Pet insurance for an older dog, or a dog with a diagnosis: what it still covers, what it won’t, and who should skip it

Usually you can still buy pet insurance for an older dog. It won’t pay for what your dog already has: all nine insurers whose documents we read on October 5, 2026 exclude conditions a dog had, or showed signs of, before coverage began, with narrow exceptions for conditions that cleared up (below). And all nine count age in the price. We quote their own pages and sample policies; terms differ by state and plan.

Quick answer

Enrolling: six of the nine say there’s no upper age limit, though Embrace takes dogs 15 and older for accident-only cover. Lemonade has a limit it doesn’t state on the pages we read.

Excluded: anything that showed up before coverage or during a waiting period, diagnosed or not. A condition that cleared up can sometimes be covered after a set symptom-free time (180 days to a year, by insurer; Pets Best instead looks back 18 months before the start date), but not chronic conditions such as heart disease, diabetes and arthritis at the insurers that name them.

Price: it can climb as your dog ages. Whether that’s worth paying is your call; the worksheet below helps.

What “pre-existing” means

The National Association of Insurance Commissioners (NAIC) model law calls a condition pre-existing if, before the policy starts or during a waiting period, “A veterinarian provided medical advice”, “The pet received previous treatment”, or “Based on information from verifiable sources, the pet had signs or symptoms directly related to the condition for which a claim is being made.” Florida’s statute uses the same three tests. California’s says signs or symptoms “consistent with the stated condition”.

No diagnosis is needed. “Conditions that have not been diagnosed or treated yet can still be considered pre-existing,” ASPCA says. Pets Best’s sample policy counts conditions “in remission or controlled by medication, whether or not the Condition is noted in your Pet’s medical records.” And the enrollment exam can add to the list: California makes insurers that require one disclose “that examination documentation may result in a preexisting condition exclusion.”

The NAIC model, which California and Florida follow on these points, also protects you: the insurer “has the burden of proving that the preexisting condition exclusion applies,” and a covered condition “cannot be considered a preexisting condition on any renewal of the policy.”

One exception we found: MetLife says that if you switch to it through your employer, “your pet’s previously covered pre-existing conditions may be covered by us, too,” which a footnote limits to people with active pet insurance buying through an employer group.

Conditions that cleared up, and conditions that never will

Most of the nine will take a second look at a condition that cleared up before coverage. Sample policies are examples; terms differ by state, plan and date. Alphabetical; all read October 5, 2026.

Insurer	When a condition that cleared up can be covered	Document
ASPCA	“curable, cured, and free of symptoms and treatments for 180 days”; not knee and ligament conditions	Pre-existing conditions page
Embrace	“symptom-free and treatment-free for 12 consecutive months”	Pre-existing conditions page
Fetch	Excluded 365 days; coverable if it doesn’t return in policy year one or two, with an annual vet exam; a return in year two means exclusion “for the life of your pet” (the sample’s definition says the same of a return “sometime after”)	California sample GPTM 050 CA 0325 A; pre-existing conditions page
Healthy Paws	“a continuous 365 days” free of signs, symptoms and treatment	Frequent questions
Lemonade	“In most states”, “at least 12 months” without recurrent symptoms or continued treatment; not knee, ligament or chronic conditions	Pet insurance FAQ
MetLife	No period given; curable conditions “can typically be covered” if the new incident “is unrelated to any of the same incidents that happened before coverage”	FAQ
Pets Best	Looks back “18 months” before the policy starts; chronic conditions, and some bilateral and intervertebral disc conditions, count if present “at any time”	California sample IAIC-PBI0001-ILL (02/2023)
Pumpkin	“free of symptoms and treatment for 180 days”; not knee and hind leg ligament conditions	Home page FAQ
Spot	“cured and free from treatment and symptoms for a period of 180 days”; not chronic, congenital, hereditary, ligament and knee, or orthopedic conditions	California sample PET-P-20000-CA-IAIC-1024

Checked October 5, 2026. These are dated examples from sample documents; confirm the policy issued in your state.

For a dog with a diagnosis, the other half matters more: what never counts as cured.

