Data accessed: September 5, 2026 · Editorial Policy

Pet Insurance Fine Print Index 2026

This index compares 16 policy terms across 13 US pet insurance companies: waiting periods, bilateral exclusion clauses, curable pre-existing windows, enrollment age limits, exam-fee rules, and what the base plan covers. Every cell links to the insurer's own website, help center, or sample policy document, accessed on September 5, 2026. Pet insurance terms vary by state and by the specific plan you choose, so treat every figure here as a starting point for your own quote, not a substitute for reading your policy certificate. This page sits alongside our full pet insurance comparison hub.

Key findings

Bilateral condition clauses are close to universal: 11 of the 13 insurers in this index confirm that a condition on one side of a paired body part, most often the cruciate ligament, hip, elbow, or kneecap, makes the same condition on the other side pre-existing, even if it first appears after enrollment.
Most insurers offer a path back to coverage: 10 of the 13 confirm an exception for curable pre-existing conditions, and 9 of those state the symptom-free window, most commonly 180 days or 12 months. Odie states that no such exception exists, and Trupanion decides case by case. Nearly all of the 9 exclude ligament, knee, and chronic conditions from the exception.
Orthopedic conditions get a longer clock: 8 of the 12 insurers whose policies state both figures set a longer waiting period for orthopedic or cruciate conditions than for ordinary illness claims; the other 4 apply the same waiting period to both.
That longer clock can sometimes be shortened: 7 of the 13 insurers confirm that the orthopedic waiting period can be waived, typically by having a veterinarian examine the pet shortly after enrollment and confirm no pre-existing signs.
Direct payment to the vet is rare: only 2 of the 13 insurers, Trupanion and Pumpkin, confirm they can pay the veterinarian directly, and one more, Odie, confirms it can do so only where it already has a payment arrangement with that specific clinic. The remaining 10 operate on a reimbursement model.
Exam fee coverage splits three ways: 6 of the 13 insurers include exam fees in the base plan, 5 offer them only as an optional add-on, and 2, Healthy Paws and Trupanion, do not cover them at all.
Dental illness coverage is close to standard: 11 of the 12 insurers whose policy states it cover non-routine dental illness under at least some conditions, and Lemonade does so only through a paid add-on. Nationwide is the one insurer in this index whose cell is classified as an exclusion, though its own Modular Plan covers dental disease if signs first appear after the waiting period.
Eight weeks is the most common minimum enrollment age, stated by 7 of the 12 insurers whose policy gives one; Odie and Pets Best accept 7 weeks, Embrace and Fetch accept 6 weeks, and Nationwide depends on the plan.

For the fuller definition of a pre-existing condition and how look-back periods work, see our Pre-Existing Conditions guide.

Waiting periods

A waiting period is the number of days after a policy starts before a claim in that category becomes eligible. Orthopedic and cruciate conditions frequently carry a separate, longer clock than ordinary accidents and illnesses. For a plain-language walkthrough of how these periods work, see our Waiting Periods Explained.

