Does Pet Insurance Cover Surgery?

Your pet is part of the family, and you'd do anything to keep them healthy and happy. But what happens if they need surgery? Will your pet insurance cover the cost? The answer isn’t always straightforward. Here's when pet insurance typically covers surgery and when it doesn’t.

Pet insurance can help pay for surgery if your pet gets hurt or sick. This could include surgeries for broken bones, cancer, objects stuck in their stomach, emergencies, ligament problems or some dental issues. If you buy a wellness plan, you may also have coverage for spaying or neutering.

But pet insurance almost never covers surgeries for pre-existing conditions or elective procedures like tail docking or dew claw removal.

Pet insurance can also help with care after surgery. Depending on your plan, it may cover things like follow-up vet visits, physical therapy and pain medication.

Pet insurance policies typically pay for surgical procedures needed to treat an accident or illness. Depending on your policy, this may include:

• Tumor removal.

• Removing objects like rocks, toys or sticks that pets accidentally swallow.

• Emergency surgeries for life-threatening situations like bloat or internal bleeding.

• Dental surgeries like extractions of a broken tooth.

• Surgeries for broken bones, ruptured knee ligaments or hip dysplasia.

• Procedures to treat hereditary and congenital conditions such as luxating patellas.

Pet insurance plans usually have a wide range of exclusions and limitations. Accident and illness plans often won’t cover:

• Surgeries to treat conditions your pet had before coverage began.

• Cosmetic or elective procedures like ear cropping, tail docking, gastropexy (a surgery to prevent bloat), declawing or dew claw removal.

• Breeding-related procedures like cesarean sections, spaying or neutering.

Some pet insurance companies offer preventive care plans that will cover some of the procedures above (such as spaying, neutering or gastropexy).

» MORE: What does pet insurance cover?

While pet insurance doesn't cover every type of surgery, it can help you save money on many procedures caused by accidents or illnesses. Here’s a look at common pet surgeries, how much they cost and whether insurance generally covers them.

Note: The costs below are estimates. Your own pet’s cost will depend on factors such as where you live, how complicated the surgery is, and the age and size of your pet.

Surgery coverage is usually a standard part of accident and illness coverage. If your pet needs surgery for a broken leg, tumor or cataracts, insurance will likely cover it.

However, having pet insurance doesn’t guarantee that all veterinary bills will be paid. These policies typically have a deductible, a reimbursement rate and a maximum coverage limit per year or per incident. Depending on your insurer, you may also be responsible for paying exam fees related to the surgery.

• The deductible is the amount you have to pay before your pet insurer will begin covering your vet bills. Most insurers charge an annual deductible, but some assess deductibles per condition. Learn more about pet insurance deductibles.

• The reimbursement rate is the percentage of your vet bills your pet insurer will cover once you’ve reached your deductible. The percentage you cover is known as a copayment.

• The maximum coverage limit is the total amount your pet insurer will pay per year or per incident. 

Say you have a pet insurance plan with a $500 deductible, 80% reimbursement rate and $10,000 annual limit. Your pet needs surgery to remove a tumor, which will cost $3,000. How much of that $3,000 you’ll have to pay depends on how your pet insurer applies the deductible and reimbursement rate.

You can find out how your insurer will calculate your claim by reading your policy documents.

» MORE: The best pet insurance companies

There are two ways to file a pet surgery claim.

The first way is with direct billing. With this option, you won't have to pay your insurer’s part of the bill out of pocket. Instead, your pet insurance company will pay your vet directly.

Direct billing isn’t that common. Pets Best, Healthy Paws and Trupanion are some of the only pet insurance companies that will pay your vet directly. Your vet must also be willing to accept payments directly from providers.

The more traditional way to file a pet insurance claim for surgery is to pay the full amount upfront and then submit the claim to your insurance company for reimbursement. To do this, you'll generally need to fill out your insurance company’s claim form and provide a copy of the itemized receipt or invoice from your vet.

Your insurance company will review your claim to make sure it meets the terms of your policy. If everything checks out, your insurer will reimburse you the covered amount, minus any deductible or copay.

» MORE: How much does pet insurance cost?

Can you buy pet insurance before surgery?

Yes, you can buy pet insurance before your pet needs surgery, but that doesn’t mean your policy will pay for the procedure.

In general, any medical condition your pet was diagnosed with before you bought the policy won't be covered. That means you can’t get a plan the day after your dog tears a cruciate ligament and expect it to pay for the surgical repair.

Pet insurance plans also have waiting periods, the length of time between when you buy your plan and when insurance will start covering eligible treatments. Common waiting periods are 14 days for illness coverage and 48 hours for accident coverage.

» MORE: Pet insurance waiting periods: What you need to know

To give you an idea of how different pet insurance companies cover surgery, we looked at three popular insurers.

Embrace surgery coverage

Embrace's standard policy covers treatment, hospitalization and surgery for injuries and illnesses, including cancer. It also covers rehabilitative therapies that might help your pet recover after surgery. By adding a wellness plan, you can get coverage for spaying or neutering and gastropexy. Embrace won’t cover surgeries arising from pre-existing conditions, fighting, racing or mistreatment. Coverage for vet exam fees and prescription medicine costs extra.

Figo surgery coverage

Figo pet insurance covers surgeries, prescription medications and diagnostic testing for accidents and illnesses, and you can pay extra to add coverage for vet exam fees. Pre-existing conditions aren’t covered unless they've been cured and the pet is symptom-free for at least 12 months. Figo has wellness plans for things like vaccines, routine exams, dental cleaning, and spay or neuter surgery.

Pets Best surgery coverage

Pets Best's surgery coverage is included in its accident and illness plan. The policy can also pay for pre- and post-surgical care like diagnostic tests, prescription medication and physical rehabilitation, depending on which tier of coverage you buy. Add a wellness plan if you want coverage for spay or neuter surgery.