• Healthy Paws gives these as examples of conditions not considered cured: “cruciate ligament tears, orthopedic conditions (e.g. medial patellar luxation and hip dysplasia), and conditions that require chronic medication and the pet’s health will regress if off the medication (e.g. heart disease, thyroid disease, seizures).”
• Pets Best: its chronic conditions include “Cruciate Ligament Event, atopy, renal disease, osteoarthritis, diabetes, inflammatory bowel disease, Cushing’s, heart disease, hyperthyroidism, and hip dysplasia.”
• MetLife: incurable conditions “like allergies, diabetes, cancer, or arthritis” that a pet already has “will likely never be covered.”
• Fetch and Embrace list allergies, diabetes, thyroid disease and arthritis or “Bone and Joint Issues” as incurable, and Lemonade says “knee or ligament conditions and chronic conditions cannot be cured”.

None of the documents we read lists canine cognitive dysfunction (dog dementia) by name. If that’s your dog’s diagnosis, ask the insurer in writing how it would treat it.

Can an older dog still be enrolled?

Mostly, yes. Alphabetically:

Insurer	Upper age limit, in its words	Document
ASPCA	“there are no upper-age restrictions for enrolling”	Senior dog insurance page
Embrace	“No upper age limit. Puppies from 6 weeks and dogs up to 14 can enroll in accident and illness coverage. Dogs 15+ can enroll in accident-only coverage.”	Dog insurance page
Fetch	Not stated on the pages we read	Not stated
Healthy Paws	Not stated on the pages we read	Not stated
Lemonade	Has one, number not given: a dog signed up for the first time “once they’ve hit our age limit” “may be declined entirely”	Pet insurance FAQ
MetLife	“We have no upper age restrictions and no breed exclusions”	FAQ
Pets Best	“no upper age limits, so you can insure your dog or cat at any age over 7 weeks”	FAQ
Pumpkin	“No upper age limits or breed restrictions”	Home page
Spot	“There is no upper age limit for coverage or enrollments.”	FAQ

Checked October 5, 2026. Dated examples; confirm the current rule with the insurer.

Some add steps for older dogs. Healthy Paws asks pets 6 and older for a vet exam within 30 days before enrolling or 15 days after, except in 16 states it lists, California among them. Embrace’s policy defaults “to an Accident only policy” without a vet exam in the 12 months before the start date or 14 days after.

Fetch’s California sample says that when you renew for a dog “age eight (8) years or older,” you “must follow your veterinarian’s advice with regards to senior wellness testing.” And Pets Best may offer only an Accident Only plan to a pet with “one of several pre-existing severe chronic conditions”.

What happens to the price as your dog ages

All nine count age:

• ASPCA, Pets Best, Pumpkin and Spot (same footer): premiums “may increase or decrease due to the age of your pet”.
• Embrace: “Premium may increase due to the age of your pet at renewal.”
• Fetch: “Puppies and kittens cost less to insure with Fetch than older dogs and cats.”
• Healthy Paws: rates reflect a “pet’s breed, gender, age, and other factors”.
• Lemonade: “as they age, their premiums may increase”.
• MetLife: premiums may increase based on “the age of Your Pet, upon renewal.”
• Pets Best (sample): renewal changes are “based on the changes in your Pet’s age as well as the overall cost of care.”
• Spot (Florida disclosure): “Insurance plan premiums will increase as the covered pet gets older.”

Healthy Paws, MetLife, Pets Best, Pumpkin and Spot say a pet’s claims don’t raise its premium; Embrace’s disclosure allows “a possible increase based on your claim history”. Advertised prices may not be yours: Spot’s is based on “a 2-year-old small mixed dog,” and a University of Maryland Extension fact sheet warns that with an older pet “your premium might be higher than what you see advertised.”

If a renewal price jumps: California and Florida law and the NAIC model make insurers disclose whether premiums rise with “the age of the covered pet”.

Healthy Paws and Lemonade say their rates are filed with state regulators, and California’s Department of Insurance has an online Virtual Viewing Room to “review property and casualty insurance company rates and rating plans” (state law defines pet insurance as a “property insurance policy”; we didn’t check that every pet insurer’s filing appears there).

The NAIC’s SERFF Filing Access site also serves California’s property and casualty filings, which it says “are made available at no cost,” once you accept its terms of use; Washington’s insurance regulator points to the same site for its filings.

Waiting periods, and what state law says

New policies usually start with a waiting period, and a condition that shows up during it counts as pre-existing. The NAIC model allows waiting periods that “do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident” and says “Waiting periods for accidents are prohibited.”

California (since January 1, 2025) and Florida say the same, and both require a way to waive the wait with a vet exam.

The NAIC’s Summer 2026 chart lists 17 states that “adopted the most recent version of the NAIC model in a substantially similar manner”: California, Delaware, Florida, Hawaii, Louisiana, Maine, Maryland, Mississippi, Montana, Nebraska, New Hampshire, Ohio, Pennsylvania, Rhode Island, Vermont, Washington, and New Jersey (effective January 1, 2027).