Waiting periods by insurer
Insurer	Accident waiting period	Illness waiting period	Orthopedic/cruciate waiting period	Orthopedic waiver available
Lemonade Pet	0 days ¹	14 days ¹	30 days ¹	Not stated
Healthy Paws	Not stated	15 days after policy effective date ²	Hip dysplasia: 12 months (pets enrolled at age 5 or below); 15 days for other orthopedic/illness/injury conditions not from accident in listed states, 30 days for hip dysplasia in those states ²	yes, waived upon completion of a complete clinical examination (stated for CA/DE/FL/HI/LA/MD/ME/MS/MT/NE/NH/OH/PA/RI/VT/WA) ²
Odie Pet Insurance	0 days: CA, DE, LA, MD, ME, MS, NE, NH, OH, PA, WA, and MT. 3 days: ND, OR, VT, and all remaining states. ^3†	14 days (all states, Trisura Unexpected Illness & Injury plan) ³	30 days (most states); 120 days in VT; 6 months in remaining states, for Cruciate Ligament Events (CLE) ³	Not stated
Trupanion	5 days ⁴	30 days ⁴	30 days (same as illness; no separate orthopedic waiting period) ⁴	not applicable - no separate orthopedic waiting period exists to waive ⁴
Embrace Pet Insurance	Not stated	14 days ⁵	Orthopedic waiting periods vary by state (see Embrace's state-specific waiting periods page); the official help article does not state a universal '6 months' duration. It separately notes a 180-day symptom exclusion for IVDD, cruciate ligament injury, patellar luxation, and hip dysplasia in dogs. ⁶	yes, via Orthopedic Exam and Waiver Process, reducible to as few as 14 days ⁶
Pets Best	3 days ⁷	14 days ⁷	6 months (for Cruciate Ligament Events, per this sample national policy form) ⁷	yes, via a vet Health Assessment Exam within a set window, submitted within 30 days ⁸
Figo Pet Insurance	1 day (national standard); 5 days in California ⁹	14 days (national); 14 days confirmed in California disclosure too ¹⁰	6 months for dogs (from Original Start Date) ⁹	yes, via Orthopedic Waiver Form completed by a vet and submitted within 30 days of the policy effective date ⁹
Fetch Pet Insurance	0 days ¹¹	15 days ¹¹	180 days ¹¹	yes, for knee conditions only, via vet exam within 180 days confirming no pre-existing knee condition ¹¹
ASPCA Pet Health Insurance	14 days ¹²	14 days ¹²	14 days on current policy forms (12 months on older BAS-series forms in some states) ¹³	Not stated
Spot Pet Insurance	14 days ¹⁴	14 days ¹⁴	14 days (same as illness; policy uses the term "ligament and knee conditions", treated as illness) ^14†	yes, via a Waiting Period Health Assessment exam completed within 3 days before to 7 days after the policy effective date, form submitted within 30 days ¹⁵
Pumpkin Pet Insurance	14 days ¹⁶	14 days ¹⁶	14 days (same as accident/illness; policy groups it under "ligament and knee conditions", not a separately named "orthopedic" category) ¹⁶	yes, in states offering the endorsement (e.g. Washington), if a vet exam occurs 3 days before to 7 days after the policy effective date and the Waiting Period Assessment Form is submitted within 30 days ¹⁷
MetLife Pet Insurance	0 days ¹⁸	14 days ¹⁸	no separate period; same as accident/illness (0/14 days) ¹⁸	Not stated
Nationwide Pet Insurance	14 days ¹⁹	14 days ²⁰	12 months for cruciate ligament/meniscal damage (first policy term); hip/elbow dysplasia and related joint conditions are excluded conditions rather than a timed waiting period ²¹	no formal exam-based waiver stated; hip/elbow dysplasia and other 'ineligible conditions' can instead be added via optional Hereditary & Congenital rider ²⁰

Pre-existing condition rules

A pre-existing condition is any illness or injury that showed signs before coverage started or during the waiting period. Two rules decide how strictly that gets applied: whether a condition on one side of a paired body part is treated as pre-existing on the other side, and whether a cured, symptom-free condition can eventually be reclassified as coverable. For the full definition and how look-back periods work, see our Pre-Existing Conditions guide.

Pre-existing condition rules by insurer
Insurer	Bilateral condition clause	Curable pre-existing symptom-free window
Lemonade Pet	yes: bilateral exclusion ²²	yes, 12 months symptom-free (excludes knee/ligament and chronic conditions) ²³
Healthy Paws	yes: bilateral exclusion, but only for cruciate ligament conditions ²	yes, 365 days (12 months) continuously symptom-free and untreated ²
Odie Pet Insurance	yes: if a bilateral condition (incl. cruciate ligament events, hip/elbow dysplasia, luxating patellas) occurred on either side pre-enrollment or during the waiting period, the condition on the other side is also deemed pre-existing ²⁴	no - pre-existing conditions are excluded for the lifetime of the policy; no symptom-free reclassification window is stated ³
Trupanion	yes: for cruciate conditions, the opposite (or same) leg is treated as pre-existing if signs occurred within 18 months before the policy effective date ²⁵	no defined general symptom-free window; eligibility is determined case-by-case via a 'medical disconnect' review (18-month lookback specifically for cruciate conditions) ²⁶
Embrace Pet Insurance	yes: bilateral exclusion if first side occurred before/during initial waiting window ²⁷	yes, 12 consecutive months symptom-free and treatment-free ²⁷
Pets Best	yes: bilateral exclusion applies (includes cruciate ligament events, hip dysplasia, elbow dysplasia, luxating patella, and others) ⁷	yes, once healed/cured - but the official page does not state a specific symptom-free day count ²⁸
Figo Pet Insurance	Not stated	yes, 12 months symptom/treatment-free; does not apply to ligament and knee conditions ⁹
Fetch Pet Insurance	yes: bilateral orthopedic exclusion ¹¹	yes, 365 days (12 months) symptom-free ¹¹
ASPCA Pet Health Insurance	yes: bilateral exclusion for ligament/knee conditions ¹³	yes, 180 days symptom-free (except ligament/knee conditions) ¹³
Spot Pet Insurance	yes: bilateral exclusion for ligament/knee conditions ¹⁴	yes, 180 days symptom-free (does not apply to chronic conditions or ligament/knee conditions) ¹⁴
Pumpkin Pet Insurance	yes: ligament and knee conditions are treated as bilateral - an occurrence on one side is treated as affecting both sides ¹⁶	yes, 180 days symptom-free and treatment-free makes it a new occurrence; this exception does not apply to ligament and knee conditions ¹⁶
MetLife Pet Insurance	yes: bilateral exclusion - other side can be classed pre-existing ²⁹	yes, if treatment-free and unrelated to prior incident (no specific day/month figure officially stated) ^30†
Nationwide Pet Insurance	Not stated	yes, cured and treatment-free for at least 6 months (with supporting vet medical records) ³¹

Eligibility and plan structure

Enrollment ages, annual payout limits, deductible structure, and reimbursement percentage together set both the price and the ceiling of a policy. These figures reflect each insurer's flagship or most commonly cited plan; several insurers sell more than one plan tier with different numbers.

