Pet Insurance Fine Print, Compared: What 12 Insurers Actually Publish

Pet insurance waiting periods by company, plus exam fees, age caps and cured-condition rules, from the policies of 12 US insurers. Sourced, October 2026.

The biggest differences between US pet insurers in 2026 are not in the price but in four rules most buyers never read: whether the exam fee is covered, how long you wait for knee and hip problems, how old a pet can be at enrollment, and whether a cured condition ever becomes covered again.

Every pet insurance website has the same hero image. A dog, mid-leap, ears inside out, apparently thrilled about deductibles. Below it sits a price that starts somewhere around ten dollars. What the page rarely puts in large type is the rule that decides whether your claim gets paid.

So we went and read the small type. Between October 1 and October 2, 2026, we went through the public websites, FAQs, state disclosures and sample policies of twelve US pet insurers: Lemonade, Trupanion, MetLife Pet, Spot, Pets Best, Healthy Paws, Embrace, Figo, ASPCA Pet Health Insurance, Nationwide, Fetch and Pumpkin. We recorded ten terms for each, and we only counted what the company itself publishes. Of the 120 cells in our table, 118 come straight from the insurer's own site or a policy document it links to. The other two are marked as unverified, because the company does not say.

A quick word on who we are. CoverHope earns a referral fee when readers get a Lemonade Pet quote through our links. None of the figures below are affected by that, there are no affiliate links in this article, and Lemonade comes out of several findings less flatteringly than its marketing would suggest.

The full table

Here is the short version of all twelve. A few terms used throughout: the annual limit is the most the insurer will pay in a policy year; the reimbursement rate is the share of each covered bill it pays back after your deductible; a waiting period is the gap between buying the policy and being covered. "Ortho/knee" means cruciate ligament tears and similar orthopedic problems, which in dogs often ends in surgery.

Terms vary by state, and several insurers use more than one policy form. Where a company's own pages disagree, we used its policy document and say so below. Every cell, with the source link and the exact quote, is in our method notes.

Finding 1: Five of twelve don't cover the exam fee in the base plan

Almost every vet visit starts with an exam, and the exam is often the part of the bill an owner expects to be covered without thinking about it. Five insurers say otherwise.

Trupanion lists "Exam fees & taxes" under what it does not cover. Healthy Paws is unusually candid about why: "By making the office visit (exam fee) part of a pet parent's financial responsibility, we can offer accident and illness plans at a more affordable monthly premium." Lemonade, Embrace and Figo all sell exam cover separately, as an add-on. Pets Best sits in the middle: most of its plans include exam fees, but the cover "can be removed to reduce your monthly premium."

That is a reasonable trade if you know you made it. MetLife Pet, Spot, ASPCA, Fetch, Pumpkin and Nationwide include the exam fee in the base plan, so their prices aren't directly comparable with the first group.

Finding 2: The knee rule is where the policies really split

A torn cranial cruciate ligament is the dog version of an ACL tear, and the repair is surgery. That is why insurers write special rules for it. Here is how far apart those rules are:

• No separate wait: MetLife Pet ("doesn't have a separate waiting period for orthopedic conditions"), Pumpkin (one wait "for all accidents & illnesses: 14 days or less, depending on your state") and Trupanion.
• 14 days, knees included: Spot and ASPCA. Their Florida sample policies use word-for-word the same sentence: a 14-day waiting period "related to accidents, illnesses and ligament and knee conditions."
• Six months: Lemonade, Pets Best, Figo and Fetch. Figo and Fetch let a vet exam waive it, and Pets Best's FAQ describes a waiver exam too.
• Twelve months before you can even buy it: Nationwide's cruciate cover "may only be available for enrollment 12 months after the initial policy inception date."
• A lifetime exclusion: in most states, Embrace treats cruciate disease, spinal disc disease, kneecap luxation and hip dysplasia that show signs "during the first 180 days" as pre-existing "for the life of the policy." California, Louisiana, New Hampshire, Pennsylvania, Vermont and Washington get a 30-day window instead, and Kansas, New Mexico and South Carolina a 6-month wait that a vet exam can shorten.

