What Pet Insurance Covers Pre-Existing Conditions (Honest, Research-Based Guide)

Almost no pet insurance covers pre-existing conditions by default. But some companies cover curable pre-existing conditions after a symptom-free waiting period. AKC Pet Insurance is currently the only company that covers curable pre-existing conditions after 365 days of continuous coverage.

I know why you are here. Maybe your pet has a chronic disease, or you are worried about whether any insurance company would help you or not. I have researched 10+ policy documents, real user complaints, verified vet insights, and official industry data, and honestly, pet insurance companies are not as glossy as they seem in ads. But some ways that could help you save your money.

How I Researched This

To write this guide, I spent about three weeks on it. I went through Nationwide’s actual policy documents (the Whole Pet and Major Medical plans), read through over 200 Reddit threads on r/petinsurancereview over the last 18 months, cross-checked pricing data from Forbes Advisor and NerdWallet’s independent reviews, and looked at their BBB complaint history and Trustpilot ratings.

I also reviewed NAPHIA’s (North American Pet Health Insurance Association) 2023 industry report for market benchmarks.

I am not affiliated with any insurer. Every recommendation below is based on verified data, not commission.

Why This Actually Matters Right Now

Nationwide offers three main types of plans, and honestly, they are not all equal in value.

Whole Pet:

This is Nationwide’s most comprehensive plan. This plan covers accidents, illness, hereditary and congenital conditions, and even alternative therapies. This is the plan most people mean when they talk about “real” pet insurance.

Major Medical:

This plan is Nationwide’s mid-tier option. This covers accidents and illness, but at a lower reimbursement ceiling. If your dog needs a $7,000 TPLO knee surgery, the gap between what Medical Major pays and your actual bill can be significant.

Pet Wellness:

This is an add-on, not a standalone plan. It covers routine care like vaccines and annual exams. Worth it only if you were already paying out of pocket for those visits consistently.

One thing Nationwide genuinely has over almost everyone else: exotic pet coverage. They cover birds, reptiles, rabbits, and other small mammals. If you own a parrot or a tortoise, Nationwide is essentially your only real option in the U.S. pet insurance market.

Source: Nationwide Pet Insurance official plan comparison page

The 2024 Cancellation — What Actually Happened

I think this is the most important thing to understand before you buy any insurance, and unfortunately, other reviews barely discuss it or skip entirely.

In 2024, Nationwide announced it was discontinuing a significant portion of its pet insurance policies, affecting policyholders in multiple states. Reports across Reddit and consumer news sites documented policyholders receiving cancellation notices with relatively little advance warning, many of whom had been loyal customers for years. Pet owners with older pets or pets with pre-existing conditions, this was a devastating thing for them, because starting with a new insurer means those conditions are now locked out of coverage permanently.

The core problem is continuity of coverage. Once Nationwide cancels your policy, no new insurance company will cover what’s already documented in your pet’s health history.

The Hidden Mechanic: Post-Claim Underwriting

This is the dark truth of the insurance industry that nobody talks about. Just imagine, you are paying a premium for 6 months t, thinking that you are “safe”, but when you claim, and you find out that the company didn’t check your record. They play a “wait and watch” game. In my opinion, companies like Embrace are better because they open up clearly at the start.

Most pet insurers do not review your pet’s medical records when you enroll. These companies review them when you file your first claim.

This is called post-claim underwriting. It is one of the most important differences between insurance companies, yet almost no comparison blog explains it.

Here is what this means in the practical world: You enroll your dog and pay six months of premiums, and then your dog tears a ligament. You file a claim, and only then insurance company go through your dog’s two to three years of vet records. If they find any one line in the file, mentioning stiffness or limping from a previous visit, they can deny the claim by labeling it as a pre-existing condition.

By contrast, Embrace reviews your pet’s medical records from the 12 months before enrollment. This means you know already what is excluded before you pay a single premium.

Source: embracepetinsurance.com

What this means for you: If your pet has any health history, look for insurers that are transparent about reviewing records before your first claim, not after.

Curable vs. Incurable Pre-Existing Conditions

This is the real dividing line in the industry.

Curable Pre-Existing Conditions

These pre-existing conditions are those your pet fully recovers from. Most insurers that offer any flexibility will cover these after your pet has been symptom-free and treatment-free for 180 days (some insurance companies require 12 months).

Conditions the industry widely recognizes as curable:

• Urinary tract infections
• Ear infections
• Upper respiratory infections
• Kennel cough
• Non-chronic vomiting and diarrhea
• Broken bones (once healed)

Incurable Pre-Existing Conditions

These are lifelong and chronic conditions. Almost every insurance company excludes them permanently, with one exception.

Conditions that are almost always permanently excluded:

• Allergies
• Diabetes
• Arthritis
• Cancer
• Epilepsy
• Heart disease
• Chronic kidney disease
• Hip dysplasia

Dr. Loke Jin Wong, Associate Veterinarian at Greenfield Veterinary Hospital, described the reality from a vet’s perspective:

Source: bestmoney.com

Which Companies Actually Cover Pre-Existing Conditions?

Based on verified policy documentation:

Sources: Company official policy pages, NerdWallet, CNBC Select verified policy documentation.

One important note on AKC: Their incurable coverage excludes diabetes and Cushing’s disease even after 365 days. Pets aged 9 and older are also restricted to accident-only plans. Read their full terms before enrolling.

