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Pet Insurance And Tracheal Collapse

A tracheal stent or ring surgery can cost thousands of dollars, so it is natural to ask whether pet insurance will help. The honest answer is that it depends mostly on one thing: whether the condition counts as pre-existing under your policy. Here is how those rules work, using a model law written for state insurance regulators and what two insurers publish about their own rules.

What The Costs Look Like

Embrace Pet Insurance puts tracheal stents at about $3,500 to $6,500 depending on how many are needed, with ring surgery in a similar range. University of Missouri Veterinary Health Center listed $2,000 to $3,500 for the workup and $3,200 to $3,600 for placement, or $5,900 to $6,500 for both, as of June 2023. See Surgery Cost for more ranges.

What "Pre-Existing" Usually Means

The NAIC Pet Insurance Model Act is a model law from the National Association of Insurance Commissioners that states can choose to adopt. It defines a pre-existing condition as one where, before the policy started or during a waiting period:

• A veterinarian gave medical advice about it, or
• Your pet was treated for it, or
• Based on information from verifiable sources, your pet had signs or symptoms directly related to it.

Notice the third point. A honking cough noted in your dog's records, even before anyone said "tracheal collapse," could count. Insurers set their own look-back periods too. Trupanion says it looks for signs within the 18 months before the policy started, and it requests your pet's records from every vet who has treated them. Embrace Pet Insurance counts anything noticed by you or your vet in the 12 months before coverage and through the waiting period, even if your pet never saw a vet for it.

Curable Versus Lifelong Conditions

Some insurers treat conditions that can be cured differently from lifelong ones. Embrace Pet Insurance says curable conditions can become eligible once your pet has had no symptoms and no treatment for 12 months in a row, while incurable or chronic conditions noted before the end of the waiting periods are permanently excluded. The American College of Veterinary Surgeons describes tracheal collapse as a chronic, progressive, irreversible disease. If your dog's cough was noted before coverage began, it may be treated as a lifelong exclusion under a rule like this. Ask the insurer in writing.

Waiting Periods

Under the model act, waiting periods for illnesses can be no longer than 30 days, and waiting periods for accidents are not allowed. Insurers using an illness waiting period must offer a way to waive it with a vet exam. If an insurer requires a vet exam to start coverage, the act says it must tell you before you buy that the exam records may lead to a pre-existing condition exclusion. Signs that show up during the waiting period can count as pre-existing.

Protections If You Already Have Coverage

• Renewal. The model act says a condition covered on a policy cannot be treated as pre-existing when that policy renews.
• Burden of proof. The insurer has to prove that a pre-existing exclusion applies to a claim.
• No exam to renew. Insurers cannot require a vet exam to renew your policy.
• Plain disclosure. Insurers must give a document titled "Insurer Disclosure of Important Policy Provisions" summarizing key terms.

Putting those rules together is our own reading, not something the model act or any insurer states: if your dog is already covered and then diagnosed, think carefully before switching companies, since a new policy would judge the cough against its own start date. Check your own state's rules, which may differ from the model.

If Your Dog Is Already Diagnosed

A new policy is unlikely to cover tracheal collapse itself. Trupanion notes that pets with pre-existing conditions can still be covered for new, unrelated injuries and illnesses, and Embrace Pet Insurance says it can cover new or unrelated conditions. That can still be worth having for a small dog prone to other problems, but it is unlikely to pay for the stent.

Questions To Ask Before You Count On Coverage

1. Has my pet had a medical history review, and what is listed as pre-existing?
2. Is a cough, or tracheal collapse, on that list?
3. Are diagnostics like fluoroscopy, CT, and bronchoscopy covered, or just the procedure?
4. Are ongoing medicines covered after a procedure?
5. What is my deductible, reimbursement rate, and annual limit?
6. Can I get pre-approval or an estimate review before the procedure?

Embrace Pet Insurance says you can request a medical history review after buying a policy, and Trupanion says actual eligibility cannot be decided until a claim is submitted. Get answers in writing. For payment plans and other options, see Paying For Surgery. To see listed practices near you that say they offer stents or ring surgery, and to ask each for a written estimate, use Find A Practice.