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Pet insurance exclusions
Which treatments and conditions aren't covered by your pet insurance policy?
Updated . What changed?
Although most pet insurance policies exclude similar treatments, each one includes different nuances and limitations on coverage. It’s important to pore over each company’s exclusions so you’re not left with unexpected out-of-pocket costs. Plus, understanding exclusions ahead of time could influence which policy you choose and how much you get paid back after major vet expenses.
What's in this guide?
10 common pet insurance exclusions
1. Pre-existing conditions
This exclusion encompasses anything your pet suffers before starting coverage or during the policy’s waiting period.
Your policy may also consider bilateral conditions pre-existing. These can affect either the left or right side of your pet’s body and may suggest a higher risk for developing the condition on both sides.
For example, if your pet suffers cruciate ligament damage in their right leg, you won’t get reimbursed if your pet needs surgery on the left leg later on.
2. Ordinary day-to-day and preventive care
Pet insurance doesn’t cover costs for routine services or care that prevents future injuries or illnesses. Daily care or routine services may include grooming, nail trimming, pet food, vaccinations or standard preventive vet visits.
3. Dental treatments
Insurance companies differ in how they cover dental procedures. Many don’t cover treatment for fractured teeth, gingivitis or regular cleaning, but some will pay for dental disease treatments or non-routine procedures. Only routine care coverage includes a benefit for dental cleanings.
4. Deliberate harm or negligence
If your pet’s health suffers because of your lack of care, your insurance company won’t shoulder the damage. The same goes for injuries you or someone living in your home caused if there’s evidence the injuries were intentional.
5. Injuries from occupation or competition
If you have a working dog who does police work, shepherding, hunting or racing, related injuries or illnesses may be excluded from your policy. However, this restriction may not extend to guide dogs or assistance animals.
6. Behavioral or alternative therapy
Many insurance policies are unleashing the restriction on behavioral or experimental treatments, but every company follows its own rules. Some companies include any holistic or alternative treatment recommended by your vet, while others only cover specific alternative treatments. Others cover behavioral training if it affects your pet’s injuries or illness.
Some companies offer this coverage as an add-on, while others include it in an accident and illness policy. Review each company’s exclusions carefully if you want this coverage.
7. Elective treatments
This exclusion means any treatment that’s not medically essential, including nail clipping, ear cropping, dewclaw removal and spaying or neutering. However, some of these treatments may be covered if you buy routine care coverage.
8. Breeding and pregnancy
You won’t be covered for breeding costs or pregnancy-related services or surgeries. If you own a breed with a high risk for cesarean deliveries, you might need to explore your payment options ahead of time.
9. DNA testing
Insurance companies may deem genetic testing an elective procedure despite the benefits of knowing your pet’s breed. You’ll have to pay for this service out-of-pocket.
10. Prescription diets, vitamins or supplements
Not everything your vet recommends can get covered under your pet policy. Prescription food products may or may not fall under exclusions, depending on your insurance company.
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What health conditions are commonly excluded?
Some health conditions might be excluded from your policy, or only covered after a long waiting period. Health conditions that may get excluded or include limitations:
- Luxating patella, or rotating knee caps
- Hip dysplasia
- Intervertebral disc disease
- Illnesses or injuries caused by parasites
- Cruciate ligament conditions
Exclusions for pet insurance add-ons
When you buy additional coverage with your pet insurance, you’ll still find conditions for that coverage to apply. Those include:
- Annual limits. You pay any costs that surpass the annual limit for each benefit covered.
- Routine care. Routine care policies list services that are covered specifically. Anything not listed may not be covered.
- Pet liability. Your pet may not get coverage if they have a history of harming other people.
- Lost pet rewards. Your policy may need a signed receipt from the person accepting your reward. Family members or anyone living with you won’t be eligible for the reward.
- Emergency boarding. You may need to be hospitalized for a specific amount of time to get reimbursed for your pet’s boarding fees.
- Vacation cancellations. You could get reimbursed for nonrefundable expenses after canceling a vacation or trip to attend to your pet’s urgent needs.
- Euthanasia. This coverage may only be paid if a vet deems euthanasia necessary and humane as the result of an illness or injury covered by your policy.
What to watch out for
Your policy’s exclusions shouldn’t catch you by surprise if you keep these watchouts in mind:
- Many insurers won’t offer illness coverage for pets over a certain age, like 10 or 14 years old. As such, your pet might qualify for only accident pet insurance.
- Specific limits may apply to some services like routine care, alternative therapy or dental procedures.
- Weigh your options if you find a cheap policy with many exclusions.
- Stay honest about your pet’s history, occupation or activities.
- If you’re unsure whether a service is covered, reach out to your insurance company.
- Your insurer might label a condition differently than you would, leading to denied claims if you don’t have the right coverage. For example, sudden vomiting might be labeled an illness, unless you can prove that your pet ate an object.
- Preventable illnesses like gingivitis or flea allergy dermatitis may not be covered with some insurers.
- Any expenses that go above your policy’s limits won’t be covered. You should have chosen an annual limit when buying or your policy may come with set limits for each condition it covers. If your expenses cost more than those limits, you’ll pay out-of-pocket.
How do I find my pet’s policy exclusions?
The best place to find your policy’s exclusions is in your pet insurance policy documents. You might find a physical copy provided to you. But you may be able to view it through an online account or in emailed documents.
Contact customer service to send you this information if you don’t have access to an official document yourself. Also, many insurance companies include a list of exclusions on their websites, though it may not be an exhaustive list.
Every pet insurance policy brings exclusions to the table, no matter how comprehensive the coverage. Although you can look for the most common exclusions listed above, many policies differ a little with certain conditions or treatments. However, the best pet insurance policies keep exclusions to a minimum, offering you as wide coverage as possible.
Frequently asked questions about pet insurance exclusions
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