Pet insurance may be more useful when purchased before an animal develops symptoms, because insurers typically treat illnesses or injuries that appear before a policy takes effect as pre-existing conditions and exclude related care from coverage.
That exclusion can extend beyond an initial diagnosis. Dr. Michael Goldstein, medical director at Billerica Veterinary Hospital and Thrive Pet Healthcare, describes how an earlier skin “hotspot” and a later ear infection might both be linked to allergies. An insurer could regard those claims as related to a condition that existed before coverage began.
Dr. Rebecca Greenstein, chief veterinarian at Kleinburg Veterinary Hospital and a veterinary expert for Rover.com, says she is seeing more claims denied on pre-existing-condition grounds. She cautions that exclusions can leave owners paying for a policy that does not cover the treatment they need.
The cost of coverage is another consideration. Accident-and-illness plans average $836 a year for dogs and $435 for cats, according to the North American Pet Health Insurance Association. Whether premiums pay off is uncertain, but veterinary expenses for chronic conditions can accumulate. The source cites annual treatment costs exceeding $1,200 for chronic kidney disease in cats, while hip surgery for a dog with hip dysplasia can cost as much as $10,000, depending on the procedure.
Some policies cover hip dysplasia treatment if it is not pre-existing, but orthopedic coverage may have a waiting period of six to 12 months. Symptoms that emerge during that period could lead the insurer to classify the condition as pre-existing.
For owners seeking a lower-cost option, accident-only plans average about $190 a year for dogs and $112 for cats, according to NAPHIA. They cover injuries from accidents, including swallowed objects or toxins, but do not cover illnesses. Lemonade said more than 60% of its pet insurance claims over the past year were for illnesses; Nationwide data also showed chronic diseases accounted for a clear majority of its pet claims in 2025.
Owners who choose accident-only coverage or go without insurance can set aside savings for unexpected veterinary bills. Greenstein says insurance can help owners choose treatment without having to base a life-or-death decision solely on what they can afford.
Sources: NerdWallet.