Source: akcpetinsurance.com

What Most Comparison Blogs Miss (Research Gap Table)

After reviewing the top two ranking competitor pages on this topic, here is what they cover versus what is actually important to you:

The “Related Condition” Denial — What Real Users Report

This is something I found documented in real, verified user reviews, and almost no major site explains this.

Insurance not only rejects conditions that are pre-existing. They sometimes deny new conditions by claiming that they are related to or associated with old ones.

One verified user, Jamie P., documented this about Pets Best:

“Pets Best denied my claim twice because they were overriding the veterinarian diagnosis to call the illness a different, unrelated pre-existing condition. I appealed twice and had my vet in contact with them on the last appeal. I don’t think the claim would have gone through without the backing of my vet.”

Source: reviews.io

Dr. Wong has seen this from the clinical side as well:

Source: bestmoney.com

What you can do is, when your pet visits a vet for any new issue, ask them to note clearly in the records that the condition is unrelated to any other previous issue. That documentation becomes your first line of defense if a claim is disputed.

The Orthopedic Exam Waiver – A Legitimate Strategy Most People Miss

Most insurance companies require a 6-month waiting period on orthopedic conditions like cruciate ligament injuries and hip dysplasia. These surgeries can cost between $3000 and $8000.

However, Emrabce Pet insurance and Figo allow you to reduce that 6-month waiting period as few as 14 days if your vet completes an orthopedic exam shortly after your policy starts and finds your pet healthy.

The trade-off: If the exam finds anything, that finding becomes a permanently pre-existing condition. For a young, healthy dog with no risk factors, this is a straightforward strategy. For breeds prone to joint issues, like Labrador Retrievers, Rottweilers, and German Shepherds, the risk of the exam revealing something is higher, and it is worth discussing with your vet first.

Source: Embrace Pet Insurance Help Center

What Happens If You Switch Insurers

This is one of the most underreported risks in pet insurance, and I would like to be honest with you in this matter.

If you are tired of your old insurance company and want to switch to a new one, every condition your pet has been diagnosed with by the previous company will become pre-existing at the new company, even if it was fully covered under your old policy. All waiting periods also restart from scratch.

The one documented exception I found in my research: MetLife Pet insurance may carry over pre-existing condition coverage for policyholders switching from a MetLife employer group benefits policy, provided there is no gap in coverage.

Source: metlifepetinsurance.com

Practical guidance: In my opinion, you should never cancel your existing policy until your new policy is active and all waiting periods have passed. You can legally hold two policies simultaneously during the transition period. The overlap cost is worth it compared to losing months of coverage.

If Your Claim Gets Denied- Exact Steps

A MarketWatch study in 2025 found that 33% of pet insurance policyholders filed at least one claim during the year, and 82% of those had no issues. But for the 18% of pet owners who did face the problems, here is what they should do:

Step 1

First of all, read the denial letter carefully. Find the reason for denial and the appeal deadline. Most insurance companies give you 30 to 90 days; if you miss this deadline, this may typically close your appeal permanently.

Step 2

Contact your vet immediately and ask them to write on their official letterhead stating that the current condition is totally different from the previous history, and explain the medical reason.

Step 3

Gather all medical records of your pet, like every vet invoice, test results, and visit notes that prove that your pet has no symptoms of this condition before your policy started.

Step 4

Submit a formal written appeal, which includes actual and solid statements. Cite the specific policy clause you believe supports your coverage. Attach your vet’s letter and all supporting medical records.

Step 5:

If the insurance company rejects your appeal, then file a complaint with your state’s department of insurance. Insurers are regulated at the state level and take formal regulatory complaints seriously.

Source on appeal timeline: money.com

Source on Dr. Wong’s escalation advice: bestmoney.com

My Research-Based Recommendations

After going through all of the above, here is my honest assessment by situation:

If your pet is young and healthy right now:

Enroll as soon as possible. Every day, week, and month you wait is a duration that can develop a new condition and become permanently pre-existing. The average accident and illness plan for dogs costs $749 per year in 2024, according to NAPHIA, which is far less than a single orthopedic surgery.

Source: petbenefits.com

If your pet has a curable pre-existing condition:

Look at ASPCA, Spot, Pumpkin, or Hartville. If your pet is symptom-free for 180 days, those conditions may become eligible for coverage again. To prove this 180-day time period, collect a dated checkup report from your vet.

If your pet has an incurable condition:

AKC Pet Insurance is currently the only way to get you coverage, which you will have to pay premiums for 365 days before this rule applies, and some conditions, like diabetes and Cushing’s, remain excluded even after this.

If you are considering switching insurers:

You should not make a quick decision. Assume your new insurer will exclude everything in your pet’s existing medical file. Consider adjusting your deductible or reimbursement rate with your current insurer first before switching.

FAQ’s About What Pet Insurance Covers Pre-Existing Conditions

About the Author

M. Nouman is a pet insurance researcher with over seven years of experience analyzing U.S. pet insurance policies, coverage terms, exclusions, and real claim practices. His work focuses on simplifying complex insurance language into clear, practical guidance so pet owners can make informed decisions based on research rather than promotional claims.

Expertise: Pet Insurance Reviews, Coverage Analysis, Claims Process, Policy Comparison

Research insights available on Quora and professional profile on LinkedIn .