What's the difference between accident-only and accident-and-illness pet insurance?

Accident-only covers injuries, like a broken leg or a swallowed object. Accident-and-illness also covers sickness, such as infections, cancer or allergies, which is where many large bills come from.

Is there a waiting period for pet insurance?

Usually, for illness. In Florida, the law allows no waiting period for accidents and up to 30 days for illness and for orthopedic conditions not caused by an accident (Fla. Stat. 627.71545).

If I switch pet insurance, will my pet's conditions be covered?

Often not. A new plan usually treats anything already diagnosed or treated as pre-existing, so switching can leave an ongoing condition uncovered.

Pre-existing conditions, and accident-only vs accident-and-illness pet plans — From Elona’s desk

Q: Does pet insurance cover pre-existing conditions?

Generally not. Most plans exclude conditions your pet was treated for, or showed signs of, before coverage began or during the waiting period.

Generally, no: most pet insurance won’t pay for a condition your pet was treated for, or showed signs of, before the policy started. And an accident-only plan won’t pay for illness at all. An accident-and-illness plan will, once its waiting period is over.

Those two sentences explain most of the surprises in pet insurance. Here’s what’s behind them.

What “pre-existing” means

A pre-existing condition is roughly anything your pet had before coverage began. In practice, plans tend to count a condition as pre-existing if, before the start date or during the waiting period:

a vet gave advice about it,
your pet was treated for it, or
your pet showed signs or symptoms of it, even if nobody had named it yet.

That last one is the one that surprises people. A limp noted in the vet’s chart months ago can be enough, even if the diagnosis came later.

Curable vs ongoing conditions

Plans don’t all treat old problems the same way. Some will cover a condition again if it was cured and your pet stayed symptom-free for a set time, such as a past ear infection. Ongoing conditions like allergies or diabetes are usually excluded for good once they’re on record. Ask how a plan handles both, and get the answer in writing.

Accident-only vs accident-and-illness

Accident-only covers injuries: broken bones, cuts, bite wounds, swallowed objects, poisoning. It’s the narrower option, and usually the less expensive one.

Accident-and-illness covers all of that plus sickness: infections, digestive problems, cancer and, on many plans, chronic conditions that first show up after coverage begins.

The catch with accident-only is that many of the most expensive vet bills come from illness, not accidents. If what you really want is protection from the big diagnosis, accident-only may not be the plan you think it is.

Waiting periods

Most plans don’t cover everything from day one. Illness often has a waiting period after you buy, and some plans have a longer one for things like knee and hip problems. Anything that starts during a waiting period is usually treated as pre-existing, which is why buying before you need it matters.

Florida

In Florida: what the law says

Florida’s pet insurance law (Fla. Stat. 627.71545) sets some ground rules:

No waiting period for accidents. For illness, and for orthopedic conditions not caused by an accident, the waiting period can be up to 30 days.
The waiting period can be waived after a vet exam, under the plan’s terms. Unless the policy says the insurer pays for that exam, you do.
The insurer must disclose a pre-existing condition exclusion in writing, and if it denies a claim on that basis, it has to prove the exclusion applies.
Once a condition is covered, it can’t be treated as pre-existing when the policy renews, and you can’t be required to get a medical exam to renew.

Illinois

In Illinois: the policy sets the rules

In Illinois, look to the policy itself for the definitions, waiting periods and renewal terms. Read the definition of “pre-existing condition” word for word before you buy.

Be careful when switching

If your pet has been diagnosed with anything, a new plan will likely treat it as pre-existing. Switching for a lower price can mean giving up coverage for the one condition you most need covered. Compare carefully, and don’t cancel the old plan until you know exactly what the new one would and wouldn’t pay.

Good to know

Ask for your pet’s records before you apply, so you know what a new plan will see.
Read the exclusions list, including anything about breed or hereditary conditions.
Keep the plan’s disclosures and sample policy. If a claim is ever turned down as pre-existing, you’ll want the exact wording to check it against.

Want me to look at a plan with you?

Send me the plan you’re considering and a summary of your pet’s history, and I’ll point out what it would likely treat as pre-existing before you sign anything.

Talk to Elona