Eligibility and plan structure by insurer
Insurer	Minimum enrollment age	Maximum enrollment age	Annual limit options	Deductible type/amount	Reimbursement percentage options
Lemonade Pet	8 weeks ³²	Not stated	$5,000 to $100,000 ³³	annual: $100 / $250 / $500 / $750 ³⁴	70% / 80% / 90% ³³
Healthy Paws	8 weeks ³⁵	Not stated	unlimited (no per-incident, annual, or lifetime caps) ²	annual (specific dollar options not stated in official pages found) ²	up to 90% (specific tier list e.g. 70/80/90% not stated in official pages found) ³⁵
Odie Pet Insurance	7 weeks ³	no upper age limit (current Trisura-underwritten plans) ³	$10,000 to $40,000 (Illness & Injury plan); $10,000 fixed (Accident Only plan) ³	annual: $100–$1,000 (Illness & Injury plan); $250 fixed (Accident Only plan) ³	70% or 90% (Illness & Injury); 90% fixed (Accident Only) ³
Trupanion	Not stated	14 years ³⁶	no annual limit (unlimited payouts for the life of the pet) ³⁷	Not stated	member selects a payout percentage at signup (changeable up or down in first 30 days, only decreasable after); exact percentage tiers not specified on the fetched official pages ³⁸
Embrace Pet Insurance	6 weeks ³⁹	14 years for accident & illness coverage; 15+ accident-only coverage available, no upper age limit for continuing coverage ³⁹	customer-selected annual maximum (no fixed tiered list stated on this page) ⁴⁰	annual (paid once per policy year, not per-condition or per-incident); accident-only plan has a $100 annual deductible ⁴⁰	customer-selected, typically 70-90% ⁴⁰
Pets Best	7 weeks ⁴¹	no upper age limit ⁴¹	$2,500 / $5,000 / $10,000 / no annual limit ⁷	annual: $50–$1,000 ⁷	70/80/90% ⁷
Figo Pet Insurance	8 weeks ⁴²	no upper age limit ⁴²	$5,000 / $10,000 / Unlimited ⁴³	annual deductible: $100-$750 ⁴³	70% / 80% / 90% / 100% ⁴⁴
Fetch Pet Insurance	6 weeks ¹¹	Not stated	$5,000 / $10,000 / $15,000 ⁴⁵	annual (per policy period): $250-$2,500 ⁴⁶	70% / 80% / 90% ⁴⁷
ASPCA Pet Health Insurance	8 weeks ⁴⁸	no upper age limit ⁴⁸	not stated as a fixed list (customizable; illustrative example uses $3,000) ⁴⁹	annual: $100 / $250 / $500 ¹²	70% / 80% / 90% ¹²
Spot Pet Insurance	8 weeks ⁵⁰	no upper age limit ⁵⁰	$2,500 / $3,000 / $4,000 / $5,000 / $7,000 / $10,000 / unlimited ⁵¹	annual: $100 / $250 / $500 / $750 / $1,000 ⁵²	70% / 80% / 90% ⁵¹
Pumpkin Pet Insurance	8 weeks ⁵³	no upper age limit ⁵³	$5,000 up to unlimited ⁵³	annual (specific dollar amount options are set on the individual declarations page; the exact list of dollar figures could not be confirmed on the official pages/PDF checked) ¹⁶	90% confirmed as an available option on an official page; the full set of tiers (commonly reported elsewhere as 70/80/90%) could not be confirmed with an official quote ⁵³
MetLife Pet Insurance	8 weeks ⁵⁴	no upper age limit ⁵⁵	$2,000 / $5,000 / $10,000 (up to unlimited on some plans) ⁵⁶	annual: $250-$2,500 (as low as $0 via claim-history reduction) ⁵⁷	up to 90% (80% shown as standard rate on plan pages) ⁵⁷
Nationwide Pet Insurance	8 weeks (Modular Plan); 6 weeks (Major Medical) ⁵⁸	varies by plan: 8 years and younger for new Illness coverage (Modular Plan); 9 years and younger (Major Medical) ⁵⁸	varies by plan: $2,500 to $10,000 (Modular Plan), $5,000 (My Pet Protection Choice), $7,500 (My Pet Protection), $10,000 (Whole Pet); Major Medical uses defined per-condition benefit schedules instead of one annual limit ⁵⁸	annual deductible: $100-$1,000 (My Pet Protection Choice); $250 fixed on most other plans (Modular, My Pet Protection, Major Medical, Whole Pet) ⁵⁸	50%, 70%, or 80% ⁵⁸

What the base plan covers

Exam fees, dental illness, prescription food, and behavioral therapy are the four coverage points that most often move between "included," "optional add-on," and "not covered" from one insurer to the next.