The chart “does not constitute a formal legal opinion,” and we read only California’s and Florida’s laws, so check with your state’s insurance department.

In the documents, illness waits are 14 days at Embrace, Lemonade, MetLife, Pets Best and Spot, 14 days “or less for all conditions” at Pumpkin, and 15 at Fetch and Healthy Paws; ASPCA coverage “starts on the 15th day after the policy effective date”. Lemonade adds “30 days for orthopedic conditions”.

Three documents, all sample terms, go further for orthopedic problems. An older example, not current California terms: Pets Best’s 2023 California sample has “6 months following the Policy Effective Date for any Cruciate Ligament Events and any related Conditions.”

Embrace’s V6 terms, linked for California and most other states, exclude cruciate ligament disease, intervertebral disk disease (IVDD), patellar luxation and hip dysplasia that “occur or show Clinical Signs during the first 180 days” “for the life of the policy.”

Fetch’s California sample excludes “Orthopedic conditions that occur during the first one hundred eighty (180) days,” with a knee exception after a clear vet exam. Embrace and Fetch write these as exclusions rather than waiting periods, and the Pets Best sample predates California’s 2025 rule; ask the insurer which orthopedic terms apply to its current policy in your state. Knee repair costs: what cruciate surgery costs.

What a policy can still do for an older dog

• New, unrelated problems. “The pre-existing condition itself will not be covered, but other new unrelated illnesses or accidents will be,” Embrace says.
• New chronic conditions. Healthy Paws covers “any new chronic conditions diagnosed after enrollment and the waiting period”.
• Renewal. Under the NAIC model and California and Florida law, a covered condition can’t turn pre-existing at renewal, no waiting period applies to a renewal, and no vet exam can be required to renew.
• End of life. Spot’s sample lists end-of-life expenses (“euthanasia, burial and cremation only”) among eligible expenses; Healthy Paws covers euthanasia “when it is medically necessary for a covered condition” but not aftercare; Pets Best’s sample excludes “Cremation and burial”.

Two limits. Exclusions reach related problems: Spot’s sample also excludes “secondary, resultant or related complications” of an excluded condition. And starting over resets the clock.

Some changes, even with the same company, mean a new policy with new waiting periods and a new pre-existing date (Spot’s, Pets Best’s and Embrace’s documents say so), and Lemonade says that after you cancel, “anything that occurred or was diagnosed during your first policy would be considered pre-existing conditions on a future policy.”

How to find out what’s excluded before you need it

Several insurers check your dog’s records when the first claim arrives; Pets Best says it “can’t guarantee coverage until you submit a claim and we review your pet’s specific conditions.” Earlier options the documents describe:

• Embrace: a “Medical History Review”, which you can request “any time after the policy fourteen (14) day Illness Waiting Period is complete.”
• Fetch (California sample): for a planned treatment, “a pre-authorization form, available by request or through your online account.”
• Lemonade: records you send “are reviewed by our team in order to determine your pet’s pre-existing conditions”.
• Pumpkin: submit your vet’s estimate through your member account, and “We’ll review it within 15 minutes.”

The other insurers’ pages we read don’t describe one.

Do you have to pay the vet first?

Usually. “Like most pet insurance, you pay your vet at the time of service, then submit a claim for reimbursement,” Embrace’s page says.

• Pay, then claim: Fetch (“Fetch does not pay the vet directly”), Lemonade (“You’ll pay the vet bill up front”) and MetLife (“you have to pay the vet bill first”). ASPCA’s pages describe paying you by direct deposit or check.
• Can pay the vet: Healthy Paws, if you ask “in advance of the treatment” (“Approval for direct payment does not mean a claim will be covered”); Pets Best, whose Vet Direct Pay sends the covered amount “directly to your veterinarian after your claim has been processed”; and Spot, whose California sample says “If you so indicate on your claim form, we can pay the veterinarian directly,” though its FAQ describes paying the bill and claiming.
• Pays you first: Pumpkin says PumpkinNow can pay eligible claims over $500 “in minutes”, “before you pay the vet”, if your bank supports real-time payments.

