Condition guide
Will pet insurance cover a torn ACL, and does one bad knee kill the other?
A torn cruciate (ACL) is one of the biggest bone-and-joint bills in dogs. Coverage usually hangs on whether any limp or knee note showed up before the bone-and-joint waiting period ended, and whether the policy treats both knees as one problem. This page maps those rules from public carrier pages.
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.
The short answer
- New tear after waits: An eligible accident-and-illness policy can cover a first cruciate event that starts after bone-and-joint / ligament waiting periods end, subject to deductible, payback %, and annual limits on the issued policy. Verify on the quote form.
- Already torn, already limping, or already noted: Treated as already there. Every carrier we reviewed excludes it. 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 conditions.
- The other knee:
- Many policies treat cruciate / ligament / knee disease as bilateral (both sides).
- If one side is pre-existing, the other side is often excluded too.
- Embrace, Fetch, and Spot (CA notice) say this explicitly on public pages we fetched.
- For other carriers.
- Verify on the issued policy, we did not invent both-sides language where we did not find it.
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.
| Carrier | Waiting periods | Quote |
|---|---|---|
| Lemonade | Lemonade’s waiting-period guide (fetched Aug 2026): 0 days for accidents, 14 days for illnesses, 30 days for orthopedic conditions. Policy effective 12:01 a.m. the day after purchase. Preventative-care packages, if purchased, start when the policy activates. Some states use different waits, Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Lemonade |
| Embrace | Embrace’s waiting-period page: 14-day illness wait; accident coverage starts on the policy effective date. Orthopedic waits vary by state. Embrace help articles and sample terms describe a 180-day (6-month) orthopedic wait for dogs, sometimes reducible with a vet orthopedic exam. Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Embrace |
| Fetch | Fetch’s public coverage pages: no waiting period for accidents (new injuries on or after the effective date, described as 1 day after you sign up). Illness waiting period of up to 15 days. Optional wellness: no waiting period. Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Fetch |
| Pets Best | Waiting periods vary by state. A Pets Best sample policy booklet (MN) lists 14 days for illnesses, 3 days for injuries, and 6 months for cruciate ligament events. Pets Best also publishes a Waiting Period Health Assessment form (dated 03/2025) that may waive waits if a qualifying exam is done 3 days before or 7 days after the effective date. Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Pets Best |
| Trupanion | Trupanion’s US public FAQ pages we successfully fetched do not publish a single nationwide waiting-period number. Waiting periods are state-specific. Do not rely on Australian Trupanion pages for a US policy. Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Trupanion |
| Spot | Spot’s California insurer disclosure (fetched Aug 2026): 14-day accident and illness waiting period on the first policy period; ligament and knee conditions also 14 days. Conditions during a wait are pre-existing. A Waiting Period Health Assessment may modify the wait. Other states may differ. Verify on the quote form and the issued policy. Terms vary by state. | Get a quote from Spot |
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.