What the base plan covers, by insurer
Insurer	Exam fees covered	Direct vet pay	Dental illness covered	Prescription food covered	Behavioral therapy covered
Lemonade Pet	optional add-on (vet visit fee add-on) ⁵⁹	no, reimbursement only ²³	yes, via Dental Illness / Dental Care add-on (not base policy) ⁵⁹	no ⁵⁹	optional add-on (behavioral conditions add-on) ⁵⁹
Healthy Paws	no ⁶⁰	no, reimbursement only by default; direct payment to vet available only by special advance request and vet cooperation, not at checkout ²	yes with conditions (non-routine dental illness and injury covered; routine dental disease/preventive-care-related periodontal disease excluded) ⁶¹	Not stated	no ⁶⁰
Odie Pet Insurance	optional add-on: Office Visits/Exam Fee coverage is a Supplemental Benefit available for additional premium, not automatically included ²⁴	conditional: reimbursement is the default model, but claims can be paid directly to the vet if Odie has an arrangement with that specific clinic ²⁴	yes with conditions: periodontal disease and traumatic dental fractures covered if eligibility requirements (age-based cleaning/exam history, no pre-existing signs) are met ³	no under the Illness & Injury policy; reimbursed only under the separate optional Wellness Plan add-on (Purina products, up to $50/year) ³	yes, included under the Illness & Injury policy (not a separate add-on) ³
Trupanion	no ⁶²	yes, at participating (VetDirect Pay-enabled) hospitals ⁶³	yes, with conditions (annual dental exam and recommended dental care compliance required) ⁶⁴	yes, for eligible conditions: 50% of cost for up to 60 days, no added premium ⁶⁵	optional add-on: Recovery & Complementary Care rider, 90% reimbursement ^66†
Embrace Pet Insurance	optional add-on, not included on all policies ⁴⁰	no, reimbursement only ⁶⁷	Yes - dental illness (periodontal disease, abscessed teeth, malocclusions, gingivitis, etc.) is covered under the base accident & illness plan, up to $1,000 per policy term; only preventative dental cleanings require the optional wellness plan ⁶⁸	covered under optional Wellness Care Plan add-on, not the base plan ⁴⁰	yes, when administered by a licensed veterinarian for a covered condition ⁴⁰
Pets Best	optional add-on (Supplemental Benefit); included on most plans but removable ⁶⁹	no, reimbursement-only (Vet Direct Pay routes the post-claim reimbursement to the vet, it is not point-of-service payment) ⁷⁰	yes with conditions (periodontal disease covered subject to age-based cleaning/exam requirements) ⁷	no (pet foods are a listed exclusion; no prescription/therapeutic-diet carve-out found in official sources) ⁷	no for training/treatment; optional add-on covers consultations and prescription medications only ⁷
Figo Pet Insurance	optional add-on (Office Visit and Exam Fees Rider) ⁹	no, reimbursement only ⁴²	yes, with conditions (must follow vet's dental-care advice; pre-existing dental disease and routine cleaning/prophylaxis excluded) ⁹	optional add-on only, included with Office Visit and Exam Fees Rider, up to $250 per policy term ⁹	optional add-on, up to $500 annually for diagnosis/treatment consultations ⁹
Fetch Pet Insurance	yes, included ⁷¹	no, reimbursement only ⁷²	yes ⁷³	no ⁷⁴	yes, up to $1,000/year, included at no extra charge ⁷⁵
ASPCA Pet Health Insurance	yes, included ¹²	No, reimbursement-based model - the pet owner typically pays the vet at time of service and is reimbursed after filing a claim; a reimbursement check can optionally be routed to the vet practice, but only post-claim-approval, not at checkout. ⁷⁶	yes ⁷⁷	yes for covered conditions ⁷⁷	yes ⁷⁷
Spot Pet Insurance	yes, included in base plan ¹⁴	no, reimbursement-based (policyholder is financially responsible to the vet; direct vet payment only possible post-claim if requested on the claim form) ¹⁴	yes, dental illness treatment is covered - periodontal disease treatment, tooth root abscesses, and oral tumors are listed as typically covered under Spot's accident & illness plan; cosmetic/orthodontic dental work, routine cleanings, and preventive dental exams/X-rays are excluded unless an optional wellness add-on is purchased. ⁷⁸	yes, for treatment of a covered condition only (not for general maintenance/prevention) ¹⁴	yes, if performed or referred by a veterinarian to a qualified behaviorist ¹⁴
Pumpkin Pet Insurance	yes, included (no separate add-on) - vet examinations/consultations are eligible covered expenses ¹⁶	yes, if indicated on the claim form, Pumpkin can pay the veterinarian directly ¹⁶	yes with conditions - dental illness treatment (e.g. tooth extractions) is covered under illness benefits, but aesthetic/cosmetic/endodontic/orthodontic dental services (caps, crowns, fillings, implants, root canals, planing) and routine cleanings (unless treating a covered illness) are excluded ^16†	yes, for treatment of a covered condition only - not for general health maintenance or prevention ¹⁶	yes, when performed by a veterinarian or via written vet referral to a qualified animal behaviorist ¹⁶
MetLife Pet Insurance	yes, included ⁵⁷	no, reimbursement only ⁵⁷	yes ⁵⁵	yes for covered conditions, vet-prescribed only ⁷⁹	optional add-on (Preventive Care) for behavior training; vet-directed behavioral treatment for a diagnosed condition may be covered under standard plan ⁵⁵
Nationwide Pet Insurance	yes, included ⁸⁰	no, reimbursement only ⁸¹	no (permanently excluded) on Major Medical, Injury, Feline Select, and Whole Pet plans; on the Modular Plan, dental disease/periodontitis is covered if signs first appear after the waiting period ²¹	yes, under certain plan types or via optional rider ⁸¹	yes, if medically necessary and prescribed by a veterinarian (optional Behavioral coverage on the Modular Plan); pet obedience training and non-medically-necessary behavioral training are excluded; other plans (Major Medical, Injury, Feline Select) exclude behavioral diagnosis/treatment/therapy entirely ²¹