If a claim is denied as pre-existing

The routes the documents describe (whether to use them is your call):

• The insurer’s appeal. Spot: “in writing”, with a time limit that “varies by the state”. Fetch’s California sample: in writing “within ninety (90) days of the denial”. MetLife’s Ohio sample: within 90 days, then an optional review by “An impartial Veterinarian” at your cost. Pets Best’s sample: a “voluntary appeals process”, then an “independent third-party Veterinarian (ITPV)”, though “Disagreements regarding direct policy exclusions, timing of coverage, and policy wording interpretations are not eligible for ITPV review.”
• Your state insurance department. The NAIC says to try the insurer first, and that state departments “can investigate complaints for free”, including “Unfair claim delays or denials.” California’s Department of Insurance takes complaints online or on its “Request for Assistance” form and answers questions at 1-800-927-4357.

One of the NAIC’s complaint tips: “Use language from your policy when possible.”

Supplements, prescription diets and complementary therapies

No general rule holds (sample terms, which vary by state):

• Spot’s California sample covers prescription food and supplements for a covered condition, and excludes herbal and herbal-like products.
• MetLife’s Ohio sample covers some holistic items, such as herbal remedies and aroma therapy, when a veterinarian prescribes them.
• Embrace’s V6 terms exclude “Natural supplements, vitamins, and all foods, whether prescribed or not.”
• Fetch’s California sample excludes “Food, including food prescribed by a veterinarian,” and covers only supplements “listed in the most current edition of the Plumb’s Veterinarian Drug Handbook.”
• Pets Best’s sample excludes “pet foods, supplements” and “Alternative and Holistic Treatments”; formulary medications, rehabilitation and acupuncture are add-ons.

ASPCA and Pumpkin cover prescription food and supplements for covered conditions. Where the documents spell out acupuncture or rehabilitation cover, it’s tied to a covered condition.

Wellness plans are not insurance

California defines a wellness program as “a subscription or reimbursement-based program that is separate from an insurance policy,” bars insurers from marketing one “as pet insurance,” and makes an insurer or agent selling one disclose it “is not a regulated insurance product”; the NAIC model is similar. “Wellness” benefits written into a policy, though, “are insurance.”

Embrace’s Wellness Rewards “is NOT INSURANCE,” Pumpkin Wellness Club “is NOT INSURANCE, nor a regulated insurance product,” and Fetch Wellness “is insurance coverage added by endorsement”.

Insurance or savings? A worksheet

Nobody can answer this in advance. Run your own numbers:

1. A: this year’s premium (monthly quote x 12) = ______
2. B: premiums for the years you’d keep it (A plus each later year, which may rise with age) = ______
3. C: a bill you worry about (your vet’s estimate) = ______
4. D: C minus anything excluded (the pre-existing condition, anything related, and items such as exam fees if the policy leaves them out) = ______
5. E: what the policy pays: D after the deductible and reimbursement percentage, in your policy’s order, up to the annual limit = ______
6. F: your share of that bill (C minus E) = ______

The order in E matters. Embrace’s disclosure takes off the deductible first (“$1,200 – $100 = $1,100”, then “$1,100 x .9 = $990 (reimbursed amount)”, its own example); Lemonade’s FAQ applies the percentage first.

Then weigh B against E for the bills you think likely. Savings can go toward anything, including what your dog already has, but only as far as they reach. Trupanion’s quiz asks the question underneath: “Would you be able to pay for a surprise $5,000 vet bill today?”

Who should skip it, and who it may still suit

An insurer says it too. Trupanion’s quiz, “Should I Get Pet Insurance?”, tells owners whose answers are mostly C (a pet over 14, often at the vet, money set aside for emergencies, wanting “Mostly basic or routine care”): “Pet insurance may not be the best choice because your pet is older and has pre-existing conditions.”

It may make little sense if the bills you expect come from a condition your dog already has or has shown signs of, especially one treated as never cured, or if you could pay a large bill from savings while premiums climb.

It may still make sense if you want help with a new illness or accident unrelated to the diagnosis, a large bill would be hard to cover, and you can live with a premium that may rise. Some insurers offer accident-only cover to older or chronically ill dogs (see above).

The decision is yours. Other ways to plan for costs: help with vet bills.

