In this article: What Is ACL Surgery? | How Does ACL Surgery Coverage Work? | What Companies Cover ACL Surgery? | Annual Cost | Is ACL Surgery Common for Dogs? | Is ACL Surgery Common for Cats? | The Bottom Line | FAQs

If your pet tears its anterior cruciate ligament (ACL), pet insurance companies will typically cover surgery to treat it. However, because ACL problems are so expensive to treat, they’re often subject to longer waiting periods and stricter exclusions than other conditions. 

We at the Home Media reviews team break down these exclusions to help pet owners learn what to expect from the best pet insurance providers when it comes to ACL tears.

What Is an ACL Injury?

Technically speaking, animals don’t have an ACL. That’s the name for one of the ligaments in the human knee that connects the thigh bone (femur) to the shin bone (tibia). In your four-legged friend, this is called the cranial cruciate ligament, or CCL, and there’s one in each hind leg. However, since this ligament is so commonly referred to as an “ACL,” that’s what we’ll call it.

A torn ACL is a fairly common injury to a dog’s knee joint, called a stifle joint. Cats can also sustain ACL injuries, though they’re most common in active dogs. A cruciate ligament injury can be part of a larger traumatic injury, or it can simply be the result of a dog landing awkwardly when running or jumping. It can also occur in older pets from long-term wear. Obesity is a risk factor for ACL tears since excessive weight puts more stress on the joints.

What Is ACL Surgery?

Cruciate ligament injuries are serious. Your pet won’t be able to put much weight on the affected leg, and the required treatment is often surgery. There are several types of ACL surgeries depending on your pet’s size and the severity of the problem.

• Lateral suture/extracapsular repair: A strong suture creates a new false ligament to replace the torn one. Over time, the joint will stabilize as scar tissue develops.
• Tibial plateau leveling osteotomy (TPLO): Cutting, reshaping and rotating the top of the tibia (shin bone) creates a more stable joint. Essentially, the weight will be distributed differently on the joint so the ACL isn’t needed.
• Tibial tuberosity advancement (TTA): Similar to a TPLO, this procedure also cuts the top of the tibia but secures it using steel plates and bone grafts.

After surgery, your pet will likely need physical therapy to complete its recovery. This may or may not fall under standard pet insurance coverage.

How Does ACL Surgery Coverage Work?

If covered, using your pet health insurance for ACL surgery works similarly to other vet bills. After an initial visit to diagnose the problem and discuss treatment options, you’ll schedule the procedure and any necessary hospitalization. You’ll pay out-of-pocket, file a claim with your insurance company and receive reimbursement. The amount you receive will be determined by your chosen reimbursement rate, coverage limit and deductible. Coverage applies to all medical expenses, including X-rays and other scans, surgery costs and medication.

However, all pet insurance coverage excludes preexisting conditions — that is, health conditions that appear before the end of the waiting period. Most policies have waiting periods of two to seven days for accidents or 14 to 30 days for injuries, but some providers have special limitations on orthopedic problems, such as ACL injuries and hip dysplasia. For those providers, you’ll have to wait six to 12 months for coverage, and any ACL problems that arise before the end of that period won’t be covered.

Additionally, some companies have bilateral condition exclusions. That means if your pet develops ACL problems in one hind leg, ACL problems in the other hind leg will be considered a preexisting condition and therefore excluded from coverage. Since providers will be able to see your pet’s medical history, even a history of limping in annual checkups may be enough to deny coverage. That’s why it’s a good idea to purchase pet insurance when your pet is young and healthy.

What Companies Cover ACL Surgery?

Here are the specifics of ACL surgery coverage offered by our recommended pet insurance providers.

Lemonade ACL Surgery Coverage

Lemonade’s basic accident-and-illness pet insurance plan will cover ACL surgery. However, the company requires a six-month waiting period for “cruciate ligament events.” That means if your pet shows signs of limping or lameness at any time during that period, ACL treatments won’t be covered, even if you don’t seek initial veterinary care. Additionally, if you want coverage for physical therapy, you’ll need to purchase a special add-on for about $2 to $5 more per month.

To learn more: Lemonade Pet Insurance review

Spot ACL Surgery Coverage

If you’re worried about ACL issues in the near future, Spot Pet Insurance has a waiting period of only 14 days for all accidents and injuries. This is the shortest possible waiting period for ACL injuries. Spot offers accident-only pet insurance at a lower cost — which would cover sudden ACL injuries — but if your pet’s joints fail over time, you would need an accident-and-illness plan. It’s also worth noting that, unlike some providers, Spot has no upper age limit for new enrollments, though premiums will be higher for senior pets.

To learn more: Spot Pet Insurance review

Trupanion ACL Surgery Coverage

Trupanion’s basic accident-and-illness plan will cover treatment for ACL issues, whether from an injury or degradation of the joint over time. With the Recovery and Complementary Care add-on, you can add on coverage for rehabilitative therapy for $2 to $30 per month. Trupanion has a five-day waiting period for accidents and a 30-day waiting period for illnesses, but there’s no extra waiting period for ACL problems. There’s also no specific bilateral condition exclusion, which is unique on this list.

