Plan restrictions
Modular Pet Insurance Plan
Excluded conditions or procedures include:
- Any veterinary services or veterinary expenses related to a pre-existing condition.
- Veterinary services or veterinary expenses related to any treatment that was performed prior to the effective date of this policy.
- Diagnosis or treatment of any complication or progression of any condition or procedure excluded by this policy.
- Diagnosis or treatment of any condition caused intentionally by you or any other resident of your household.
- Any (1) behavioral training that is not medically necessary for a diagnosed medical condition; or (2) pet obedience training.
- Acupuncture, chiropractic care, holistic care, etc. unless it is performed or prescribed by your veterinarian to treat your pet’s covered condition.
- Veterinary expenses for prescriptions: (1) above and beyond the amount prescribed by your veterinarian for your pet; or (2) for more than the length of a single policy term.
- Food or treats of any type other than prescription pet food or nutritional supplements. For example, we will not pay for the following types of items even if they are prescribed by a veterinarian for your pet’s condition: over-the-counter therapeutic diets or dog treats; life stages food (puppy, senior, etc.); low calorie, sensitive stomach, raw, or custom diets; groceries, whole foods, or limited ingredients.
- Boarding or accommodation, housing, transportation, grooming (including, but not limited to, services like nail trims, shampoos, ear cleaning or irrigation, or bathing), or items like bedding, crates, cages, ramps, feeding, feeding bowls, exercise, toys, clothing, leashes, collars, muzzles, storage.
- Fees or other expenses for pet services and supplies not prescribed by your veterinarian to prevent, diagnose, or treat your pet’s condition.
- Fees or other expenses not directly related to veterinary services, including, but not limited to: (1) waste disposal; (2) record access or copying; (3) any license or certification, except a state or federal health certificate provided to you by your veterinarian; (4) compliance with any government rule or regulation; (5) any tax; or (6) any charge assessed by any bank, credit card company, or other financial institution. This provision does not apply in those states where it conflicts with state law or regulation.
- Medical, wellness, or preventive care plans, clubs, subscriptions, or cash back programs provided by your veterinarian or a third-party provider. These uncovered costs include the initial signup fee as well as any monthly charges, recurring fees, and/or related charges.
- Veterinary expenses arising out of or related to any treatment for oral health, including but not limited to dental disease, malocclusions and deciduous teeth, where clinical sign(s) (including, but not limited to, tartar, gingivitis, pulp exposure, periodontal disease, or halitosis) were present prior to the effective date of the policy or during the waiting period beginning on the effective date of this policy.
- Veterinary expenses arising out of or related to any treatment associated with damage or rupture of cruciate ligaments or menisci of the knee where clinical sign(s) occur during the first term that the policy is in effect.
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the veterinary medical board of your state. Substances that are illegal under federal or applicable state law are also excluded (e.g., cannabis).
- Diagnosis or treatment of any condition caused directly or indirectly by war, rebellion, insurrection, or any release of nuclear radiation or radioactive contamination.
- Cosmetic procedures that fall outside your selected Accident coverage, Illness coverage, Behavioral coverage, prescription pet food and nutritional supplements coverage, Congenital & Hereditary coverage, Cruciate coverage, Wellness coverage.
- Diagnosis, treatment, tests, or procedures associated with breeding including, but not limited to: (1) postpartum and pre-mating examinations; (2) procedures related to breeding (e.g., artificial insemination, progesterone testing, seme collection, etc.); or (3) conditions or complications resulting from the breeding of your pet.
- Surgeries or procedures not associated with an eligible condition.
- Veterinary expenses when you or your family member is the veterinarian conducting, supervising or treating the pet.
- Veterinary expenses from any business in which you or a member of your household have an ownership or employment interest.
- Anal gland expression services exceeding $80 per policy term, unless associated with an active anal gland pathologic condition. We will not pay for anal gland expression as a preventive or routine care treatment.