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How to read this table

A numbered superscript links to the matching entry in the Sources list below; follow it to the insurer's own page or policy document that states the value. A dagger (†) next to a number means the value was found on the insurer's own page but has not yet been independently re-checked in a second verification pass. "Not stated" means the insurer's public website, help center, and sample policy documents do not address that specific field; it is not a claim that no such term exists in your state's policy, only that we could not locate an official statement of it.

State and plan variations

The tables above show each insurer's flagship or most commonly cited plan. Several insurers flag their own state-by-state or plan-by-plan differences in the documents we reviewed.

Lemonade. Lemonade's own documentation notes several state-by-state differences: the claim filing window is 180 days in most states but only 90 days in Texas, its Dental Care add-on and Preventative+ dental options vary by state, its end-of-life add-on waiting period varies by state, and preventative care package availability and benefits vary by state.

Healthy Paws. Healthy Paws describes its own state-dependent variation as significant, particularly around which states qualify for the orthopedic waiting-period waiver shown in the table above; its public FAQ does not itemize every state-level difference beyond that list.

Pets Best. The figures shown here for Pets Best come from a generic national sample policy form, so a state-specific policy form you are actually issued may set different terms.

Figo. Figo confirms a concrete state variation: its accident waiting period is 5 days in California versus 1 day under its national policy.

Fetch. Fetch maintains separate state-specific policy forms for California, Alaska, and Arkansas; the figures in this index come from its generic national sample form.

ASPCA. ASPCA's own California residents' notice describes a state-specific difference between its current BAS-series and PET-P policy forms.

Pumpkin. Pumpkin's figures come from a generic national sample policy, and the orthopedic waiver process shown in the table is confirmed only for Washington through the company's own state notice page, so its availability elsewhere is not confirmed.

MetLife. MetLife's publicly posted sample policy is Ohio-specific, and the company's own pages show deductible and annual-limit figures that vary slightly from page to page.

Nationwide. Nationwide sells seven distinct plan structures; the figures in this index default to its flagship Modular Plan where possible, so a different Nationwide plan may set different terms.

Methodology

Sources for this index are limited to each insurer's own website, help center, and publicly posted sample policy documents; no third-party comparison sites, forums, or review aggregators were used as a source for any cell. Every value was accessed on September 5, 2026, and checked in two independent passes before publication. Where an insurer's live site blocked automated access, an archived copy from the Wayback Machine was used instead and is labeled as such in the Sources list below.

This index is a reference for comparing published policy language. It is not legal or insurance advice, and it does not replace reading your own policy certificate before you buy. Pet insurance terms frequently vary by state and by the specific plan you select, so treat every figure here as a starting point for your own quote. We review this index quarterly and update it when an insurer changes its public policy language.

Download the dataset (JSON), which includes every quoted excerpt and citation behind the tables above.

