What Does Pet Insurance Not Cover? Limits and Benefits

Pet insurance provides peace of mind when your furry friend comes down with an illness or has an emergency. Instead of breaking the bank, insurance will help cover the unexpected costs. 

With any insurance policy, there are limits to coverage. What is not covered by pet insurance? Know about all the conditions pet insurance does not cover before signing up for your policy. 

Limits and Conditions Not Covered

What does pet insurance not cover? Find out with our comprehensive list. And remember, Odie always has you covered, offering wellness add-ons and extra coverage plans that override many of these limitations.

• Waiting period – Each insurance policy has a waiting period. You must have insurance for a specific amount of time before covering accidents or illnesses. Waiting periods exist to help protect insurance companies against fraudulent claims from individuals who bind a policy immediately after they find out about a large expense and want coverage that same day. Pet insurance waiting periods vary for different types of claims. Usually, the shortest waiting periods are for accident claims, followed by illness claims. The longest waiting periods are for cruciate ligament injuries – knee and joint issues. 

• Pregnancy and birth – Does pet insurance cover pregnancy? Pet insurance does not cover breeding, including pregnancy and birth costs. It is rare to find pet insurance for pregnant dogs or cats.
• Preventable conditions – Insurance covers preventable diseases if preventative care measures are taken. If you are diligent about keeping up with vaccinations and maintenance care for your pet and they still contract a condition (such as Bordetella), then pet insurance will cover the disease. If your pet contracts a disease that could have been prevented, the insurance policy may not cover treatment.  
• Elective procedures – Pet insurance does not cover grooming or cosmetic procedures, including ear cropping, tail docking, or cat declawing. If the procedure is not necessary for the health and well-being of your pet, it is not covered.  
• Certain breeds – Some breeds are prone to illness or disease and are either not covered by pet insurance or are offered at a higher cost. At Odie, we do not have any breed restrictions.
• Age – Some pet insurance companies will not cover pets over 14 years of age. Odie pet insurance covers pets beginning at just 7 weeks old.
• Specific Exclusions or Limitations – All policies will come with limitations of pet insurance. Learn about these pet insurance coverage gaps from your insurance company. For example, pet insurance deductibles and co-pays are specific to your selected policy. Also, out-of-pocket maximums are the most amount of money that an insurance policy will pay out over the course of a year. 

The following limitations will be discussed in further detail before discussing when to get pet insurance and what pet insurance is good for. 

• Pre-Existing conditions
• Alternative medicine treatments
• Bilateral conditions
• Friends of your furry companion
• Routine pet care
• Office visits and exams

Pre-Existing Conditions

Pet insurance policies often deny coverage for your pet’s illnesses or injuries before coverage begins. Conditions they develop during the insurance company’s waiting period may also be denied coverage.

What conditions do pet insurance companies consider pre-existing? All health issues that your pet shows signs of before coverage begins are often labeled as pre-existing conditions in pet insurance. 

Even if the illness or injury were not diagnosed or treated by a vet, it would still be considered pre-existing if your pet showed symptoms before the end of the policy’s waiting period. For example, if the pet experiences paralysis in its hind legs, this is a cause for concern and would be considered a pre-existing condition. On the other hand, if the pet suffers from an infection that is fully resolved before starting pet insurance, it is not a pre-existing condition if the infection reoccurs a few months later. 

A common reason for pet insurance claim denials is if the pet has a costly ongoing condition, and the owner seeks pet insurance to help pay for it. If you already know about a condition and try to get pet insurance to pay for the treatment, it is a pre-existing condition and will not be covered. For most conditions, the waiting period is usually 14 to 30 days. The waiting period for health problems like hip dysplasia could be much longer. 

Once you start a new pet insurance coverage, it’s crucial to make a note of the start date, also known as the policy effective date. This is important because your pet’s new insurance plan won’t cover any ailments, illnesses, and other issues that predate the start of coverage. That’s because insurers can’t really be liable for things that happened before the start of coverage. So, if you’re shopping for new coverage after your pet’s accident or diagnosis, any claim you make will be denied.

Odie waiting periods include the following: 

• 3 days for accidents
• 14 days for illnesses
• 6 months for cruciate ligament events and other complex conditions

Can I Get Insurance That Covers Pre-existing Conditions?

Unfortunately, you cannot get coverage for a pre-existing condition. Without this provision, pet owners could hold off on insurance coverage until they need it, signing up and retroactively applying coverage for their pet to a previous accident or event. 

