What's not covered by pet insurance

Pet Insurance

What is Not Covered by Pet Insurance

By Odie Blog Editors on April 14, 2021

Pet insurance can help you afford emergency vet visits or treatments for unexpected illnesses. However, there are a few exclusions to pet insurance policies that are worth noting.  For example, pre-existing conditions are often not covered. Many policies also have restrictions in coverage based on the tier you sign up for. In this blog, we give you an overview of what is not covered by pet insurance so you can make an informed decision when selecting a policy.

Does Pet Insurance Cover 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? Any health issue that your pet shows signs of having before coverage begins is often labeled as a pre-existing condition by pet insurance companies. Even if the illness or injury was not diagnosed or treated by a vet, it would still be considered pre-existing if your pet showed symptoms of the condition before the end of the policy’s waiting period. For most conditions, the waiting period is usually 14 to 30 days. For health problems like hip dysplasia, the waiting period could be much longer, up to six months.

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 conditions that occur after the waiting period is over.

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. If you have pet insurance, you could be reimbursed 70-90% of the vet bill’s cost. This reimbursement makes seeking care for your hurt or ill pet a more accessible option and mitigating the risk of a budget-hurting vet bill.

What Else Does Pet Insurance Not Cover?

In addition to not offering coverage for pre-existing conditions, there are commonly a few other exclusions in coverage.   These exclusions can often be found on the insurers’ website under a heading such as “What’s Not Covered.” Here is a list of standard exclusions to a pet insurance policy:

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 have the option of signing up for additional benefits, such as coverage for office visits and exam fees or take home prescription medications.

At Odie Pet Insurance, we have three different tiers—Great, Better, and Best.   Each tier is customizable to offer the level of coverage you are seeking.   If you only need a small amount of coverage, then the Great policy would be the perfect place to start.  However, if you’re looking for a bit more coverage and additional options included, then you might want to try the Better or Best coverage plans.

Before choosing an insurance policy, consider the maximum annual coverage you’d like to have, 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 the care your pet needs, 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 may be able to add additional policies to your contract so that you can receive reimbursement for such things as emergency exam fees or physical therapy for your pet.

Even if you choose to add a supplemental benefit policy, there are still restrictions related to this coverage. For example, most insurers will not cover exam, 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. However, some insurance providers, such as Odie Pet Insurance, provide 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, be sure to review the “What’s Not Covered” sections so you can start creating a budget for any non-reimbursable veterinary bills.

What Is Covered By Pet Insurance?

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 the health of your pet. 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, there are certain things that are covered by just about all pet insurance policies. Here at Odie, here’s what we cover, and here are what your options are when you sign up for pet insurance with us.

All 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

Regardless of what is not covered by pet insurance elsewhere, Odie gives you the ability 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 preventative coverage, and that can help prevent a serious issue down the line with your pet. 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 right away 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 types of 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 to 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, as well as coverage for rehab and physical therapy.

What Is Not Covered By Pet Insurance

As we already mentioned, there are some things that won’t be covered by pet insurance. Things such as pre-existing conditions, elective procedures, preventative care, parasites, non-veterinary expenses, food, special diets, vitamins, supplements, herbal treatments, holistic care and experimental therapies and medicines are all not covered by insurance. But considering everything that is covered, Odie Pet Insurance is often the best choice for pet owners that want the best for their pets.

What Is Not Covered by Pet Insurance – Continued

If you’re still confused as to what is not covered by pet insurance, let’s go over it again. Pet insurance covers a lot of things, but it doesn’t cover everything, so if you’re wondering what pet insurance covers, it’s important to keep these things in mind. 

Pre-Existing Conditions

Once you start a new pet insurance plan, it’s crucial to make note of the start date. Also known as the effective date, the start date is simply the date that coverage starts. This is important because any ailments, illnesses and other issues that predate the start of coverage won’t be covered by your pet’s new insurance plan. That’s because insurers can’t really be liable for things that happened prior to the start of coverage, so if you’re shopping for new coverage after your pet had an accident or diagnosis, any claim you make to that effect would be denied.

Without this provision in place, pet owners could hold off on insurance coverage until they actually 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, and it’s why they won’t extend coverage to pre-existing conditions.

Routine Care and Wellness

Another common assumption of pet insurance plans is that they cover routine care such as shots, medications and microchipping. While many pet insurers do offer this kind of coverage, it’s often an add-on to their regular plans, and unless you spring for it, that regular coverage won’t cover those routine visits to the vet. That means things like spaying and neutering, check-ups, vaccinations, heartworm medications, cleanings and other routine care will not be covered, forcing you to pay for those things out of pocket.

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. Besides, if you really want the coverage, you can spring for a wellness add-on, ensuring that your pet will be covered when it comes to more routine issues. Some pet owners love this type of coverage because it means not worrying about the health of their pet 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. Unfortunately, most pet insurance doesn’t cover routine 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 types of limits are in place to ensure that you only seek out 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 is able to 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.

If you’re ready to sign up for an affordable, totally customizable pet insurance plan, contact Odie Pet Insurance. Have questions about exclusions and restrictions? Give us a call! We would be happy to answer all of your questions.


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