| Carrier | Pre-existing | Curable path | Quote |
|---|---|---|---|
| Lemonade | Not covered. A pre-existing condition is any issue the pet showed signs of, was diagnosed with, or was treated for before the waiting period ended. Pets with pre-existing conditions can still be insured; related bills are not reimbursed. | In most states Lemonade describes a 12-consecutive-month symptom- and treatment-free path for some temporary conditions. Knee/ligament conditions and chronic conditions (examples Lemonade lists: arthritis, allergies, asthma, cancers, endocrine diseases) cannot be ‘cured’ under that rule. | Get a quote from Lemonade |
| Embrace | Not covered. Embrace defines a pre-existing condition as any injury, illness, or irregularity noticed by you or your veterinarian before the end of the waiting period, even if the pet never saw a vet for it. | Curable vs incurable: Embrace lists diabetes and allergies as examples of incurable pre-existing conditions. Ear infections and undiagnosed vomiting or diarrhea are examples of curable issues that may be eligible after 12 months symptom-free. Bilateral conditions (hip dysplasia, cruciate tears): if one side is pre-existing, the other side is not covered. | Get a quote from Embrace |
| Fetch | Not all pre-existing conditions are covered. Fetch says no pet insurance covers all of them. Defined as any injury, illness, or condition noticed before signup, before the effective date, or during the wait of up to 15 days. | Fetch describes a two-year path for curable conditions (UTI, URI, bite wounds, ear infection, diarrhea, etc.): 1 year symptom- and treatment-free, with a second chance in year 2. Incurable examples Fetch lists: torn ligament, allergies, arthritis, IVDD, diabetes, thyroid disease. Orthopedic bilateral: a prior cruciate on one knee typically excludes the other knee. | Get a quote from Fetch |
| Pets Best | Not covered. Pets Best: any condition present before the end of waiting periods, even if not formally diagnosed. Signs or symptoms before the policy started mean no coverage for that condition. | Pets Best says some conditions (examples: broken legs, kennel cough) that heal and require no further treatment are not treated as pre-existing once healed. The MN sample policy treats chronic conditions, bilateral conditions, and intervertebral-disc conditions as pre-existing if present at any time before the effective date or wait end, with an 18-month lookback for other conditions. | Get a quote from Pets Best |
| Trupanion | Not covered. Trupanion’s US FAQ: a pre-existing condition is any illness, condition, or injury for which signs or evidence of potential manifestation existed within the 18 months prior to the effective date or applicable waiting periods. Recurrence of a prior injury is also pre-existing. Eligibility for a specific condition cannot be determined until a claim is submitted. | Trupanion’s US FAQ example: allergies diagnosed as a puppy remain excluded even after years without symptoms. Trupanion does not describe a 12-month ‘cured’ path on the US pre-existing FAQ we fetched. A hip-dysplasia example was covered when Trupanion found a medical disconnect from an old sprain. We do not treat ACL/cruciate as curable on Trupanion based on that page. | Get a quote from Trupanion |
| Spot | Not covered. Spot: any illness or injury that shows signs before the policy and before the wait ends, usually including undiagnosed issues. | Spot: cured/curable pre-existing conditions (examples: broken bones, foreign-object ingestion) may be covered later if the pet has gone 180 days symptom- and treatment-free. This does not apply to ligament and knee conditions. Spot’s CA notice: ligament and knee are bilateral and related regardless of cause, one side affects both. | Get a quote from Spot |
What wellness and accident-only will not do
Wellness / preventive add-ons pay routine care on a schedule, not TPLO or other cruciate surgery. Accident-only plans pay unexpected injuries, not chronic bone-and-joint disease that was already in the record.
Mixing product types is how families buy the wrong thing. See accident-only vs wellness.
Get a quote (official carrier URLs)
We do not run a fake quote widget. These buttons open the carrier.
Waiting periods, both-sides definitions, and premiums are state-specific, verify on the quote form and the issued policy.
Sources (fetched 30 August 2026)
Facts below come from official public carrier pages. Waiting periods, age caps, and premiums change by state and over time. Label anything operational as stale-prone: verify on the quote form.
- Lemonade: Lemonade: pre-existing conditions · Lemonade: waiting periods · Lemonade: Golden Retriever page · Lemonade: French Bulldog page · Lemonade: Labrador Retriever page · Lemonade: German Shepherd page
- Embrace: Embrace: coverage FAQ · Embrace: dog insurance · Embrace: waiting periods · Embrace: orthopedic waiting period
- Fetch: Fetch: pre-existing conditions · Fetch: coverage
- Pets Best: Pets Best: coverage · Pets Best: FAQ
- Trupanion: Trupanion: pre-existing conditions FAQ · Trupanion: get a quote (age copy on form)
- Spot: Spot: pre-existing conditions · Spot: CA insurer disclosure · Spot: older pets