After visiting the vet, they could cancel the coverage again and avoid paying all those premiums. Insurers know this. So, they won’t extend coverage to pre-existing conditions.

Should You Still Get Insurance if Your Pet Has a Pre-existing Condition?

Even if your dog or cat shows signs and symptoms of a pre-existing condition, you can still get pet insurance. While pet insurance policies will not offer coverage for an accident or illness that developed before you signed up, the policies will still cover eligible conditions that occur after the waiting period is over.

For example, if your pet has a heart condition before signing up for pet insurance, any treatment related to the heart disease will not be covered. But if they develop Giardia unrelated to the heart condition, pet insurance will cover the treatment for Giardia.

What does pet insurance do if it doesn’t cover the pre-existing condition? If your pet gets into another accident or becomes sick, your pet insurance will often provide some much-needed relief on medical bills. In the United States, pet owners could end up with $800 to $1500 in vet bills from an unexpected vet visit and treatment. You could be reimbursed 70-90% of the vet bill’s cost while understanding pet insurance benefits. 

This reimbursement makes seeking care for your hurt or ill pet a more accessible option and mitigates the risk of a budget-hurting vet bill.

Alternative Medicine Treatments

A basic pet insurance policy does not always cover alternative medicine treatments, like CBD oil and massage. If you want extra coverage for these treatments, you can customize advanced coverage. The good news is that chiropractic care and acupuncture may be covered by pet insurance as part of rehabilitative care.

Seek alternative treatments for calming your pet during thunderstorms, including CBD oil and other tips.

Bilateral Conditions

Pet insurance does not always cover a bilateral condition if your pet is likely to contract the same illness on one side of the body as it did on the other. For example, cataracts in one eye could signify that your pet is vulnerable to contracting it in the other eye. Hip dysplasia is also a common condition to occur on one side of the body and shows up later on the other side.

Routine Care and Wellness

Another common assumption of pet insurance plans is that they cover routine care such as shots, medications, and microchipping. While these costs do not qualify under insurance, it’s often offered as a wellness add-on to their regular plans.

For pet owners, the good news is that these types of visits are typically predictable, making it easy for you to plan and budget for them without much issue.

Add a wellness plan to your insurance to cover things like spaying and neutering, check-ups, vaccinations, heartworm medications, cleanings, and other routine care. Some pet owners love this type of coverage because it means not worrying about their pet’s health during the year, though it does mean slightly higher premiums.

Office Visits and Exams

When you take your pet to the vet, you’ll likely be charged a flat fee for the vet to see your pet, plus whatever it costs for the examination, consultation, or exam. If you’re bringing your pet in often, those fees can quickly add up. Like routine care, most pet insurance doesn’t cover office visits and exams, especially if you have an unlimited plan.

On the other hand, if your plan has an annual limit on reimbursements, these types of visits are often covered since it works against that reimbursement limit.

For the most part, these limits are in place to ensure that you only seek care for your pet when it’s needed instead of visiting the vet for every little worry. By moving the burden of those routine visits to the customer, the insurance provider can provide coverage at an affordable rate without worrying about abuse. But if you know that you’ll be bringing your pet to the vet frequently throughout the year, it may make sense to opt for additional coverage.

Different Tiers Come with Different Levels of Coverage

Pet insurance providers, such as Odie Pet Insurance, offer different coverage levels based on the policy you sign up for. For example, some policies will cover dental care while others will not. Additionally, based on the tier, you may be able to sign up for additional benefits, such as coverage for office visits and exam fees or take-home prescription medications. Choosing the right pet insurance policy is important.

Before choosing an insurance policy, consider the maximum annual coverage you’d like, the percentage you would like to be reimbursed, and the monthly premium that feels the most comfortable.  The different tiers of pet insurance policies provide completely customizable options for your pet’s care at a price that fits your budget.

Restrictions by Policy Type

Just as there are different levels of coverage depending on the tier you sign up for, there are also various restrictions based on the policy type. You will not receive coverage for most basic plans for pre-existing conditions, annual vet visits, spaying or neutering, supplements, elective procedures, or alternative treatments. For higher tiers, you can add additional policies to your contract to receive reimbursement for such things as emergency exam fees or physical therapy for your pet. Even if you add a supplemental benefit policy, there are still restrictions related to this coverage. For example, most insurers will not cover exams, treatment, or medication fees for preventable conditions. 

Before signing up with an insurance provider, be sure to review each policy’s restrictions.

