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HealthyAssurance by petMD

Healthy Assurance's mission is simple: To provide pet owners with unbiased, reliable, helpful, and timely information on pet insurance from a veterinarian’s perspective. And what better veterinarian to write this blog than Dr. Kenney, a small animal practioner and author of Your Guide to Understanding Pet Health Insurance

Why Coverage For Chronic Illnesses is Also a Big Deal

Chronic conditions are diseases that cannot be cured, but may be treated and controlled so that your pet may live several more years with minimal symptoms and a good quality of life. It is important to select a policy with adequate coverage for chronic conditions when purchasing pet insurance.

Virtually all dogs and cats, if they live long enough, will eventually develop an ongoing condition requiring monitoring and treatment for the rest of the pet’s life. Such conditions include, but are not limited to, diabetes, heart failure, kidney failure, Cushings disease, arthritis, hypo- or hyperthyroidism, and cancer.

Some companies will cover a disease in the year it is first diagnosed and treated, but not in succeeding years because the policy is renewable annually and the disease is considered "preexisting" in succeeding years. These companies may offer coverage for chronic, on-going conditions as an add-on rider to their base policy for an additional premium. Other companies, meanwhile, will cover a chronic disease in succeeding years until you use up the per-incident limit for that disease. And still others will cover chronic conditions in succeeding years up to their annual maximum, and then allow you to renew the coverage every year. This is preferable.

With a chronic disease such as diabetes, once the initial diagnostic workup is done and the problem is diagnosed, medication is prescribed and response to treatment is monitored via frequent testing until the disease is under control. If all goes well, rechecks and monitoring are generally required less frequently.

Every case is different, however. I’ve seen some diabetics go 2 or 3 years symptom free with good control of their blood sugar and virtually no change in the insulin dose. A case like this may only require a recheck and blood tests every 6 months. In contrast, whenever symptoms recur and the insulin dose needs to be changed, it may require frequent rechecks until the dog or cat is "re-regulated." Dogs or cats with heart or kidney failure may have crisis situations that require hospitalization and treatment until they are compensated again.

So, monitoring and treatment of a chronic disease in the succeeding years after initial diagnosis can add up to a significant outlay of money. In fact, annual expenses for just one chronic condition can range from several hundred dollars to several thousand dollars. This is especially concerning since it isn’t unusual for an older pet to have 2 or 3 chronic diseases at the same time. Therefore, if you were to purchase a policy that did not cover chronic conditions or had very limited coverage and your pet got sick with a chronic illness just before the policy term ended, you wouldn’t get much benefit from the expenses incurred in treating the condition.

When doing your research, ask about any limits on what a company will pay in succeeding years for chronic diseases, and if there are any chronic diseases that are excluded. Is the level of coverage adequate? If this coverage costs extra, how does the level of coverage and extra premium compare to a company that includes coverage for chronic conditions in their base policy?

Dr. Doug Kenney


Pet of the day: Tortie by Paul Long

Arthritic cat in front of computer

Comments  3

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  • Good Info
    06/02/2011 06:40am

    Thanks for an excellent post, Dr. Kenney,

    It wouldn't have occurred to me that, after paying premiums for years, insurance for an ongoing condition would, in effect, be cancelled when the policy is up for annual renewal.

    It would be frustrating to be in the middle of chemo or diabetes treatment and all of a sudden, no longer have coverage.

    My critters go to the doctor 2 to 3 times a month for ongoing conditions even when they're not in crisis - I'm trying to avert a crisis! I do my own BG curves about once a month which is much more inexpensive and more accurate, but it's still expensive.

    Sounds like most policies wouldn't cover that if the critter is considered "stable".

  • 06/02/2011 11:40pm

    Higher premiums for chronic illnesses may not be obvious. In addition to your questions above, I would encourage everyone to ask how often, how much, and on what basis do annual premiums increase. I believe the company I have calculates increases on the age of the pet (e.g. every policy increases every year) and some risk factor (i.e. my pet has multiple claims every year so it is very likely I will file claims during the next policy year; therefore, my premiums increase.) Because most of my claims are chronic illness related, I'm ultimately paying a higher premium because of the chronic illness even if the policy is not explicitly written that way.

    I adopted my dog when he was 2 from a local animal shelter. The staff impressed on us that most shelter dogs are brought in as strays and we should be sure our house/yard is secure. I got insurance because I was concerned my dog would take off, get hit by a car, and require expensive care before I was bonded enough to feel o.k. about a large bill. My plan was to cancel the insurance after the first year when I thought the accident risk would be less.

    Well, he was diagnosed with a chronic illness within the first six months. After a few years, he reached the life time maximum for that illness category. I was tempted to cancel the insurance when the max was reached. However, I had received more than I had paid so I kept the policy figuring that even without another claim I would break even by the end of my dog's life. I did not expect that the premiums would increase so much every year. I’m not sure now that I will break even unless my dog gets another expensive illness. Obviously, not something I would wish on my dog just to make my insurance gamble pay off.

  • 06/03/2011 08:03am


    There are 3 reasons that I'm aware of for premiums to increase:

    1) Age
    2) Inflation
    3) Claim experience

    The first two you can't really do anything about, but you can search for a company that doesn't raise premiums based on claim experience. Some companies have written guidelines on the number of claims submitted in a policy year that automatically triggers a certain percent increase in your premium. The higher the number of claims - the higher the percentage of increase in premiums. So, be sure to ask about this. Not every company does this.

    The second issue that you shared is that you reached your category maximum and the chronic illness was no longer eligible for reimbursement. The same could be said for those policies with a per-incident (per disease) maximum. The way to avoid this is to buy a policy without such restrictions.


About Healthy Assurance

  • Dr Kenney, DVM
    Lisa Radosta, DVM, DACVB

    Doug Kenney practices small animal medicine and surgery at Houston Levee Animal Hospital in Cordova, Tennessee. He has a special interest in wellness care...

    Extended Bio