Does Pet Insurance Cover Congenital Eye Conditions?

By | 2018-12-11T16:04:11-05:00 December 11th, 2018|Pet Insurance|0 Comments

Hereditary and congenital conditions are those that are present at birth. This category of diseases can affect the eyes in addition to many other bodily systems. Congenital eye diseases are less common in cats than in dogs, but occur among both species. Such conditions can cause symptoms that severely inhibit pets’ quality of life, including pain, nerve damage, or even blindness. Common examples, as described in detail on pet insurance provider Trupanion’s blog, include:

  • Glaucoma: A buildup of fluid in the eye that can cause pressure and optic nerve damage. This can eventually lead to blindness. Glaucoma treatment can cost anywhere from $1,000 to $3,000.
  • Cherry eye: When the tear gland of the third eyelid protrudes, appearing as a red bulge in the eye corner. Irritation of this protruding gland can lead to ulcers. Treatment costs between $100 and $900, typically.
  • Entropion and ectropion: The former refers to the eyelids turning inward, and the latter to eyelids turning outward. This causes eyelashes to rub on the eye and dry eyes, respectively. Surgery for either eyelid condition can cost hundreds of dollars.

Coverages Will Vary By Provider and Policy

It really depends on the policy of the insurance provider, which will vary. Nearly all pet insurance companies state definitively that they will not cover pre-existing conditions, and generally, they will place congenital conditions (including congenital eye diseases) under that umbrella.

However, there are certain companies that do not exclude congenital eye conditions from coverage. That’s because these pet insurance providers do not necessarily consider congenital eye conditions to be pre-existing conditions. In the case of Trupanion, for instance, their “policy states that as long as the pet had full policy coverage before the first signs or symptoms of the condition were noted, treatment for the condition is covered.” Trupanion will pay 90% of the bill, putting no limits on payment.

Healthy Paws has a similar policy. As they state on their website, they “don't place coverage restrictions on hereditary or congenital conditions. Pets are eligible for coverage so long as the signs and symptoms first manifest after enrolling, including any applicable waiting periods.” As with Trupanion’s policy, as long as your pet hasn’t shown any symptoms before coverage begins, they’ll be covered for congenital conditions.

ASPCA Pet Health Insurance’s Complete Coverage includes coverage for hereditary and congenital conditions, listing eye disorders among those covered. Once again, they exclude pre-existing conditions from coverage, defining them as conditions that arise before coverage has begun.

As you’ve probably gleaned from this summary, there are pet insurance providers who will cover your pet’s congenital eye condition. But because they won’t cover them as pre-existing conditions, you should consider purchasing pet insurance for your pet now if you think there’s a chance that your dog or cat will develop symptoms of a congenital eye disorder as they age.

About the Author:

Nina Gunther-Segal is as avid an animal lover as she is a writer. Her fascination with the animal kingdom was sparked by a childhood spent around all kinds of creatures, from the usual suspects--dogs and cats--to hamsters, rats, snails, fish, horses, and all kinds of farm animals. Today, Nina enjoys taking her Lab-Akita mix, Henry, on walks in the woods and to local swimming holes.

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