Your pet is family, and as you research what’s included or excluded in the right protection coverage for your cat, kitten, puppy, or dog, you may start wondering, what even is a pre-existing condition in pet insurance? Does pet insurance cover any pre-existing conditions? And how do pet insurance companies determine pre-existing conditions?

Pre-existing conditions in pet insurance are generally defined as any illness, condition, injury, or complication that developed or redeveloped prior to your pet insurance policy’s effective date and before the end of any policy waiting periods.

For example, if your dog, Bella, or your kitten, Willow, has a history of injuries or medical conditions such as gastrointestinal disorders, eye or nasal problems, or diabetes that arose before the start of your pet insurance policy, they may be deemed pre-existing conditions and not eligible for coverage under many pet insurance policies.

However, if your cat, Daisy, or puppy, Charlie, has a hereditary or congenital condition, these may be eligible for coverage as long as symptoms do not arise until after enrolling and completing any waiting periods stated in the policy.

So why are they different from pre-existing? Hereditary conditions include any abnormality that’s genetically transmitted from parent to child that may cause illness or disease; think bladder stones, heart disease, epilepsy, and brachycephalic syndrome.

With congenital conditions, these issues are present from birth, caused by inherited genes or the environment, and may cause illness or disease; like cleft palate, limb deformities, or umbilical hernias.

If you already know your pet has a congenital condition before enrollment, it may qualify as pre-existing, but there may be coverage as an exception to a pre-existing conditions exclusion depending on policy conditions. Under many policies, as long as there are no clinical signs or symptoms before you enroll, many congenital conditions that show up later in life may be covered.

Although it’s hard to predict or be 100% sure when your pet will become injured or start showing signs of a medical condition, enrolling in pet insurance earlier reduces the risk that a condition could come up and be excluded as pre-existing.

Plus, you don’t want to wait and become one of the 20% of pet owners who had pet insurance claims denied due to pre-existing conditions, according to a 2025 MarketWatch survey. The longer you wait, the more likely it becomes that a pre-existing condition will arise and potentially preclude you from the support pet insurance can provide you and your furry family against nerve-wracking emergencies with large vet bills.

• Policy Effective Date vs. Symptom Onset

When you sign up for pet insurance, what counts as a pre-existing condition for pets, and what are the most significant dates to know?

Date #1: Policy Effective Date: The specific day and time when your policy is now active. For example, Healthy Paws pet parents’ policies are effective at 12:01 a.m. the day after you enroll your pet. The policy effective date also dictates the start of your 12 months of coverage and the beginning of your annual limit (your max annual payout for claims), if that’s part of your policy.

Date #2: Waiting Period: The 15- to 30-day [RW1] [JS2] , depending on the state you live in, before you can submit and get reimbursement for claims. After the end of your state-dependent waiting period, you can begin submitting claims for accidents, illnesses, and injuries and receive your payouts.

It’s important to note that if your pet has an emergency or symptoms begin during your waiting period, it’s not covered in some states. However, if you enroll in Healthy Paws, there is no waiting period for virtual vet access through Airvet where you can speak to a vet immediately about your pet’s health.

Policy effective dates are crucial because if an unlikely emergency happens, you want your pet to be covered as soon as possible.

And that date affects which conditions are considered pre-existing; it’s the line in the sand between newly-occurring accidents, illnesses, injuries, and conditions and any health issues your pet had before that policy effective date.
 

• Medical Records Review

Any pet insurance provider you choose will also review your pet’s full medical history including standardized records, called SOAP (Subjective, Objective, Assessment, and Plan) notes, from any vets your pet has seen.

If you’re curious about how pet insurance companies know about pre-existing conditions or how pet insurance companies determine pre-existing conditions? It’s these SOAP notes.

Inside, details on overall exam and symptoms, lab tests and results, any diagnoses and their specific dates, records of recommended and completed treatments, and medications are included; plus, if symptoms existed before or after the start of your policy effective date and end of your waiting period. If your pet has records of symptoms before the effective date and waiting period end date, that’s what counts as a pre-existing condition for pets on your policy.
 

• Timing Windows and Coverage Gaps

Even though your policy began on your effective date, you may still have 15- to 30-days attached as your waiting period. Those pre-existing conditions for pet insurance also include any symptoms, illnesses, injuries, or accidents that occur during that waiting period. After that period ends, you’re free to file claims for reimbursement.

If there is some question about the applicability of a pre-existing condition, many pet insurers, including Healthy Paws have formal dispute processes that may help.

What Are The Most Common Pre-Existing Conditions in Pets?

To simplify what are pre-existing conditions for cats and dogs, this table highlights conditions that commonly arise as pre-existing conditions. Such conditions may still be eligible for coverage, however, depending on when symptoms arise and in some cases, whether conditions fully resolve (e.g., ear infections) prior to the insurance effective date.

Each year more pet parents are saying, “Yes,” to insuring their loved fur family members. BluePearl Pet Hospital stated pet insurance coverage rose by 18% in 2020. And the AVMA (American Veterinary Medical Association) found that because veterinary prices climbed faster than inflation in 2025, there was 20% increase in policies for pets from 2024 to 2025.

If your puppy, Teddy, jumps off the final stair and miscalculates the landing, breaking a leg; you find out your kitten, Mochi, has seasonal allergies; Lucy, your dog, eats a tennis ball; your cat, Luna, has a UTI (Urinary Tract Infection); or your pet ends up in the emergency room with vomiting and diarrhea, many accidents, illnesses, injuries, and conditions are covered throughout your pet’s life.

Even if your pet has a pre-existing condition that would not be eligible for coverage, pet insurance can still provide great value as new health-related issues can arise over the lifetime of your pet.

For example, with Healthy Paws, cruciate ligament (CL, CCL, and ACL) injuries are eligible for coverage if your pet doesn’t have a history prior to your effective date. Hip dysplasia is also included as long as your pet is under six at enrollment and there’s no signs or symptoms within the first 30 days to 12 months of your effective date depending on your state. Hereditary and congenital conditions are eligible for coverage, too, as long as any signs show after your effective date and waiting period.

There’s plenty of financial value with enrolling in pet insurance ahead of time to offset rising vet costs, handle chronic curable conditions, and support out-of-the-blue treatments or emergencies.

FAQs About Pre-Existing Conditions:

How do insurance companies know about a pet’s pre-existing conditions?

You must submit medical records, AKA your vet’s SOAP notes, when you enroll and when you submit claims, which include your pet’s entire medical and surgical history.

Conclusion/CTA: Don’t Let Pre-Existing Conditions Stop You From Protecting Your Pet

Knowing whether pet insurance will cover pre-existing conditions and what is considered a pre-existing condition for your pets is crucial to enrolling them with the right policy, honestly and effectively.

Accidents, illnesses, and injuries happen to pets every day. From puppies playing too hard and breaking bones, to cats fighting and chipping teeth, these new injuries and emergencies are typically covered under pet insurance policies helping pet parents get the right care for their pets.

As soon as you bring your new fur family member home, consider enrolling them, even if they have pre-existing conditions, to maximize emergency and new health trouble benefits.

If you’d like to enroll today, consider exploring Healthy Paws coverage options to protect your pet for their long life.