Sources

Pet Insurance Waiting Period Guide • Lemonade: https://www.lemonade.com/pet/explained/waiting-periods/
Frequently Asked Questions | Healthy Paws (archived copy of www.healthypawspetinsurance.com): http://web.archive.org/web/20260613092710/https://www.healthypawspetinsurance.com/frequent-questions.html
Help Center - Comprehensive Pet Insurance and Wellness Plans | Get Odie: https://getodie.com/help-center/
When does my coverage start? | Trupanion Pet Medical Insurance: https://www.trupanion.com/pet-insurance-faq/article/when-does-my-coverage-begin
What Waiting Periods Does Embrace Have? | Embrace Pet Insurance Help Center: https://www.embracepetinsurance.com/help/article/what-waiting-periods-does-embrace-have
What Is the Waiting Period for Orthopedic Conditions? | Embrace Pet Insurance Help Center: https://www.embracepetinsurance.com/help/article/what-is-the-waiting-period-for-orthopedic-conditions
Pets Best Pet Health Insurance Policy - Accident & Illness (Sample), APIC-PBI0001-ILL (12/2015): https://www.petsbest.com/download.ashx?file=Policies%2FPOL_APIC_1_PETS_PolicyBookletAnnualIllness_Sample_v1.pdf
Waiting Period Health Assessment Form (03/2025): https://www.petsbest.com/download.ashx?file=misc%2FPets_Best_Waived_Waiting_Periods_Form.pdf
Figo Sample Policy - Dog (08/01/2023): https://assets.ctfassets.net/wcjeikrx8553/2D7uiYmiwcmvk6PlNsHptw/dda1584912b94bd24f0d8467abc69d46/Figo_Sample_Policy_-_Dog_-_08012023.pdf
California Insurer Disclosure of Important Policy Provisions | Figo Pet Insurance: https://figopetinsurance.com/california-insurer-disclosure-of-important-policy-provisions
Pet Health Insurance Policy Terms and Conditions, GPTM 050 0125 A (Sample Policy): https://cdn.prod.website-files.com/664b8c1e077f005566b9425c/68add0656ed7a71438bc8baa_GPTM%20050%20(v2)%200125%20A%20-%20Sample%207.24.25.pdf
Compare ASPCA Pet Health Insurance vs. Trupanion: https://www.aspcapetinsurance.com/research-and-compare/compare-plans/competitors/trupanion/
Important Policy Notice to California Residents: https://www.aspcapetinsurance.com/more-info/notice-to-california-residents/
Sample Policy - Spot Pet Insurance (Accident & Illness Policy, PET-P-20000-1024): https://spotpet.com/spot-sample-policy.pdf
Waiting Period Health Assessment Form - Spot Pet Insurance (California): https://spotpet.com/Spot-California-Waiting-Period-Health-Assessment-Form.pdf
Accident and Illness Coverage - Sample Policy (PET-P-20000-0920): https://pumpkin-assets.s3.amazonaws.com/pdfs/Sample_Policy_AccidentIllness.pdf
Notice to Washington Residents | Pumpkin Pet Insurance: https://www.pumpkin.care/legal/notice-to-washington-residents
Get Covered: Pet Insurance With No Waiting Period | MetLife Pet Insurance: https://www.metlifepetinsurance.com/blog/pet-insurance/no-waiting-period/
Accident & Injury Pet Insurance: https://www.petinsurance.com/whats-covered/accident-only-pet-insurance/
Hip Dysplasia Pet Insurance Coverage: https://www.petinsurance.com/whats-covered/hip-dysplasia-pet-insurance/
Nationwide Pet Insurance Plan Restrictions | Excluded Conditions: https://www.petinsurance.com/plan-restrictions/
Pet Health Conditions - Lemonade: https://www.lemonade.com/pet/explained/pet-health-conditions/
The Ultimate Lemonade Pet FAQ • Lemonade Insurance: https://www.lemonade.com/pet/explained/lemonade-pet-insurance-faq/
Odie Pet Insurance Marketing, Inc. - Sample Unexpected Illness and Injuries Policy: https://getodie.com/wp-content/uploads/2021/04/SAMPLE_Odie_Unexpected-Illness-and-Injuries-Policy.pdf
Do we cover cruciate surgeries for pets? | Trupanion: https://www.trupanion.com/pet-insurance-faq/article/cruciate-surgeries
Does Trupanion cover pre-existing conditions? | Trupanion FAQs: https://www.trupanion.com/pet-insurance-faq/article/pre-existing-conditions
Pet Insurance For Pre-Existing Conditions | Embrace Pet Insurance: https://www.embracepetinsurance.com/coverage/pre-ex-conditions
Pet Insurance for Pets with Pre-Existing Conditions | Pets Best: https://www.petsbest.com/coverage/pre-existing-coverage
Bilateral Conditions: Are They Covered? | MetLife Pet Insurance: https://www.metlifepetinsurance.com/blog/pet-insurance/bilateral-conditions/
Pet Insurance & Pre-Existing Conditions | MetLife Pet Insurance: https://www.metlifepetinsurance.com/pre-existing-conditions/
Pet Insurance | What's Not Covered | Pre-Existing Conditions & More: https://www.petinsurance.com/whats-not-covered/
Orthopedic Conditions in Dogs - Lemonade: https://www.lemonade.com/pet/explained/orthopedic-conditions-in-dogs/
Pet Insurance Terms, Explained • Lemonade: https://www.lemonade.com/pet/explained/pet-insurance-terms-explained/
What's a Pet Insurance Deductible? | Lemonade: https://www.lemonade.com/pet/explained/pet-insurance-deductible/
Pet Insurance for Cats | Healthy Paws (archived copy of www.healthypawspetinsurance.com): http://web.archive.org/web/20260613084852/https://www.healthypawspetinsurance.com/cat-insurance.html
Is my pet eligible for pet insurance? | Trupanion: https://www.trupanion.com/pet-insurance-faq/article/is-your-pet-eligible
Pet Insurance Coverage, Redefined | Trupanion: https://www.trupanion.com/pet-insurance
How our payouts work | Trupanion: https://www.trupanion.com/pet-insurance-faq/article/unlimited-payouts-plan
Dog and Puppy Insurance Plans & Coverage | Embrace: https://www.embracepetinsurance.com/dog-insurance
Embrace Pet Insurance Coverage | Frequently Asked Questions: https://www.embracepetinsurance.com/coverage/faq
