What Does Pet Insurance Not Cover
If you’re thinking about buying pet insurance, one of the most important questions you should ask is:
What does pet insurance NOT cover?
While pet insurance can save you thousands of dollars in unexpected vet bills, it does not cover everything. Many pet owners are surprised to learn that certain treatments, conditions, and services are excluded from standard policies.
In this detailed guide, you’ll learn:
- ✅ The most common pet insurance exclusions
- ✅ What accident-only vs. comprehensive plans leave out
- ✅ Breed-specific and pre-existing condition rules
- ✅ Hidden exclusions most pet owners miss
- ✅ How to avoid claim denials
- ✅ FAQs pet owners search on Google
Let’s break it down.
Most pet insurance policies in the U.S. are reimbursement-based. Providers like:
- Healthy Paws
- Nationwide
- Trupanion
- ASPCA Pet Health Insurance
work this way:
- You pay the vet bill upfront.
- You submit a claim.
- The insurer reimburses a percentage (usually 70%–90%) after your deductible.
But reimbursement only applies to covered conditions.
Now let’s look at what is usually NOT covered.
1. Pre-Existing Conditions (The #1 Exclusion)
This is the most common exclusion across all pet insurance companies.
What is a pre-existing condition?
Any illness or injury that:
- Occurred before your policy started
- Showed symptoms before coverage began
- Was diagnosed before the waiting period ended
Examples:
- Chronic ear infections
- Diabetes diagnosed before enrollment
- ACL injuries that happened previously
Most insurers will permanently exclude these conditions.
⚠️ Important: Even minor symptoms noted in vet records can be classified as pre-existing.
2. Routine & Preventive Care (Usually Not Included)
Basic pet insurance policies do not cover routine care, unless you purchase a wellness add-on.
Not covered under standard plans:
- Vaccinations
- Annual wellness exams
- Flea & tick prevention
- Heartworm prevention
- Routine bloodwork
- Nail trimming
- Grooming
Some companies offer wellness packages at extra cost, but these are not part of accident/illness coverage.
3. Cosmetic & Elective Procedures
Pet insurance does not cover procedures that are considered cosmetic or non-medically necessary.
Examples:
- Tail docking
- Ear cropping
- Declawing
- Cosmetic dental procedures
If a procedure is not medically necessary, it will likely be excluded.
4. Breeding & Pregnancy Costs
Most standard pet insurance policies exclude:
- Pregnancy expenses
- Labor & delivery
- C-sections (unless medically required and covered)
- Breeding-related complications
- Fertility treatments
If you plan to breed your pet, you’ll need to verify coverage very carefully — most insurers do not cover these costs.
5. Experimental & Alternative Treatments (Sometimes Excluded)
Some policies do not cover:
- Experimental treatments
- Clinical trial procedures
- Unproven therapies
However, some providers do cover alternative therapies such as:
- Acupuncture
- Chiropractic care
- Hydrotherapy
Coverage varies by company and plan level.
6. Behavioral Training (Often Limited or Excluded)
Coverage for behavioral issues depends on the insurer.
Many policies exclude:
- Basic obedience training
- Aggression training
- Behavioral consultations (unless tied to a medical condition)
Always check your policy details.
7. Dental Care (With Major Limitations)
This surprises many pet owners.
Most plans:
- Cover dental injuries (like broken teeth)
- Cover illness-related dental disease
But often exclude:
- Routine dental cleanings
- Pre-existing dental issues
- Periodontal disease if no dental exam history
Dental exclusions are one of the most common claim denial reasons.
8. Waiting Period Illnesses
Every policy has waiting periods.
Typical waiting periods:
- 2–14 days for accidents
- 14–30 days for illnesses
- 6–12 months for orthopedic conditions (like ACL tears)
If your pet becomes sick during this time, it will not be covered.
9. Hereditary & Breed-Specific Conditions (Sometimes Excluded)
Some policies limit or exclude hereditary conditions common to certain breeds.
Examples:
- Hip dysplasia
- Heart disease
- Respiratory issues in flat-faced breeds
Modern insurers are improving in this area, but restrictions still apply depending on the provider.
10. Boarding, Grooming & Non-Medical Costs
Pet insurance does not cover:
- Boarding fees
- Pet sitters
- Food
- Supplements (unless prescribed)
- Travel expenses
- Microchipping (unless wellness add-on)
These are considered non-medical expenses.
Accident-Only vs. Comprehensive Plans: What’s Excluded?
Accident-Only Plans DO NOT Cover:
- Illnesses
- Cancer
- Infections
- Chronic diseases
They only cover:
- Broken bones
- Bite wounds
- Swallowed objects
- Poisoning
Accident & Illness Plans Still Exclude:
- Pre-existing conditions
- Routine care
- Cosmetic procedures
- Breeding
Understanding this difference is critical before buying a plan.
Hidden Exclusions Most Pet Owners Miss
Here are lesser-known exclusions:
- Conditions related to neglect
- Injuries from organized fighting
- Claims without medical records
- Conditions noted during waiting periods
- Prescription food (unless specified)
Always read the policy fine print.
How to Avoid Pet Insurance Claim Denials
To maximize coverage:
- Enroll your pet early (before health problems start).
- Keep complete vet records.
- Ask your insurer about breed exclusions.
- Understand waiting periods.
- Confirm dental coverage rules.
- Review annual and lifetime limits.
Is Pet Insurance Worth It Despite Exclusions?
Even with exclusions, pet insurance can be financially life-saving.
Emergency surgeries can cost:
- $2,000–$5,000 for foreign object removal
- $3,000–$7,000 for ACL repair
- $5,000+ for cancer treatment
If your pet is young and healthy, enrolling early gives you the best protection.
Frequently Asked Questions (FAQ)
Does pet insurance cover vaccinations?
No, not unless you purchase a wellness add-on.
Does pet insurance cover pre-existing conditions?
Almost never.
Does pet insurance cover dental cleaning?
Usually not under standard plans.
Does pet insurance cover spaying and neutering?
Only if included in a wellness package.
Does pet insurance cover cancer?
Yes, if it develops after the policy starts and after waiting periods.
Final Thoughts: What Pet Insurance Doesn’t Cover
Pet insurance does NOT typically cover:
- Pre-existing conditions
- Routine and preventive care
- Cosmetic procedures
- Breeding and pregnancy
- Experimental treatments
- Waiting period illnesses
- Non-medical expenses
The key to choosing the right policy is reading the fine print and enrolling early.