Will pet insurance cover a torn ACL, and does one bad knee kill the other?

ACL, CCL, cruciate, same family problem

Dogs tear the cranial cruciate ligament (CCL), the same role as the human ACL. Owners, vets, and insurers use ACL, CCL, and “cruciate” interchangeably.

The insurance question is the same either way: was there a sign before coverage started, and does the policy treat the other knee as related?

A quote is often still available for a dog that already tore one. That does not mean the tear, or the other knee, will be paid back.

See problems already in the record for the general rule.

bone-and-joint and cruciate waiting periods

Anything that starts during a wait is typically classified as pre-existing for the life of that policy. Cruciate waits are often longer than ordinary accident waits.

All waits: verify on the quote form.

• Lemonade: 0 days accidents, 14 days illness, 30 days bone-and-joint (Lemonade waiting-period guide). State exceptions exist.
• Embrace: 14 days illness; accidents on the effective date; bone-and-joint often 180 days for dogs, sometimes reducible with a vet bone-and-joint exam.
• Fetch: no accident wait on public coverage pages; illness wait up to 15 days. Bone-and-joint bilateral rules still apply after that.
• Pets Best: state-specific. MN sample policy: 3 days injury, 14 days illness, 6 months for cruciate ligament events. A Waiting Period Health Assessment form may waive waits if a qualifying exam is done in the published window.
• Spot (CA disclosure): 14 days accident and illness; ligament and knee also 14 days on that notice. A Waiting Period Health Assessment may modify the wait. Other states may differ.
• Trupanion: US FAQ pages we successfully fetched do not publish one nationwide waiting-period number. Waiting periods are state-specific. Verify on the quote form.

Short version from public carrier pages. Rules change by state. Verify on the quote form. The long version, with sources, is on what counts as pre-existing.

both-sides exclusions: one bad knee, two knees out

Dogs that tear one cruciate often tear the other later. Insurers know that.

Several public pages we fetched treat ligament / knee / cruciate conditions as bilateral (both sides), meaning a problem on the left can exclude the right, and vice versa, regardless of cause.

• Embrace: both-sides conditions (examples include hip dysplasia and cruciate tears): if one side is pre-existing, the other side is not covered.
• Fetch: bone-and-joint bilateral, a prior cruciate on one knee typically excludes the other knee. Torn ligament is listed as lifelong.
• Spot (CA notice): Ligament and knee are both-sides and related regardless of cause, one side affects both. Spot’s 180-day cured path does not apply to ligament and knee conditions.
• Pets Best: The MN sample policy treats both-sides conditions as already there if present before the effective date or wait end. A documented ACL is pre-existing; cruciate events also carry a long wait on that sample. both-sides rules often take the other knee with it, confirm on the issued policy for your state.
• Lemonade: Knee/ligament conditions cannot use the 12-month cured path. We did not find a separate public Lemonade both-sides-cruciate sentence in the pages we fetched; treat many policies’ both-sides practice as something to verify on the issued policy.
• Trupanion: A documented ACL with signs before the effective date is pre-existing. We did not invent a Trupanion-specific both-sides cruciate rule from the US FAQ we fetched. Verify on the issued policy.

Many policies treat cruciate as bilateral (both sides) even when marketing copy is quiet about it. Read the definitions section of the policy you are actually offered.

pre-existing limp notes matter more than the MRI

A formal ACL diagnosis is not required for an exclusion. A chart note that the dog was “off on the right hind,” intermittent limping, or “possible CCL” before the wait ended can be enough.

That is how carriers date pre-existing, signs, not just surgery dates.

If you are still shopping and the dog is sound today, do not wait for the limp to start before you look at bone-and-joint waits. If the dog already limps, assume that side, and often both sides, will be carved out, then decide whether a policy still makes sense for unrelated accidents and illnesses.

For seniors, see senior dogs over 8.

Short version from public carrier pages. Rules change by state. Verify on the quote form. The long version, with sources, is on what counts as pre-existing.

Get a quote (official carrier URLs)

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Waiting periods, both-sides definitions, and premiums are state-specific, verify on the quote form and the issued policy.