Major Medical Plan
Excluded conditions or procedures include:
- Pre-existing conditions
- Any additional excluded condition listed on the policy declarations page or renewal certificate
- Certain bone or joint conditions associated with (1) hip dysplasia, or any luxation or subluxation associated with hip dysplasia, (2) elbow dysplasia, (3) patellar luxation or subluxation, (4) osteochondritis dissecans, or (5) any fracture, luxation, or subluxation associated with aseptic necrosis of a femoral head, but we do provide limited additional coverage for specified ineligible conditions
- Cruciate ligament or meniscal damage or rupture that occurs during the first twelve (12) calendar months of the policy
- Cervical vertebral instability/wobbler syndrome, but we do provided limited additional coverage for specified ineligible conditions
- Angular limb deformity
- Congenital anomalies or developmental defects
- Hereditary disorders, but we do provide limited additional coverage for specified ineligible conditions
- Diagnosis or treatment for: (1) removal or treatment of deciduous (baby) teeth, (2) cosmetic dental restoration including veneers, crowns, caps or other prosthetic devices, (3) temporomandibular joint (TMJ) disease, (4) enamel hypoplasia, (5) gingivitis, or (6) tooth hygiene or appearance including teeth cleaning and polishing
- Diagnosis of, or treatment for, internal or external parasites
- Elective procedures or cosmetic surgeries
- Expression of anal glands, anal sacculitis, or removal of anal glands
- Preventive gastropexy, tail docking, dewclaw removal, ear cropping, skin fold resection, vulvar episioplasty, declawing, or nail trims
- Breeding or pregnancy including Cesarean section, dystocia, termination of pregnancy, pseudopregnancy, spaying or neutering
- Spay/neuter (unless optional wellness rider with spay/neuter benefits is purchased)
- Special diets, pet foods, or dietary or nutritional supplements
- Boarding, transportation, grooming, or bathing
- Routine examinations, preventive treatment—including vaccines, or diagnostics associated with preventive treatment (unless optional Pet Wellness plan is purchased)
- Diseases that are preventable by vaccination
- Age-related changes to your pet's eyes or ears
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the board of veterinary medicine of your state
- Diagnosis, treatment, training, or therapy for behavioral problems
- Fees or other expenses not directly related to veterinary services
- Diagnosis or treatment of any complication or progression of any condition excluded by this policy
Major Medical Plan
Excluded conditions or procedures include:
- Pre-existing conditions
- Any additional excluded condition listed on the policy declarations page or renewal certificate
- Certain bone or joint conditions associated with (1) hip dysplasia, or any luxation or subluxation associated with hip dysplasia, (2) elbow dysplasia, (3) patellar luxation or subluxation, (4) osteochondritis dissecans, or (5) any fracture, luxation, or subluxation associated with aseptic necrosis of a femoral head
- Cruciate ligament or meniscal damage or rupture that occurs during the first twelve (12) calendar months of the policy
- Cervical vertebral instability/wobbler syndrome
- Angular limb deformity
- Congenital anomalies or developmental defects
- Hereditary disorders
- Diagnosis or treatment of any condition consisting of, caused by, or associated with: (1) renal dysplasia, (2) cystine or urate urolithiasis, (3) collapsed trachea, (4) prolapsed gland of the third eyelid, (5) everted, scrolled or inverted cartilage of the third eyelid, (6) distichiasis, (7) trichiasis, (8) ectopic cilia, (9) ectropion, (10) entropion, (11) primary glaucoma, (12) retinal dysplasia, (13) progressive retinal atrophy, (14) corneal dystrophy, (15) cataracts of dogs under seven years of age, unless secondary to injury or diabetes mellitus, (16) sex hormone dermatosis, (17) growth hormone dermatosis, (18) hemophilia, (19) inherited coagulation (bleeding) disorders, (20) von Willebrand's disease
- Diagnosis or treatment for: (1) removal or treatment of deciduous (baby) teeth, (2) cosmetic dental restoration including veneers, crowns, caps or other prosthetic devices, (3) temporomandibular joint (TMJ) disease, (4) enamel hypoplasia, (5) gingivitis, or (6) tooth hygiene or appearance including teeth cleaning and polishing
- Diagnosis of, or treatment for, internal or external parasites
- Elective procedures or cosmetic surgeries
- Expression of anal glands, anal sacculitis, or removal of anal glands
- Preventive gastropexy, tail docking, dewclaw removal, ear cropping, skin fold resection, vulvar episioplasty, declawing, or nail trims
- Breeding or pregnancy including Cesarean section, dystocia, termination of pregnancy, pseudopregnancy, spaying or neutering
- Spay/neuter (unless optional wellness rider with spay/neuter benefits is purchased)
- Special diets, pet foods, or dietary or nutritional supplements
- Boarding, transportation, grooming, or bathing
- Routine examinations, preventive treatment—including vaccines, or diagnostics associated with preventive treatment (unless optional Pet Wellness plan is purchased)
- Diseases that are preventable by vaccination
- Age-related changes to your pet's eyes or ears
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the board of veterinary medicine of your state
- Diagnosis, treatment, training, or therapy for behavioral problems
- Fees or other expenses not directly related to veterinary services
- Diagnosis or treatment of any complication or progression of any condition excluded by this policy
Injury Plan
Excluded conditions or procedures include:
- Illnesses
- Pre-existing conditions
- Any additional excluded condition listed on the policy declarations page or renewal certificate
- Certain bone or joint conditions associated with (1) hip dysplasia, or any luxation or subluxation associated with hip dysplasia, (2) elbow dysplasia, (3) patellar luxation or subluxation, (4) osteochondritis dissecans, or (5) any fracture, luxation, or subluxation associated with aseptic necrosis of a femoral head