To learn more: Trupanion Pet Insurance review

Fetch ACL Surgery Coverage

Fetch by Dodo offers a single accident-and-illness plan that will cover ACL surgery, but there is a six-month waiting period for all injuries of the hips and knees. However, if in the first 30 days of your policy you have a vet examine your pet and certify that there are no preexisting knee problems, you can have this waiting period waived. In that case, only the regular waiting period of 15 days for all accidents and illnesses applies. Fetch will also cover post-surgical rehabilitation.

To learn more: Fetch by the Dodo Pet Insurance review

Embrace ACL Surgery Coverage

Similar to Fetch, Embrace also offers a single accident-and-illness plan with a six-month waiting period for orthopedic conditions including cruciate ligament problems. There’s also an Orthopedic Exam and Waiver process that can reduce this waiting period to 14 days after a vet exam. Bilateral conditions are not covered, but some forms of rehabilitation, such as hydrotherapy, are covered.

To learn more: Embrace Pet Insurance review

Healthy Paws ACL Surgery Coverage

With its accident-and-illness plan, Healthy Paws will cover ACL surgery after only a 15-day waiting period. There are also no payout caps per incident, year or lifetime. However, bilateral conditions are excluded.

To learn more: Healthy Paws Pet Insurance review

Prudent Pet ACL Surgery Coverage

Prudent Pet offers an accident-only plan that would cover ACL surgery as the result of an injury as well as an accident-and-illness plan to cover chronic conditions. There is a six-month waiting period for knee and ligament issues that can be waived with a physical exam. Like many insurers, Prudent Pet includes a bilateral condition exclusion for ACL problems.

To learn more: Prudent Pet Insurance review

Annual Cost of ACL Surgery Coverage

Here’s some sample pricing for plans that cover ACL surgery. These prices exclude add-ons for wellness or preventive care to cover vaccinations, spaying and other expected healthcare costs.

*Our sample pricing is based on quotes we obtained for a 4-year-old, medium-sized, mixed-breed male dog and a 4-year-old, medium-sized, mixed-breed, medium-hair cat in Denver.

Is ACL Surgery Common for Dogs?

Fortunately, only about 5% of male dogs neutered before age 1 and 8% of female dogs develop cruciate ligament problems. However, about half of dogs who have an ACL injury in one leg will eventually injure the other. The following dog breeds are more prone to this ligament breaking down over time, ultimately tearing or rupturing. 

• Labrador retrievers
• Newfoundlands
• German shepherds
• Rottweilers
• Golden retrievers

Is ACL Surgery Common for Cats?

ACL problems are less common in cats, but they do happen. It may be possible to deal with a partial tear or rupture with medication, joint supplements and exercise restriction. However, if there hasn’t been significant improvement after about six weeks or so, surgery is usually the next course of action.

The Bottom Line: Does Pet Insurance Cover ACL Surgery?

A standard pet insurance policy will usually cover ACL surgery, but there are some substantial limits, including longer waiting periods and exclusions for a bilateral condition. Overall, Spot and Healthy Paws offer pet parents the quickest ACL problem coverage, and Trupanion offers the most complete coverage for ACL treatments (including surgery).

Methodology: Our System For Ranking The Best Pet Insurance Companies

Our review of pet insurance companies is based on in-depth industry research that includes reading hundreds of customer reviews, simulating the quote and purchasing process, speaking to representatives on the phone to assess the customer service experience and surveying 1,000 dog and cat owners nationwide to determine the most important elements of pet insurance coverage. We have scored each provider on a 100-point scale based on those elements.

Here are more details about each factor and how they’re weighted:

• Monthly pricing (25 points): How much each company charges for its pet insurance plans is an important part of a customer’s decision. The best pet insurance companies combine comprehensive coverage and plan options with affordable rates.
• Plans (15 points): The top pet insurance companies offer accident and illness plans, accident-only plans and wellness or preventive care add-ons to give customers the option to choose a plan that’s best for their pet.
• Covered treatments (15 points): With this factor, we scored companies based on the treatments and procedures they cover. Companies with a breadth of included treatments and unique coverages received more points than providers with more standard or general policies.
• Customization options (10 points): Customizing your policy is a valuable way to ensure you only pay for what your pet needs. Providers with more options for their annual limit, deductible and reimbursement rate earned the highest scores.
• Customer care (10 points): We scored companies on their website accessibility and overall usability, customer service availability, mobile apps (if any), money-back guarantees and veterinarian telehealth options, awarding points to the insurers with more customer experience offerings.
• Industry reputation (10 points): To determine each company’s industry reputation, we reviewed up-to-date ratings and accreditation information from the Better Business Bureau (BBB) and scored companies on their years of experience in the industry and their state availability.
• Waiting periods (10 points): Companies with shorter accident, illness and orthopedic waiting periods between the sign-up and coverage start date scored higher than companies with longer waiting periods.
• Eligible age (5 points): Some companies don’t offer policies for pets that are over a certain age. We deducted points from providers that have age limits for covered pets.

We use our rating system to compare and contrast each company against key factors to help us determine the best pet insurance companies in the industry. Additionally, we keep our research up to date and revisit our reviews on a regular basis.