Frequently Asked Questions | Pets Best Pet Insurance: https://www.petsbest.com/faq
Dog Insurance | Figo Pet Insurance For Dogs And Puppies: https://figopetinsurance.com/dog-insurance
Pet Insurance in Illinois | Figo Pet Insurance: https://figopetinsurance.com/locations-Illinois
Pet Insurance in Florida | FIGO Pet Insurance: https://figopetinsurance.com/locations-florida
Annual coverage limit | Fetch Pet Insurance (archived copy of www.fetchpet.com): https://web.archive.org/web/20251108041300/https://www.fetchpet.com/faqs/annual-coverage-limit
What is a Pet Insurance Deductible? | Fetch® FAQs (archived copy of www.fetchpet.com): https://web.archive.org/web/20251209140419/https://www.fetchpet.com/faqs/what-is-pet-insurance-deductible
Can I Customize My Pet Insurance Plan? | Fetch® FAQs (archived copy of www.fetchpet.com): https://web.archive.org/web/20251116065226/https://www.fetchpet.com/faqs/can-i-customize-my-pet-insurance-plan
The Best Senior Dog Insurance | ASPCA Pet Health Insurance: https://www.aspcapetinsurance.com/senior-dog-insurance/
Dog Insurance Plans | ASPCA Pet Health Insurance: https://www.aspcapetinsurance.com/dog-insurance/
Pet Insurance FAQs: Common Questions Answered | Spot Pet Insurance: https://spotpet.com/commonly-asked-questions
How Annual Limits Work and Why They Matter | Spot Pet Insurance: https://spotpet.com/blog/why-pet-insurance/what-is-an-annual-limit-in-pet-insurance
Pet Insurance Deductibles Explained: Annual vs. Per-Incident in 2025 | Spot Pet Insurance: https://spotpet.com/blog/why-pet-insurance/deductibles-in-pet-insurance
Top-Rated Dog Insurance plans by Pumpkin | Pumpkin Pet Insurance: https://www.pumpkin.care/dog-health-insurance
Puppy Insurance From MetLife Pet | Get Award-Winning Coverage: https://www.metlifepetinsurance.com/dog-insurance/puppy/
Coverage and Exclusions | MetLife Pet Insurance: https://www.metlifepetinsurance.com/coverage-exclusions/
Pet Insurance Plans | MetLife Pet: https://www.metlifepetinsurance.com/plans/
Pet Insurance FAQs | MetLife Pet Insurance: https://www.metlifepetinsurance.com/faqs/
Pet Insurance Plans for Dogs, Cats & Exotic Pets | Nationwide: https://www.petinsurance.com/all-products/
Lemonade's Pet Insurance Add-Ons, Explained • Lemonade: https://www.lemonade.com/pet/explained/lemonade-pet-add-ons/
Pet Insurance Coverage | Healthy Paws Pet Insurance (archived copy of www.healthypawspetinsurance.com): http://web.archive.org/web/20260323175608/https://www.healthypawspetinsurance.com/pet-insurance-coverage-and-exclusions.html
Pet Insurance for Dental | Healthy Paws (archived copy of www.healthypawspetinsurance.com): http://web.archive.org/web/20260713182815/https://www.healthypawspetinsurance.com/pet-insurance-coverage-and-exclusions/dental-health.html
What does a Trupanion pet insurance policy cover? | Trupanion FAQ: https://www.trupanion.com/pet-insurance-faq/article/what-a-trupanion-policy-covers
How we Work with Veterinarians | Trupanion Vet Direct Pay: https://www.trupanion.com/pet-insurance/veterinarians
Dental insurance for pets | Trupanion Coverage: https://www.trupanion.com/pet-insurance-faq/article/dental
Does Trupanion cover prescription pet food? | Trupanion FAQs: https://www.trupanion.com/pet-insurance-faq/article/prescription-pet-foods
Pet insurance recovery & complementary care | Trupanion: https://www.trupanion.com/pet-insurance-faq/article/recovery-complementary-care
What Is the Reimbursement Process for Embrace Claims? | Embrace Pet Insurance Help Center: https://www.embracepetinsurance.com/help/article/what-is-the-reimbursement-process-for-embrace-claims
Embrace Pet Insurance Coverage | Dental Coverage: https://www.embracepetinsurance.com/coverage/dental-coverage
Pet Insurance Plans | Pets Best: https://www.petsbest.com/plans
Vet Direct Pay | Pets Best: https://www.petsbest.com/vet-direct-pay
Pet Insurance Terms, Explained (archived copy of www.fetchpet.com): https://web.archive.org/web/20250917164646/https://www.fetchpet.com/pet-insurance-terms
Pet Insurance Reimbursement | How Does it Work? | Fetch® (archived copy of www.fetchpet.com): https://web.archive.org/web/20251104212815/https://www.fetchpet.com/claims/reimbursement
Pet Dental Insurance for Dogs & Cats | Fetch® Covers Dental (archived copy of www.fetchpet.com): https://web.archive.org/web/20251114140353/https://www.fetchpet.com/pet-insurance/dental-coverage
Does Pet Insurance Cover Prescription Food? | Fetch® FAQs (archived copy of www.fetchpet.com): https://web.archive.org/web/20251205103754/https://www.fetchpet.com/faqs/does-pet-insurance-cover-prescription-food
Does Pet Insurance Cover Anxiety Medication? | Fetch® FAQs (archived copy of www.fetchpet.com): https://web.archive.org/web/20251208152105/https://www.fetchpet.com/faqs/does-pet-insurance-cover-anxiety-medication
Veterinarian FAQs | ASPCA Pet Health Insurance: https://vet.aspcapetinsurance.com/faqs/
What Does Pet Insurance Cover? | ASPCA Pet Health Insurance: https://www.aspcapetinsurance.com/research-and-compare/pet-insurance-basics/whats-covered/
Does Pet Insurance Cover Dental? | Spot Pet Insurance: https://spotpet.com/blog/why-pet-insurance/does-pet-insurance-cover-dental
MetLife Pet Insurance Sample Policy (PET21-01-V, OH): https://www.metlifepetinsurance.com/content/dam/metlifecom/us/MetLife-MetGen-Pet-Insurance-Policy-Sample-1.pdf
America's #1 Emergency Pet Insurance: https://www.petinsurance.com/whats-covered/emergency-pet-insurance/
Nationwide® Pet Insurance FAQ | What's Covered, How it Works & Claims: https://www.petinsurance.com/faq/

