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Bilateral conditions: if one knee (or hip) is out, does the other side get covered?
By Bradley Jacobs · Published Sep 9, 2026
“both-sides” means both sides. Many pet policies treat knees, hips, or eyes as a pair. If one side is already in the record, the other side can be left out too, even if it looks fine today.
What “both-sides” means on a pet policy
Embrace’s coverage FAQ defines a both-sides condition as a condition or disease that affects both sides of the body, and names hip dysplasia and cruciate ligament tears as examples. Spot’s California insurer disclosure says ligament and knee conditions are both-sides and related regardless of cause, an occurrence on one side affects both.
Fetch’s pre-existing page uses the same idea for bone-and-joint both-sides conditions: a prior cruciate on one knee typically takes the other knee with it.
The practical owner question is usually the second knee: the first tear (or dysplasia note) already sits in the record, and the “good” side looks fine today. Under both-sides rules, that second side may never be eligible on that policy.
Related pages: ACL / cruciate, hip dysplasia, bone-and-joint waiting periods, and problems already in the record.
The short answer
- One side already pre-existing:
- Embrace, Fetch, and Spot (CA notice) say publicly that the other side is not covered for that related both-sides condition.
- Pets Best’s MN sample policy language we previously mapped also treats both-sides conditions as pre-existing when present before the wait ends.
- Verify your state’s issued policy.
- First side covered, then the other side later: Embrace’s FAQ states the flip case: if a pet is diagnosed with one covered both-sides condition, Embrace will also cover the condition if it occurs on the other side. That only helps when the first side was eligible, not when it was already excluded.
- Knee / ligament often cannot “cure” out: Lemonade says knee/ligament conditions cannot use the 12-month cured path. Fetch lists torn ligament as lifelong. Spot’s 180-day cured path does not apply to ligament and knee. Waiting out a year rarely unlocks the second knee.
Carrier-by-carrier both-sides language
Facts below come from public pages fetched or re-checked in September 2026. They are not personalized underwriting.
Label anything operational stale-prone: verify on the quote form and the issued policy.
- Embrace:
- Coverage FAQ, both-sides examples include hip dysplasia and cruciate ligament tears.
- Because the pet runs a higher risk of the same condition on the other side, a pre-existing instance means Embrace is not able to cover the condition on the other side.
- If one covered both-sides condition occurs, the other side can also be covered when it happens later.
- Fetch: problems already in the record page, torn-ligament example: with bone-and-joint bilateral conditions, the pet runs a higher risk of the same condition on the other side, and future occurrences (such as a cruciate tear on the left after a prior right tear) are treated as already there and not covered. Torn ligament is listed as lifelong on that page.
- Spot (CA disclosure): Ligament and knee conditions are both-sides and related regardless of cause, an occurrence on one side affects both sides. Spot’s can clear up / 180-day path does not apply to ligament and knee. Other states may differ, verify.
- Pets Best:
- State-specific.
- The MN sample policy booklet we previously mapped treats both-sides conditions (along with chronic and intervertebral-disc conditions) as already there if present before the effective date or wait end.
- Confirm your state’s booklet rather than assuming MN language.
- Lemonade:
- Public pre-existing guide we fetched does not use the word “both-sides” the way Embrace and Spot do.
- It does say knee or ligament conditions cannot be cured under the 12-month symptom-free path, and that chronic conditions stay excluded.
- Do not invent a Lemonade both-sides clause, verify how your issued Lemonade policy treats the contralateral knee or hip.
- Trupanion:
- US pre-existing FAQ we successfully fetched defines pre-existing with an 18-month lookback and does not publish a single nationwide both-sides sentence on that page.
- Eligibility for a specific condition is often determined at claim time.
- Verify on the quote form and issued policy.
| Carrier | Age to join | Illness wait | Knee or joint wait | Cured problems | Quote |
|---|---|---|---|---|---|
| Lemonade | From 2 months. Top age depends on breed and state | 14 days | 30 days for joints | Some short-term problems after 12 months clear. Not knees or long-term problems | Get a quote from Lemonade |
| Embrace | 6 weeks to 14 (15+ accident-only) | 14 days | Often 6 months, varies by state | Some short-term problems after 12 months clear | Get a quote from Embrace |
| Fetch | From 6 weeks, no top age listed | Up to 15 days | Check the quote form | Some short-term problems after 1 year clear | Get a quote from Fetch |
| Pets Best | From 7 weeks, no top age | 14 days in the sample we read | 6 months for knee ligaments in the sample we read | Some problems that fully heal | Get a quote from Pets Best |
| Trupanion | Under 14 | Varies by state | Varies by state | No cured path on the page we read | Get a quote from Trupanion |
| Spot | From 8 weeks, no top age | 14 days | 14 days for knees in CA | Some problems after 180 days clear. Not knees | Get a quote from Spot |
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.
Why the second-knee question shows up so often
Cruciate disease and hip dysplasia are common in Labs, Goldens, German Shepherds, French Bulldogs, and other breeds owners already worry about. The first side often appears as intermittent limping, a “soft tissue” note, or a rule-out before anyone buys a policy.
Once that note is in the chart, both-sides language can lock out both sides even if the contralateral joint still looks clean on exam day.
Bone-and-joint waiting periods compound the problem: a limp during the wait can make that side, and, under both-sides rules, often the other side, pre-existing for the life of the policy. See bone-and-joint / cruciate waiting periods.
For dogs already in the senior chart with joint notes, see senior dogs over 8.
| Carrier | Age to join | Illness wait | Knee or joint wait | Cured problems | Quote |
|---|---|---|---|---|---|
| Lemonade | From 2 months. Top age depends on breed and state | 14 days | 30 days for joints | Some short-term problems after 12 months clear. Not knees or long-term problems | Get a quote from Lemonade |
| Embrace | 6 weeks to 14 (15+ accident-only) | 14 days | Often 6 months, varies by state | Some short-term problems after 12 months clear | Get a quote from Embrace |
| Fetch | From 6 weeks, no top age listed | Up to 15 days | Check the quote form | Some short-term problems after 1 year clear | Get a quote from Fetch |
| Pets Best | From 7 weeks, no top age | 14 days in the sample we read | 6 months for knee ligaments in the sample we read | Some problems that fully heal | Get a quote from Pets Best |
| Trupanion | Under 14 | Varies by state | Varies by state | No cured path on the page we read | Get a quote from Trupanion |
| Spot | From 8 weeks, no top age | 14 days | 14 days for knees in CA | Some problems after 180 days clear. Not knees | Get a quote from Spot |
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.
What a quote still can (and cannot) do
- A dog with one bad knee can often still get a quote. That is not the same as coverage for either knee.
- New, unrelated accidents and illnesses after waits can still be in scope on an accident-and-illness policy. both-sides exclusions are condition-specific, not a total denial of every future claim.
- Switching carriers generally starts new waits and a fresh medical-history review. A prior cruciate on carrier A is usually still history for carrier B. Do not assume a move unlocks the second knee.
- Accident-only plans will not stand in for illness / bone-and-joint both-sides coverage on the “good” side. See accident-only vs wellness.
Get a quote (official carrier URLs)
We do not run a fake quote widget. These buttons open the carrier. both-sides definitions, waiting periods, and premiums are state-specific, verify on the quote form and the issued policy.
General carrier rules (waits, age limits, pre-existing) come from official carrier pages. The full list of those sources is on what counts as pre-existing.