Pet insurance companies have waiting periods to keep pet owners honest. We think insurance is all about us, but we forget that the insurers’ main motivator is to make money for owners or shareholders.
Companies calculate premiums based on projections of how long people will pay in before using the insurance. Get those calculations wrong, and the company doesn’t stay in business for long. Without waiting periods, pet owners would only purchase insurance once they knew their pets were ill, and premiums would skyrocket.
With any new policy, it becomes active on its ‘effective date.’ That’s when any waiting period begins.
Waiting Periods Can Take Three Formats
- An initial waiting period is when all events under a category (say ‘accident’ or ‘illness’) are not covered, often 24-48 hours for accidents and 14+ days for illnesses.
- A disease-specific waiting period – usually 6-12 months – tends to include costly orthopedic procedures, such as elbow or hip dysplasia, patellar luxation, and intervertebral disk disease (IVDD).
- A pre-existing condition waiting period is where a pre-existing condition, usually never covered, is covered after a certain period without incident, at the insurer’s discretion.
For example, ASPCA Pet Health Insurance will cover an illness after it is treatment- and symptom-free for 180 days, even if it occurred during an active waiting period.
Which Conditions Are Typically Covered Without a Waiting Period?
Two types of coverage are most likely not to have a waiting period.
Accidents are typically covered with no waiting period or with a very short one. For example:
- ASPCA Pet Health Insurance has a no-wait policy on accidents, offering immediate coverage.
- PetFirst has less than a 25-hour waiting period for accidents (midnight EST next day).
- AKC Pet Insurance (CompanionSelect plan) and Pets Best offer coverage of whatever occurs just three days after enrollment.
Wellness plans (also called ‘preventive’ or ‘routine care’ plans) will usually be effective immediately. Pets Best’s routine care plans and Nationwide’s Pet Wellness plan begin coverage the day after enrollment and receipt of payment.
Which Conditions Are Typically Covered With a Waiting Period?
Orthopedic conditions are the ones most likely to be covered by a waiting period, including those related to cruciate ligaments and disk disease.
- PetFirst has a 12-month waiting period for intervertebral disk disease, and all the cruciate ligaments (anterior, media., posterior, and cranial). However, it covers hip dysplasia after 14 days, along with other illnesses.
- Healthy Paws subjects hip dysplasia to a 12-month waiting period for pets under six years old and does not cover it at all for pets who are older at time of enrollment. All other illnesses or conditions (including accidents) have a 15-day waiting period.
Is There Any Way to Get Around the Waiting Period?
Some policies’ waiting periods can be shortened. Figo’s five days for accidents and 14 days for illnesses can be waived if you purchased your policy using a Veterinary, Shelter, or Humane Society partner code, plus got your pet a wellness exam within 48 hours before purchase.
Figo’s 6-month exclusion on cruciate and patella issues can be removed by getting your pet examined within the first 30 days of the policy and if the medical record reports no pre-existing conditions being found in the knees.
Embrace’s single comprehensive plan can reduce its 6-month waiting period to 14 days for conditions such as dysplasia, luxation, disk disease, and cruciate tears by having your vet follow the company’s ‘Orthopedic Exam and Waiver Process.’
There are two options remove the waiting period almost entirely.
One is to take out a PetFirst policy called FirstCoverage that covers low veterinary bills resulting from an accident or illness, up to $1,000 per year ($500 per incident/condition) after just 48 hours. However, if you want to change to more robust coverage later, you will have pre-existing conditions to deal with.
The second option is to turn to Pet Assure, a quick-enroll discount program that – for about $10 per month – pays 25% of an in-network vet’s invoice for all medical conditions, no exceptions, no deductibles, no waiting periods. The downside is that you will have to settle for paying 75% on those conditions going forward since most insurance companies will consider them pre-existing.