- Cruciate ligament or meniscal damage or rupture that occurs during the first twelve (12) calendar months of the policy
- Cervical vertebral instability/wobbler syndrome or intervertebral disc disease, rupture, or herniation
- Angular limb deformity
- Gastric torsion, dilation, or bloat
- Diagnosis or treatment for: (1) removal or treatment of deciduous (baby) teeth, (2) cosmetic dental restoration, (3) temporomandibular joint (TMJ) disease, or (4) tooth hygiene or appearance
- Diagnosis of, or treatment for, internal or external parasites
- Elective procedures or cosmetic surgeries
- Expression of anal glands, anal sacculitis, or removal of anal glands
- Preventive gastropexy, tail docking, dewclaw removal, skin fold resection, or nail trims
- Breeding or pregnancy or conditions related to breeding or pregnancy
- Medication prescribed more than one year after your pet's injury
- Special diets, pet foods, or dietary or nutritional supplements
- Boarding, transportation, grooming, or bathing
- Diagnosis, treatment, training, or therapy for behavioral problems
- Routine examinations, preventive treatment—including vaccines, or diagnostics associated with preventive treatment (unless optional Pet Wellness plan is purchased)
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the board of veterinary medicine of your state
- Fees or other expenses not directly related to veterinary services
- Diagnosis or treatment of any complication or progression of any condition excluded by this policy
Feline Select® Plan
Excluded conditions or procedures include:
- Pre-existing conditions
- Any additional excluded condition listed on the policy declarations page or renewal certificate
- Certain bone or joint conditions associated with (1) hip dysplasia, or any luxation or subluxation associated with hip dysplasia, (2) elbow dysplasia, (3) patellar luxation or subluxation, (4) osteochondritis dissecans, or (5) any fracture, luxation, or subluxation associated with aseptic necrosis of a femoral head
- Diagnosis of, or treatment for: (1) angular limb deformity or (2) cruciate ligament or meniscal damage or rupture
- Conditions caused by or resulting from a foreign body
- Conditions caused by or associated with neoplasia other than benign skin neoplasia
- Congenital disorders or developmental defects
- Hereditary conditions
- Diagnosis or treatment for: (1) removal or treatment of deciduous (baby) teeth, (2) cosmetic dental restoration, (3) temporomandibular joint (TMJ) disease, (4) enamel hypoplasia, (5) gingivitis, or (6) tooth hygiene or appearance
- Diagnosis of, or treatment for: (1) any insect bite or sting or (2) any internal or external parasite
- Elective procedures or cosmetic surgeries
- Expression of anal glands, anal sacculitis, or removal of anal glands
- Preventive gastropexy, tail docking, dewclaw removal, skin fold resection, or nail trims
- Breeding or pregnancy or conditions related to breeding or pregnancy
- Spaying or neutering (unless optional CareGuard® Premier is purchased)
- Special diets, pet foods, or dietary or nutritional supplements
- Boarding, transportation, grooming, or bathing.
- Routine examinations, preventive treatment—including vaccines, or diagnostics associated with preventive treatment (unless optional Pet Wellness plan is purchased)
- Age-related changes to your pet's eyes or ears
- Fees or other expenses not directly related to veterinary services
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the board of veterinary medicine of your state
- Diagnosis, treatment, training, or therapy for behavioral problems
- Diagnosis or treatment of any complication or progression of any condition excluded by this policy
Whole PetSM
Excluded conditions or procedures include:
- Pre-existing conditions
- Additional excluded conditions identified on the declarations page or renewal certificate of your policy
- Behavioral training, therapy or treatment that is: (1) not prescribed by a veterinarian or (2) pet obedience training
- Foods or dietary or nutritional supplements used to preserve or improve general nutrition or health (as opposed to treating a condition), even if prescribed by a veterinarian
- Cruciate ligament or meniscal damage or rupture that occurs during the first twelve (12) calendar months of the policy
- Routine examinations, preventive treatment—including vaccines, or diagnostics associated with preventive treatment
- Boarding, storage, transportation, grooming or bathing
- Fees or other expenses not directly related to veterinary services including (1) waste disposal, (2) record access or copying, (3) any license or certification, except a state or federal health certificate provided to you by your veterinarian, (4) compliance with any government rule or regulation, (5) any tax, or (6) any charge assessed by any bank, credit card company, or other financial institution
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the veterinary medical board of your state
Whole Pet with Wellness®
Excluded conditions or procedures include:
- Pre-existing conditions
- Additional excluded conditions identified on the declarations page or renewal certificate of your policy
- Behavioral training, therapy or treatment that is: (1) not prescribed by a veterinarian or (2) pet obedience training
- Foods or dietary or nutritional supplements used to preserve or improve general nutrition or health (as opposed to treating a condition), even if prescribed by a veterinarian
- Cruciate ligament or meniscal damage or rupture that occurs during the first twelve (12) calendar months of the policy
- Boarding, storage, transportation, grooming or bathing
- Fees or other expenses not directly related to veterinary services including (1) waste disposal, (2) record access or copying, (3) any license or certification, except a state or federal health certificate provided to you by your veterinarian, (4) compliance with any government rule or regulation, (5) any tax, or (6) any charge assessed by any bank, credit card company, or other financial institution
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the veterinary medical board of your state