Does pet insurance cover surgery?

What surgeries are covered by pet insurance?

Pet insurance typically covers surgeries due to accidents, illnesses and emergencies. Common covered procedures include repairing broken bones and tumor removal. Insurance also typically covers gastrointestinal obstructions caused when pets swallow items like toys or bones.

Elective procedures like spaying or neutering aren’t typically included in standard coverage but may be covered through wellness plans or preventive care add-ons.

What surgeries aren’t covered by pet insurance?

Most pet insurance doesn’t cover elective or cosmetic surgeries. These procedures aren’t medically necessary and are often done for non-health-related reasons. Examples of these types of surgeries include tail docking, ear cropping and declawing.

Pet insurance often excludes surgeries related to breeding — for example, C-sections aren’t covered.

It’s also important to note that surgeries related to preexisting conditions — illnesses or injuries that occurred before your pet’s policy began — typically aren’t covered. Some providers, however, offer coverage for curable preexisting conditions after a symptom-free waiting period.

How pet insurance decides surgery coverage

Pet insurance companies decide whether your pet’s surgery is covered based on factors like policy type and whether the condition is considered preexisting. Here are some other factors that can affect coverage:

Policy type

The type of pet insurance policy you choose determines whether your pet’s surgery is covered. For example, Embrace Pet Insurance covers surgeries related to accidents and illnesses but requires an additional wellness add-on for preventive surgeries like spayings, neuterings and routine dental cleanings. Similarly, Lemonade typically covers surgery for accidents and illnesses, but elective procedures may require additional coverage.

Preexisting conditions

Whether surgery is covered or not often depends on whether the condition is classified as preexisting. Preexisting conditions are generally excluded, but some insurers, like ASPCA Pet Health Insurance, make exceptions for curable conditions. For example, if your pet has been symptom-free and hasn’t required treatment for 180 days, the condition may no longer be classified as preexisting and could be eligible for coverage.

AKC Pet Insurance provides similar coverage after a specific waiting period with select plans. Be sure to review policy details for exact timing.

Breed-specific factors

Certain breeds are more prone to hereditary or genetic conditions that may require surgery. For example, dachshunds are at higher risk for intervertebral disc disease (IVDD), which may require costly spinal surgery. Embrace Pet Insurance does provide some protections for hereditary conditions, but coverage depends on your pet’s breed and age. Confirm these specifics in your policy to avoid gaps in coverage.

Customizing your policy

How you customize your policy through optional add-ons can significantly impact surgery coverage. Adding a wellness plan or other optional coverage can help fill gaps for elective or preventive procedures. Review your policy carefully to confirm what surgeries are covered and ensure the plan aligns with your pet's specific needs and circumstances.

How much does surgery cost without pet insurance?

Surgery for your pet can be expensive, with costs ranging from $500 to over $7,000, depending on the type and complexity of the procedure. To give you an idea of the price of specific surgeries, here’s a cost breakdown using figures provided by Lemonade:

As you can see, the cost of surgery can add up quickly, and there are other costs to consider, like follow-up visits, medications or supplies your pet may need to recover from a procedure.

How Location Impacts Surgery Costs and Premiums

Your geographic location can significantly impact both the cost of surgery and your pet insurance premiums. Veterinary care, including surgery, tends to be more expensive in urban areas, while costs may be lower in rural locations. When reviewing pet insurance policies, keep in mind how your location may influence the cost of both premiums and potential surgeries.

How to choose the right pet insurance for surgery coverage

To find pet insurance that covers surgeries, check for add-ons that cover preventive care and evaluate costs, like premiums and deductibles. Here are the main factors to consider when trying to find the right policy for your pet:

• Compare plans for accidents and illnesses vs. wellness add-ons: Some policies cover only accidents, while others include illnesses and elective procedures with add-ons. Ensure the plan aligns with your pet’s risk factors when it comes to surgical needs.
• Review exclusions: Check for exclusions related to elective surgeries, preexisting conditions and hereditary diseases.
• Understand reimbursement percentages and deductibles: Most plans reimburse between 70% and 90% of covered costs. Balance reimbursement rates with deductibles and premiums to find the best option.
• Consult your vet: Your veterinarian can help identify potential surgical risks for your pet and recommend policies that cover those needs.

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