Does Pet Insurance Cover ACL Surgery? Costs & Exclusions

Updated • Mar 11th '25

Introduction

ACL injuries are common among pets, particularly dogs, and often require surgical intervention. The cost of ACL surgery can be significant, ranging from $1,500 to $10,000 or more. Pet insurance can help ease this financial burden, but coverage depends on various factors, including policy type, pre-existing conditions, and specific exclusions. In this guide, we’ll explore how pet insurance handles ACL surgery and what pet owners need to know before making a claim.

Understanding ACL Injuries in Pets

While humans have an anterior cruciate ligament (ACL), dogs and cats have a similar structure called the cranial cruciate ligament (CCL). When this ligament tears, it can lead to severe pain and mobility issues, making surgery a necessity. ACL injuries can occur suddenly due to an accident or develop over time due to degeneration.

Some common causes of ACL injuries in pets include:

Sudden trauma: A bad jump, fall, or rough play can cause ligament tears.
Obesity: Excess weight puts more pressure on a pet’s joints, leading to injury.
Age-related degeneration: Older pets are more susceptible to ligament wear and tear.
Breed predisposition: Some breeds, like Labrador Retrievers and Rottweilers, have a higher risk of ACL injuries.

Early signs of an ACL tear include limping, swelling around the knee, and difficulty standing or walking. If your pet shows these symptoms, consult a veterinarian immediately.

Does Pet Insurance Cover ACL Surgery?

Most pet insurance policies cover ACL surgery under specific conditions. The key factors that determine coverage include:

Pre-Existing Conditions: If your pet had signs of an ACL injury before enrollment, it might not be covered.
Waiting Periods: Many insurers impose waiting periods (often six months) before ACL-related claims can be made.
Policy Type: Comprehensive insurance is more likely to cover ACL surgery, while accident-only policies may only cover cases caused by sudden trauma.
Bilateral Conditions: Some insurers won’t cover ACL injuries on both legs if one side was already injured before getting insurance.

Types of Pet Insurance and ACL Coverage

1. Comprehensive Pet Insurance

Comprehensive plans, also known as accident and illness policies, offer the broadest coverage. These policies generally cover ACL surgery unless it falls under a pre-existing condition or occurs within the waiting period.

2. Accident-Only Pet Insurance

Accident-only policies cover injuries caused by unexpected events, such as falls or sudden trauma. However, ACL injuries caused by gradual degeneration are typically excluded. If your pet’s torn ligament resulted from an accident, the surgery may be covered under this type of plan.

How to File a Pet Insurance Claim for ACL Surgery

If your pet requires ACL surgery, follow these steps to increase the likelihood of a successful insurance claim:

Recognize Symptoms: If your pet is limping or showing signs of pain, consult a veterinarian.
Schedule a Vet Appointment: Your vet will conduct an examination and diagnostic tests, such as X-rays.
Obtain a Diagnosis: If an ACL tear is confirmed, discuss treatment options, including surgery.
Review Your Insurance Policy: Check your policy for coverage details, exclusions, and waiting periods.
Pay for the Surgery: Most insurance plans require you to pay upfront and submit a claim for reimbursement.
Submit a Claim: Provide itemized invoices, medical records, and any required documentation to your insurer.
Wait for Approval: The insurer will review your claim and determine how much of the cost is covered.

Common ACL Surgery Exclusions and Limitations

While many pet insurance plans cover ACL surgery, they may include specific exclusions, such as:

Bilateral Conditions: If your pet has an ACL injury on one leg before getting insurance, a future ACL tear on the other leg may not be covered.
Long Waiting Periods: Some insurers have extended waiting periods for cruciate ligament injuries.
Pre-Existing Conditions: Any signs of knee problems before enrollment may lead to claim denial.
Rehabilitation and Physical Therapy: Some policies exclude post-surgery treatments unless you purchase additional coverage.

Factors That Affect the Cost of ACL Surgery

The cost of ACL surgery varies due to multiple factors, including:

Severity of the Injury: The more severe the tear, the more complex and expensive the surgery.
Type of Surgery: Procedures like TPLO (Tibial Plateau Leveling Osteotomy) or TTA (Tibial Tuberosity Advancement) tend to be more expensive than extracapsular repair.
Veterinary Clinic Location: Urban areas and specialized veterinary hospitals often have higher costs.
Size and Breed of Your Pet: Larger dogs generally require more anesthesia and post-operative care, increasing costs.
Post-Surgical Care Needs: Costs may include follow-up visits, pain medications, rehabilitation, and mobility aids.

Many veterinary offices require payment upfront, and pet owners must seek reimbursement from their insurance provider. Depending on your policy, you may still be responsible for deductibles and co-insurance.

Recovery and Post-Surgery Care

Healing from ACL surgery takes time, typically around three to six months. Key aspects of post-surgery care include:

Rest and Restricted Movement: Keep your pet in a confined space to prevent excessive movement.
Pain Management: Follow the vet’s prescribed medication plan.
Physical Therapy: Some pets benefit from rehabilitation to regain strength.
Follow-Up Vet Visits: Regular check-ups ensure proper healing.

Some pet insurance policies cover rehabilitation and post-op care, but others require additional coverage. Check your policy for details.

Choosing the Right Pet Insurance for ACL Coverage

If ACL surgery coverage is a priority, compare different insurance providers and consider the following:

Policy Cost vs. Coverage Benefits
Waiting Periods for Cruciate Ligament Injuries
Exclusions for Bilateral Conditions
Reimbursement Rates and Deductibles
Customer Reviews and Claim Processing Efficiency

Some popular pet insurance providers that cover ACL surgery include:

Embrace Pet Insurance
Lemonade Pet Insurance
Fetch Pet Insurance

Always request a personalized quote and review policy details before choosing an insurance plan.

Final Thoughts

ACL surgery is a common yet costly procedure for pets. Having the right pet insurance policy can save you thousands of dollars, but it’s essential to understand your policy’s terms and conditions. Be proactive by enrolling in pet insurance before health issues arise and reviewing policy details to ensure comprehensive coverage for potential ACL injuries.

By planning ahead and choosing the right pet insurance plan, you can provide the best medical care for your furry companion while minimizing financial stress.