A checklist before you buy

Built on the University of Maryland Extension worksheet “Is Pet Insurance Right for Me?” (FS-2023-0678), with questions added for older and diagnosed dogs:

• The sample policy for your state and its “Insurer Disclosure of Important Policy Provisions”.
• The pre-existing definition, look-back and cured-condition rule, and how it would treat your dog’s diagnosis, by name, in writing.
• Whether it reviews records before a claim, and any exam it requires for an older dog.
• Waiting periods, including orthopedic and cruciate rules, and how to waive them.
• “Is the deductible per year or per incident?” And the annual limit.
• Exam fees, prescriptions, prescription diets and rehabilitation: base plan or add-on?
• How age and claims change the premium at renewal, and whether it can pay your vet directly.
• The free look. A new policy can be returned for a refund within 15 days under the NAIC model, 30 days in Florida unless you’ve filed a claim, and at least 30 days in California unless the insurer has paid, or promised in writing to pay, a claim. It is a cancellation window, not an appeal.
• “If my claim is denied … how can I appeal the denial?” and “Does the plan have end of life benefits?”
• The free-look period.

This page is general information, not insurance, legal or financial advice. We aren’t licensed insurance agents, and we earn nothing from any insurer named here.

Keep reading

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References and further reading

• National Association of Insurance Commissioners. Pet Insurance Model Act (#633), Summer 2022 edition: sections 3 (definitions), 4 (disclosures), 5 (policy conditions) and 6 (wellness programs). naic.org (PDF)
• National Association of Insurance Commissioners. Pet Insurance Model Act state page, Summer 2026 edition. naic.org (PDF)
• National Association of Insurance Commissioners. How to File a Complaint. naic.org
• California Insurance Code, Part 9, Pet Insurance: sections 12880 (definitions), 12880.2 (disclosures and free look), 12880.7 (pre-existing conditions and waiting periods; effective January 1, 2025) and 12880.8 (wellness programs). leginfo.legislature.ca.gov
• Florida Statutes (2026), section 627.71545, Pet insurance; noninsurance wellness programs. leg.state.fl.us
• California Department of Insurance. Getting Help (consumer complaints; Request for Assistance form CSD-001-P) and Virtual Viewing Room. insurance.ca.gov (help); insurance.ca.gov (viewing room)
• National Association of Insurance Commissioners. SERFF Filing Access, California page; Washington State Office of the Insurance Commissioner, Search company filings with SERFF Filing Access. serff-sfa.naic.org; insurance.wa.gov
• Sorenson C. Is Pet Insurance Right for Me? (FS-2023-0678). University of Maryland Extension, November 2023. extension.umd.edu (PDF)
• ASPCA Pet Health Insurance. Pet insurance and pre-existing conditions; Senior dog insurance; Top questions. pre-existing conditions; senior dogs; top questions
• Embrace Pet Insurance. Insurer Disclosure of Important Policy Provisions (INDPP 01/23); Embrace Pet Health Insurance V6 policy terms; Pre-existing conditions; Dog insurance. disclosure (PDF); V6 terms; pre-existing conditions; dog insurance
• Fetch Pet Insurance (AXIS Insurance Company). Sample policy, California, form GPTM 050 CA 0325 A; Terms and conditions; Pre-existing conditions; Does Fetch pay the vet directly? sample policy (PDF); terms; pre-existing conditions; direct pay
• Healthy Paws Pet Insurance. Frequent questions; Coverage and exclusions; Chronic condition coverage. frequent questions; coverage and exclusions; chronic conditions
• Lemonade. Pet insurance; Lemonade pet insurance FAQ. pet insurance; pet insurance FAQ
• MetLife Pet Insurance (Metropolitan General Insurance Company). Insurer Disclosure of Important Policy Provisions for residents of California; Sample policy, form PET21-01-V (Ohio); FAQs; Home page. California disclosure (PDF); sample policy (PDF); FAQs; home page
• Pets Best (Independence American Insurance Company). Sample accident and illness policy, form IAIC-PBI0001-ILL (02/2023), with California Insurer Disclosure of Important Policy Provisions; FAQ; Home page. sample policy (PDF); FAQ; home page
• Pumpkin Pet Insurance. Home page; FAQs (including PumpkinNow). home page; FAQs
• Spot Pet Insurance (Independence American Insurance Company). Sample accident and illness policy, California, form PET-P-20000-CA-IAIC-1024; Florida Insurer Disclosure of Important Policy Provisions; FAQs; Home page. sample policy (PDF); Florida disclosure; FAQs; home page
• Trupanion. Quiz: Should I Get Pet Insurance? (published February 20, 2024). trupanion.com
• All insurer documents and statutes above were read on October 5, 2026. Sample policies are examples; the terms in your own policy and its declarations page are what apply.

Frequently asked questions

This guide is general information about paying for veterinary care, not veterinary, insurance, legal or financial advice. Prices, terms and eligibility rules change; check them with the provider. Treatment decisions belong with your veterinary team.