Does pet insurance cover bilateral hip dysplasia?

"Yes, but there's a catch. If your pup's left hip was already showing signs" of dysplasia before your waiting period ended, the insurance company will almost always deny coverage for the right hip later on. They call it a 'bilateral exclusion.' It's incredibly frustrating, which is why getting them insured as a puppy is so important.

Are there breed-specific exclusions for hip dysplasia?

"Not usually based purely on breed anymore, thank goodness. But because we" see this so often in German Shepherds, Goldens, and Danes, a lot of companies slap a long 'orthopedic waiting period' on the policy—sometimes up to 6 months. They want to make absolutely sure your dog's joints are healthy before they commit to paying for them.

Can I get pet insurance if my dog already has hip dysplasia?

"You can absolutely still get insurance, and honestly, you still should." The dysplasia itself will be stamped as a 'pre-existing condition' and won't be covered. But if your dog eats a sock, gets cancer, or tears a ligament in their knee (which happens a lot when they compensate for bad hips!), the insurance will cover those new, unrelated disasters.

Does Pet Insurance Cover Hip Dysplasia? What You Need to Know

German Shepherds with their gorgeous slopes, Goldens with their goofy smiles, Great Danes that think they are lap dogs. Owning a large breed is amazing, but it comes with a terrifying shadow: hip dysplasia. I’ve been a vet tech in emergency and orthopedic practices for 15 years, and let me tell you, watching a two-year-old Lab struggle to stand up from their bed because their own joints are failing them is absolutely heartbreaking. It’s a genetic hand grenade.

The ball and socket of their hip just don’t fit right. Instead of gliding smoothly, the bones grind together with every single step. It leads to loose joints, microscopic bone fractures, and eventually, crippling arthritis.

Treating it isn’t cheap. I’ve had to hold the paws of too many weeping owners who had to choose “economic euthanasia” simply because they couldn’t afford a $7,000 hip replacement for a dog that had years of life left.

So, when clients ask me, “Does pet insurance actually cover hip dysplasia?” I give them the honest truth.

Yes, most standard pet insurance plans will cover hip dysplasia—but only if you beat the clock. You have to enroll them before their hips start showing signs of trouble.

Let’s break down what this actually looks like, what the treatments really involve, and how to avoid the fine-print traps that insurance companies use to deny claims.

The Brutal Reality of Treating Hip Dysplasia

To understand why I push insurance so hard for large breeds, you need to know what we’re actually doing in the treatment room and what it costs.

Initial Diagnosis ($200 – $500): We have to heavily sedate your dog to get the perfect X-rays. We need their muscles completely relaxed to see exactly how loose that joint is.
Conservative Management ($50 – $150/month): This isn’t a cure. This is daily pain meds (NSAIDs) to keep the inflammation down, joint supplements, and a strict diet because every extra pound is a knife in those joints.
Physical Therapy ($50 – $75/session): We put them on underwater treadmills to build the muscle around the hip without putting weight on the grinding bones.
Femoral Head Ostectomy / FHO ($1,500 – $3,000 per hip): We literally cut off the ball part of the femur bone. Sounds barbaric, right? But taking away that bone-on-bone grinding allows scar tissue to form a “false joint.” It works well for smaller dogs, but it’s tough on the big guys.
Total Hip Replacement / THR ($5,000 – $7,000+ per hip): This is the holy grail. We hollow out the bone and implant a titanium and plastic artificial joint. Your dog wakes up, and the mechanical pain is just… gone. But if they need both hips done, you’re staring down a $14,000 bill.

How to Get Insurance to Actually Pay for It

If you want the insurance company to hand over a check for a $7,000 titanium hip, you have to play by their rules. Here are the three hurdles you have to clear.

1. The Pre-Existing Condition Trap

No insurance company will cover a burning house. If your dog is already “bunny hopping” up the stairs, struggling to get into the car, or has a documented limp in their medical records, the insurance company will label it a pre-existing condition.

Because dysplasia is lifelong, it will be permanently excluded from your coverage. This is why I practically beg new puppy owners to get insurance at 8 weeks old. Get the policy before the genetics kick in.

2. The Dreaded Orthopedic Waiting Period

Let’s say you sign up today, and your dog seems fine. Most policies have a standard 14-day waiting period for illnesses. But because companies know how expensive hips are, many slap on a special “orthopedic waiting period” that can last up to 6 months.

If your dog starts limping on day 150 of a 180-day waiting period, your claim gets denied. Period.

3. The Bilateral Exclusion (The “Other Hip” Rule)

This one makes me so mad, but you need to know about it. Dysplasia usually affects both hips eventually. If your dog’s left hip goes bad before your waiting period is up, the left hip isn’t covered. But read the fine print: many companies will also refuse to cover the right hip if it goes bad a year later. They argue the genetic flaw was already there. It’s called a bilateral exclusion, and it’s a financial nightmare.

Which Companies Handle Hips Best?

Not all policies are created equal. Here’s my blunt take on how some of the big names handle this.

Trupanion

We love dealing with Trupanion at the front desk for big surgeries.

The Good: They have no extended orthopedic waiting period. Just their standard 30-day illness wait. They don’t do bilateral exclusions for hips.
The Catch: You need their “Recovery and Complementary Care” rider if you want them to pay for underwater treadmill therapy or acupuncture, which are huge for rehab.

Embrace

Embrace is great, but you have to do your homework.

The Good: They cover the surgeries and meds well.
The Catch: They have a 6-month orthopedic waiting period. However, you can bring your dog to us for an “Orthopedic Exam.” If we sign a waiver saying their joints feel tight and healthy, Embrace drops that wait time down to 14 days. Do this.

Lemonade

Lemonade is super popular because the app is easy to use.

The Good: Standard 14-day waiting period in most states (though check your local rules, they change).
The Catch: Their base plan doesn’t cover physical therapy. You must buy the Physical Therapy add-on if you want help paying for conservative management.

Pets Best

A solid, budget-friendlier option.

The Good: They cover the big surgeries and even mobility aids like wheelchairs if it comes to that. Standard 14-day wait for hips (though they have a 6-month wait for knee ligaments).
The Catch: They do enforce bilateral exclusions. If one hip is pre-existing, you’re on your own for the other one.

Nationwide

You have to be incredibly careful which plan you pick here.

The Good: Their “Whole Pet” plan covers a straightforward percentage of your vet bill.
The Catch: Their “Major Medical” plan uses a benefit schedule. It might cap your hip dysplasia payout at something ridiculous like $1,500 for the year. That barely covers the X-rays and a few months of meds. You’ll be left holding the bag for the actual surgery.

My Advice from the Clinic Floor

If you have a Lab, a Shepherd, a Mastiff, or any large breed, assume their hips are going to be a problem. Don’t wait for a limp.

Insure them the day you bring them home. Eight weeks old is the perfect time.
Ask about the waiver. If you go with a company that has a 6-month wait, ask us to do the orthopedic exam to reduce it.
Check the physical therapy coverage. Surgery is great, but rehab is how they actually recover. Make sure your plan covers it.

Hip dysplasia is a horrible diagnosis, but it shouldn’t be a death sentence just because of the cost. Get the insurance. Let us fix your dog’s hips so they can get back to chasing tennis balls, and let the insurance company worry about the bill.