For a puppy owner, that last row matters more than anything on the price page. A limp in month five means something very different at Embrace than it does at MetLife.

Finding 3: "No upper age limit" sometimes has an asterisk

Seven insurers say plainly that there is no upper enrollment age: MetLife Pet, Spot, Pets Best, Figo, ASPCA, Fetch and Pumpkin. (Fetch's own dog page still says it is "probably not the best choice" for senior dogs, which is refreshingly honest.)

The others draw a line. Nationwide's Modular plan offers new illness cover "only for dogs and cats 8 years and younger," the tightest cap in the group. Trupanion enrolls pets "before their 14th birthday." Embrace advertises "No upper age limit," then explains that dogs 15 and older can enroll in accident-only cover. Lemonade refers to "our age limit" in its FAQ without publishing the number, and Healthy Paws didn't publish a maximum on any page we could read.

If your cat is twelve, as ours is, that list does most of the shopping for you.

Finding 4: When does a cured condition stop being "pre-existing"?

Every insurer excludes pre-existing conditions. The difference is whether a curable one (an ear infection, a bout of vomiting, a broken leg that healed) can ever be covered again. The answers:

• After 180 days symptom-free: Spot, ASPCA and Pumpkin, with knee and ligament problems excluded from the rule.
• After 12 months: Lemonade ("in most states"), Embrace, Figo, Fetch and Healthy Paws.
• On request, after 6 to 12 months and a vet re-exam: Nationwide.
• No fixed period: MetLife Pet will cover a new incident that is unrelated to the old one.
• No such provision: Trupanion defines pre-existing as anything with signs in the 18 months before coverage starts.
• Unclear: Pets Best says cured conditions can stop counting after "the required period" but doesn't say how long that is.

One oddity worth flagging: Lemonade's main pet page says "Currently, we don't cover pre-existing conditions," while its FAQ and cost guide describe the 12-month curable rule. Both are on lemonade.com. We'd read the policy for your state before relying on either.

Finding 5: The advertised prices cannot be compared

We didn't use any third-party price surveys in this piece, and after reading the insurers' own price claims, we'd suggest treating those with care too.

• Trupanion and Healthy Paws publish no price at all.
• Nationwide's "from" price is $11, $12 or $13 a month depending on which page you land on, and all three are for accident-only cover, not accident and illness.
• ASPCA's "as low as $10/month" is based on a quote "as of 6/1/22" for a young Chihuahua mix with a $3,000 limit.
• Figo's only published average, "around $31 a month," comes from a blog post dated August 2021.
• MetLife's "from $16 a month for dogs" is an average "for select plans and coverages in Florida."
• Fetch gives two averages for the same period: $35 for dogs and $22 for cats on its cost page, $34 and $21 in its FAQ.

Lemonade at least states its own figures clearly: it "starts at $10/month," and its internal averages are about $48 a month for dogs and $27 for cats across ages, breeds and locations. But that is still Lemonade's own blend, not a quote for your pet. The only number that means anything is the one you get for your animal, in your ZIP code, at the limit and deductible you'd actually choose.

Finding 6: Several insurers' websites disagree with themselves

We expected terms to vary by state. We didn't expect so many companies to contradict themselves on the same site.

• Lemonade lists three different accident waits: 2 days in its policy disclosure, "no waiting period at all" in its waiting-period guide, an orthopedic wait of 30 days in its FAQ, and a 6-month cruciate wait in its disclosure.
• Trupanion says pets can enroll "from birth" in one FAQ and at "eight weeks" on its kitten page. Its FAQ lists 5- and 30-day waits; its disclosure for five states says there are none.
• Nationwide's generic sample policy applies the 14-day wait to "All coverages"; its Ohio disclosure applies it to illness only. Its homepage example uses 90% reimbursement, which no current plan card offers.
• ASPCA gives the lowest annual limit as $2,500 on one page and $3,000 on another.
• Fetch says accidents have no waiting period on most pages, while its waiting-period FAQ treats an accident during the waiting period as pre-existing.

