Does pet insurance cover surgery?

👉 Before you dive into the article, be sure to familiarize yourself with the terms and verbiage used regularly when talking about pet insurance in our pet insurance glossary.

As a pet parent, you never want to hear that your pet needs surgery, especially if it’s unexpected. Surgery costs are high and can be a financial burden if you aren’t prepared. Pet insurance can help absorb some of those costs — but first, you need to find out if the surgery your pet needs is covered.

Not all surgeries are covered by pet insurance. Two main factors determine your coverage:

• Insurance plan. Traditional insurance policies cover accidental and sudden injuries, while wellness plans help cover your pet’s routine care. Some policies also offer add-ons that might help cover certain surgeries and procedures. It all depends on the type of policy you choose.
• Surgery type. Different surgeries have different coverage. Spay and neuter surgeries are covered under some wellness plans, for example, but won’t be covered under a traditional insurance policy.

Unlike health insurance for humans, pet insurance policies are on a reimbursement basis. Pet owners are responsible for covering all charges out of pocket, then your pet insurance will reimburse you a certain percentage back for your pet’s surgery based on your policy’s reimbursement level and annual deductible.

There are three main types of pet insurance to know about when looking into pet insurance plans. Since all insurance plans cover different types of surgeries, it’s important to understand what’s covered before you sign.

Accident-only insurance. This insurance exists to cover accidental injuries like broken bones. Most cover surgery, but only for those for an accidental injury. There’s a required waiting period in most cases, which is the time between sign-up and when the policy goes into effect. Unfortunately, this could mean a waiting period of up to six months for serious procedures like surgeries.

Accident and illness insurance. Similar to the first coverage, this insurance covers accidental incidents but also includes illnesses. (And neither can be tied to a pre-existing condition.) Surgery is covered, but as with accident-only insurance, there could be a waiting period before coverage kicks in.

Wellness plans. Wellness insurance doesn’t cover injuries or illnesses like traditional policies. These plans only cover routine care, such as regular checkups, labs, and exams. Surgery is only covered for general wellness procedures, like spaying and neutering.

👉 Most traditional insurances consider spay and neuter surgeries as elective procedures, but they are typically covered under wellness plans.

Most insurance policies will only cover medically necessary or life-saving surgeries. For example, this would include surgeries to address a blockage, like a bladder stone, or an accidental injury like a broken bone.

Wellness plans, on the other hand, may help cover a portion of the cost of elective or preventative procedures or dental cleanings.

Most pet insurance policies won’t cover surgeries that are a result of a pre-existing condition or procedures that are considered elective. These can include:

• Anal gland removal
• Tail docking or ear cropping
• Declawing or dewclaw removal
• Spaying and neutering
• Dental cleanings
• Bilateral injuries (any injury that has already happened to one side of your pet’s body, such as hip dysplasia, cruciate ligament issues, or dog or cat cataracts)
• Surgeries as a direct cause of other conditions such as diabetes, cancer, etc.

👉 If your pet’s surgery isn’t covered under your insurance policy, payment plans with your vet could be an option. Be sure to check with your vet before surgery to see if this could be an option. Programs like Pawp or CareCredit may also be able to help with out-of-pocket costs.

To break this information down further, let’s look at the most common surgeries for pets. Most of the surgeries below are covered if the pet is insured before the injury happens.

• ACL surgery. ACL injuries don’t usually occur from one singular action, but instead from continual use over time. Some breeds are more prone to this injury than others. Most ACL surgeries are covered by insurance plans.
• Eye surgery. There are many eye surgeries a pet may have to go through. While prices vary depending on the procedure, they can be high.
• Hip surgery. Certain breeds, especially larger dog breeds, are prone to hip replacements. Most pet insurance plans cover this type of surgery if it isn’t due to a pre-existing condition.  
• Dental surgery. Dental care generally falls under a wellness insurance plan, including yearly dental cleanings. If your pet needs to go under emergency oral surgery, this could fall under accident and illness surgery.
• Tumor removal surgery. Some tumors are benign and can be left alone while others could need surgery. If a tumor needs removing, it’s likely covered under insurance.
• Limb amputation. Surgical procedures that require limb amputation usually fall under life-saving procedures and are covered by insurance policies.
• Foreign object removal. If your pet eats something they shouldn’t, it can often lead to surgery. Surgeries like this will be covered under a pet insurance plan if it doesn’t happen after the incident.
• Spaying and neutering. Not all insurance plans cover spaying and neutering as they can be seen as elective surgeries. Wellness plans are more likely to cover these procedures.
• Joint surgery. Depending on the cause, joint surgery may be covered under pet insurance. If it’s a chronic condition or stems from something pre-existing, it won’t be.