Note “What’s Not Covered” When Selecting a Policy

While pet insurance can save you hundreds of dollars, there are a few notable exclusions and restrictions. Some insurers will not cover certain breeds of dogs or cats, and they will not offer reimbursements for treatment or medication for preventable diseases. The good news is that Odie Pet Insurance has no breed restrictions.

In addition, Odie Pet Insurance provides supplemental benefits so you can receive coverage for some exam fees, take-home prescription medications, routine care, or even rehab treatment. Whichever level of insurance you sign up for, review the “What’s Not Covered” sections to create a budget for any non-reimbursable veterinary bills.

What is Covered by Pet Insurance?

How much is pet insurance, and what does it cover? Each pet insurance policy cost will vary. Now that we’ve discussed what is not covered by pet insurance, let’s take a look at what pet insurance covers. Pet insurance is designed to protect you and your pet from unexpected events that affect your pet’s health. Things like illnesses, accidental injuries, and routine medical care are all covered by pet insurance, which can help minimize expenses and provide peace of mind for you when it comes to the health of your pet.

While most pet insurance is customizable with extra coverage so that you can design the perfect policy for you and your pet, certain things are covered by just about all pet insurance policies.

At Odie, here’s what we cover, and here are your options when you sign up for pet insurance with us.

All Odie Pet Insurance Plans

All Odie Pet Insurance plans cover accidents and injuries, hereditary and congenital conditions, emergency care, surgery, cancer treatment, outpatient care, dental disease and fractures, illnesses, diagnostic and testing, hospitalization, specialist care, ongoing and chronic conditions as well as MRIs, CT scans and X-rays. We realize that different pets have different health risks and concerns, and it’s our goal to protect them all.

Customize Your Coverage

Odie allows you to customize your pet’s coverage according to your need. From unexpected accidents and illnesses to emergency care and hospital stays, you can choose the right coverage for you and your pet without being forced into a one-size-fits-all coverage plan. We’ll even let you choose your deductible ($50 to $1,000) and your reimbursement percentage (70 to 90 percent).

Additional optional benefits include coverage for office visits and exam fees, take-home prescription medications, routine care plans and rehab, and acupuncture and chiropractic care.

Both Routine and Extra Coverage

With Odie Pet Insurance, you can also opt for a Wellness Plan, which provides preventative coverage to protect your pet from serious issues. Instead of waiting for something to pop up, our routine care plans come with an annual schedule of benefits that you can utilize for exams, preventive diagnostics, vaccinations, flea and tick medications, and more.

Just send your bills to us, and we’ll reimburse you for the expense. There’s no annual deductible or coinsurance, and coverage starts immediately with no waiting periods. Even pets with pre-existing conditions are covered, and you also get an extra boost to your pet’s insurance plan, which helps you budget and pay for your pet’s preventative care. Compared to other pet insurance plans, you can save hundreds per year on preventative care visits with Odie.

For the best in coverage, upgrade your pet’s plan to Odie’s extra coverage options to protect yourself against unforeseen expenses and give your pet the coverage they deserve. From exam fee coverage to emergency office visits, it’s easy to give your pet the coverage they need with extra coverage from Odie. But don’t forget the prescription medication coverage of up to almost 1,000 take-home prescriptions and rehab and physical therapy coverage.

Pet Insurance: Find the Best Plan for Your Pet

Choosing the right insurance policy for your pet will save you thousands of dollars in the long run. Gain peace of mind when you have an insurance policy that will cover 70-90% of injuries and accidents. If you are worried about the basic plan restrictions, sign up for extra coverage with Odie.

We want you to get the most out of your pet insurance policy. Read our blog, Pet Insurance: Find the Best Plan for Your Pet, for further guidance.

FAQs

Does Odie Pet Insurance Cover Emergency Visits?

Prepare for the unexpected with pet insurance policies that cover emergency visits. When you receive and pay the vet bill, simply send it to Odie, and we’ll reimburse you for eligible items. Find financial relief through pet insurance with Odie.

Does Pet Insurance Cover X-Rays?

Yes, pet insurance does cover X-rays. If your dog or cat has a fracture, you can identify it with an X-ray. Then your vet will proceed with the proper treatment for broken bones.

Will Pet Insurance Cover Surgery?

Pet insurance does cover surgery costs. If you are past the waiting period, you can enjoy the benefits of coverage for cataracts, ACL surgery, and hip dysplasia.

You can also read more about pet insurance and dental care here.

Do you have an senior dog? Read more on which pet insurance is best for older dogs.