None of this means anyone is hiding anything. It mostly means marketing pages get updated on a different schedule from policy forms. But it is the reason we'd always ask for the sample policy for your state before you pay.

Finding 7: Different brands, same insurer

Brand names suggest more choice than exists underneath. Spot, ASPCA and Pumpkin each name the same two underwriters, Independence American Insurance Company or United States Fire Insurance Company. Figo also uses Independence American, and Pets Best lists it among four. Spot's and ASPCA's Florida sample policies carry the same form version and identical waiting-period text. ASPCA states that it "is not an insurer" and licenses its name for a royalty, and Pumpkin describes itself as a licensed agency.

That isn't a criticism. Shared paper is normal in insurance. It does mean that shopping three of these brands can be less different than it looks, and that the meaningful differences are the add-ons, prices and service, not the core contract.

What we'd actually do with this

Start with your pet, not the brand. Decide what you need covered: a puppy needs a forgiving knee rule; a senior pet needs an insurer that will still enroll it; anyone who visits the vet often should make sure the exam fee is covered. Then cut the list using the table above, get real quotes from the two or three that remain, and read the sample policy for your state before you sign.

If Lemonade is on your shortlist, our Lemonade vs Trupanion, Lemonade vs MetLife and Lemonade vs Spot vs Pets Best comparisons go deeper, including where Lemonade loses.

Frequently Asked Questions

Which pet insurance has the shortest waiting period?

For accidents, MetLife Pet and Embrace start cover with no accident wait, and Figo's is one day. For illness, most insurers use 14 or 15 days. Trupanion is the outlier at 30 days for illness, though it has no extra wait for orthopedic conditions. Terms vary by state, so check the sample policy for yours.

Which pet insurers have a 6-month wait for cruciate ligament injuries?

Lemonade, Pets Best, Figo and Fetch all publish a 6-month wait for cruciate or orthopedic conditions. Figo and Fetch let a vet exam waive it. MetLife Pet, Pumpkin and Trupanion have no separate orthopedic wait, while Embrace, in most states, permanently excludes knee and hip conditions that show signs in the first 180 days.

Does pet insurance cover the vet exam fee?

Not always. Trupanion and Healthy Paws exclude it, and Lemonade, Embrace and Figo sell it as an add-on. MetLife Pet, Spot, ASPCA, Fetch, Pumpkin and Nationwide include it in their base accident and illness plans.

Is there a pet insurance with no upper age limit?

Yes. MetLife Pet, Spot, Pets Best, Figo, ASPCA, Fetch and Pumpkin publish no upper enrollment age. Nationwide only offers new illness cover to pets 8 and under, Trupanion enrolls before the 14th birthday, and Embrace limits pets 15 and older to accident-only cover.

How we did this

We read each insurer's public website between October 1 and 2, 2026, including FAQs, coverage pages, state disclosures and the sample policies the insurers link to. We counted a document as primary only if it sits on the insurer's domain or is linked from it. We didn't log into any account or request quotes, and we didn't use third-party price figures. Where an insurer offers more than one plan, we used the accident and illness plan sold to individuals. Two values could not be confirmed from the insurer's own pages: Healthy Paws' maximum enrollment age and the length of Pets Best's cured-condition period. Both are marked as unpublished.

Policies change, and terms vary by state. If you are an insurer and something here is out of date, write to hello@coverhope.com and we'll correct it with a dated note. Journalists and researchers are welcome to use this data with a credit and a link to this page; the full sourced dataset, with the exact quote behind every cell, is available on request.