Frequently asked questions

What is a bilateral condition clause?

A bilateral condition clause treats a condition affecting paired body parts, most often the cruciate ligament, hip, elbow, or kneecap, as pre-existing on both sides once it shows up on one. Eleven of the 13 insurers in this index confirm a bilateral clause, most commonly for cruciate ligament events, hip and elbow dysplasia, and luxating patellas.

What is a curable pre-existing condition window?

It is the length of time a pet must stay symptom-free and treatment-free after a prior illness or injury before an insurer will stop treating it as pre-existing. Ten of the 13 insurers confirm such an exception, and 9 of those state the window, most commonly 180 days or 12 months. Nearly all of them exclude ligament, knee, and chronic conditions from it.

Why do orthopedic waiting periods differ from illness waiting periods?

Orthopedic and cruciate conditions, such as ligament tears and hip dysplasia, can take longer to reveal a pre-existing history than a typical illness, so insurers commonly extend the waiting period specifically for them. Of the 12 insurers whose policies state both figures, 8 set a longer orthopedic waiting period than illness waiting period.

Which insurers pay the vet directly?

Only 2 of the 13 insurers in this index, Trupanion and Pumpkin, confirm they can pay the veterinarian directly. Odie confirms it can do so only where it already has a payment arrangement with that specific clinic. The remaining 10 insurers operate on a reimbursement model: you pay the vet, then file a claim.

Are exam fees covered?

It depends on the insurer. Six of the 13, Fetch, ASPCA, Spot, Pumpkin, MetLife, and Nationwide, include exam fees in the base plan. Five, including Lemonade, Odie, Embrace, Pets Best, and Figo, cover them only through an optional add-on. Two, Healthy Paws and Trupanion, do not cover exam fees at all.

How current is this index?

Every value in this index was accessed on September 5, 2026, directly from each insurer's own website, help center, or sample policy document, and checked in two independent passes. The index is reviewed quarterly, and terms can change between reviews, so confirm anything material against the insurer's current policy before you buy.