Does pet insurance cover cataract surgery? Cataracts in pets is a particularly common concern in aging dogs and some cats, are a common concern that can significantly affect vision and the quality of life.
A cataract is a clouding of the eye’s lens, which can lead to partial or complete blindness if left untreated. For many pet owners, the idea of their furry companion losing sight is heartbreaking.
Fortunately, the procedure for cataract surgery is already well-established and is an often successful treatment that can restore vision.
However, the same procedure is complex, involves specialized veterinary care, and can be quite costly typically ranging between $2,000 and $4,000 per eye.
This leads many pet owners to wonder whether their pet insurance covers cataract surgery. Understanding how pet insurance works with this is crucial, especially if your pet has already been diagnosed with cataracts or is at risk due to breed or age.
How Does Pet Insurance Cover Cataract Surgery
Pet insurance is designed to help pet owners manage all costs of unexpected medical care, but not all procedures or conditions are automatically included.
The surgery for cataract falls under the category of a major medical treatment, and whether it’s covered depends on the specifics of your plan and provider.
Furthermore, most comprehensive pet insurance plans offer coverage for accidents and illnesses, including surgeries required due to medical conditions.
Cataract surgery can be covered if the condition was not pre-existing at the time you enrolled in the policy. Insurance providers will usually require that the condition develop after the waiting period and while the policy is active.
How Does The Cataract Surgery Work Under The Pet Insurance?
Let’s take a look at how cataract surgery coverage typically works under pet insurance:
- Eligibility Depends on Timing: If your pet develops cataracts after the policy’s waiting period and the condition is not considered pre-existing, the surgery is likely to be eligible for reimbursement.
- Reimbursement and Deductibles: You may actually be reimbursed for a portion of the cost but it depends on your plan. For example, the reimbursement amount could be up to 70% to 90% after meeting the deductible.
- Requires Comprehensive or Illness Coverage: Accident-only plans won’t cover cataract surgery unless the cataract was caused by a traumatic injury.
- Pre-Authorization May Be Needed: Some insurers require pre-authorization before approving the procedure
Conditions That Affect Insurance Coverage for Cataracts
While cataract surgery may easily be covered, there are still several conditions and factors that can influence whether a claim is approved.
What’s more, the insurance companies have specific rules regarding pre-existing conditions, breed-specific exclusions, and hereditary conditions.
Many dogs, especially certain breeds like Poodles, Cocker Spaniels, and Siberian Huskies, are genetically predisposed to cataracts. If your pet is diagnosed before you sign up for insurance, the cataracts will likely be labeled as pre-existing, and surgery will not be covered.
Some of the conditions and terms that can affect your claim are listed as such:
- Pre-existing Conditions: If your pet had symptoms, diagnosis, or treatment for cataracts before your policy started, it won’t be covered.
- Hereditary or Congenital Conditions: Some insurers offer coverage for breed-related genetic conditions, but only under specific plans or with added riders.
- Policy Waiting Periods: Every policy has a waiting period before coverage begins. Also, the conditions that arise during this time may not be eligible.
What to Look for in a Pet Insurance Policy for Eye Surgery
Before you enroll in a pet insurance plan, it is wise to review what’s included, especially if your pet is prone to eye issues.
Not all policies offer the same level of surgical care, so it’s important to choose a provider and plan that includes robust coverage for medical procedures.
Here’s what to consider when evaluating insurance policies:
- Firstly, ensure that the plan includes illness-related surgical procedures.
- Surgery usually requires tests like ultrasounds and blood work. You must confirm if these tests are reimbursed.
- Next, look for plans that cover medications, follow-up visits, and any complications from surgery.
- Ask if your pet’s breed is subject to exclusions for hereditary eye issues.
- Some plans have limits on how much they’ll reimburse per year or per condition.
This is why, once again I remind you, that it is very important you read the fine print and asking questions can prevent disappointment when you need financial help the most.
Frequently Asked Questions
Is Cataract Surgery Covered Under All Pet Insurance Plans?
No, it isn’t. Don’t be mistaken, only comprehensive illness plans typically cover cataract surgery. Accident-only or basic policies usually do not unless the cataracts result from an injury.
How Much Does Cataract Surgery Cost for Pets?
Cataract surgery can range from $3,500 to $4,000 per eye, depending on the location, vet specialist, and whether any complications are involved.
Do I Need to Get Pre-Approval From My Insurer Before The Surgery?
Some insurance companies require pre-authorization to guarantee coverage for procedures like cataract surgery. It’s best to confirm with your provider.
