s health needs²⁴.

It’s vital to check the details of pet insurance coverage closely²³. Some treatments and care might not be covered, leaving you to pay for them²⁴. Also, pre-existing conditions, breed issues, and age can affect what’s covered and how much you pay²³.

Being well-informed helps you make a smart choice for your pet’s insurance²³. This way, your pet gets the care they need without unexpected costs²³. Think about using savings or other plans to cover all your pet’s care needs²⁴.

FAQ

What are the most common exclusions in pet insurance policies?

Pet insurance often doesn’t cover pre-existing conditions or certain breeds. It also excludes pets over a certain age. Routine care, like vaccinations, is also not included. Behavioral issues, pregnancy costs, and some genetic conditions are also excluded.

Does pet insurance cover pre-existing conditions?

No, most policies don’t cover pre-existing conditions. These are health issues present before the policy starts. Some may cover them if the pet has been healthy for about 180 days.

Are there any breed-specific exclusions in pet insurance?

Yes, some breeds are more prone to certain health issues. For example, German Shepherds and Golden Retrievers might not be covered for degenerative myelopathy. This can make insurance more expensive for purebred pets.

Do pet insurance policies have age restrictions?

Yes, many policies don’t cover pets under eight weeks or over 14 years. This affects how much you can get covered and the cost, mainly for older pets.

Does pet insurance cover routine and preventive care?

Standard policies usually don’t cover routine care like exams and vaccinations. But, some offer wellness coverage as an extra option.

Are behavioral issues covered by pet insurance?

Coverage for behavioral issues varies. Some policies might cover issues like chewing or aggression. Others might not cover them at all or offer them as extra coverage. Alternative therapies are often not included.

Does pet insurance cover breeding and pregnancy-related costs?

Most policies don’t cover costs related to breeding or pregnancy. This includes prenatal care and delivery costs. Some policies for breeders might offer limited coverage.

How are bilateral and hereditary conditions handled in pet insurance?

Bilateral conditions, like hip dysplasia, are often excluded. If one side is affected before the policy starts, the other might not be covered. Hereditary conditions may be covered by some policies but not others, depending on the breed.

Are elective and cosmetic procedures covered by pet insurance?

Most policies don’t cover cosmetic procedures like tail docking. They also exclude certain dental or soft tissue surgeries unless they’re medically necessary.

What non-veterinary services are excluded from pet insurance?

Pet insurance usually doesn’t cover grooming, boarding, or training. It also excludes alternative or experimental treatments, including holistic options.

Source Links

1. What Is Not Covered by Pet Insurance?
2. Comparing Types of Pet Insurance | ASPCA Pet Health Insurance
3. 10 Common Types of Exclusions in Pet Insurance
4. What Does Pet Insurance Cover? | ASPCA® Pet Health Insurance
5. Does Pet Insurance Cover Pre-Existing Conditions?
6. Pet Insurance and Pre-existing Conditions | ASPCA® Pet Health Insurance
7. Pet Insurance Questions Answered For Insurance Agents
8. This is what pet insurance does (and doesn’t) cover
9. What Medical Expenses Does Pet Insurance Cover For Your Pet? | Bankrate
10. Pet Insurance Coverage
11. Pet Insurance For Behavioral Problems | ASPCA® Pet Health Insurance
12. Does Pet Insurance Cover Behavioral Issues?
13. Pet Insurance That Covers Behavioral Training | Spot®
14. Nationwide Pet Insurance Plan Restrictions | Excluded Conditions
15. Does Trupanion Cover Breeding Costs? Get the Facts
16. Bilateral Conditions: Overview | MetLife Pet Insurance
17. Does Pet Insurance Cover Pre-Existing Conditions?
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19. Does Pet Insurance Cover Surgery? – NerdWallet
20. Consumer Advisory: What is Pet Insurance?
21. Pet Insurance Pre-existing Condition Exclusions
22. Ultimate Pet Insurance Guide – WesVet
23. What Does Pet Insurance Not Cover? 13 Exclusions (With Examples) | PangoVet
24. What Does Pet Insurance Cover?