Research reviewed August 6, 2026. Pet insurance can be especially difficult to compare for giant-breed dogs because the words “covered” and “eligible” do not mean that every future claim will be paid. A hereditary condition may be listed as covered while a waiting period, age rule, preexisting-condition definition, bilateral-condition exclusion, deductible, reimbursement percentage, or annual limit still changes the result.
This guide compares five widely available providers by the policy features that matter most for giant-breed owners. It is an editorial comparison, not a quote, policy contract, or recommendation to buy a particular plan. Availability and terms vary by state. Always read the sample policy for your state and obtain a personalized quote before enrolling.
Quick comparison
| Provider | Features worth examining | Important limits to verify |
|---|---|---|
| Trupanion | Hereditary and congenital conditions are included when eligible; no annual or lifetime payout cap; 90% coverage for eligible veterinary costs; direct payment may be available at participating hospitals; deductible is generally per condition. | Preexisting conditions are excluded. Waiting periods and available options vary by location. A per-condition deductible behaves differently from an annual deductible, especially when a dog develops several unrelated conditions. |
| Embrace | Accident-and-illness policies can include eligible breed-specific, genetic, congenital, chronic, and orthopedic conditions; several annual-limit, reimbursement, and deductible choices may be available. | Orthopedic and illness waiting periods vary by state. Medical history before and during a waiting period can affect eligibility. Confirm whether a state-specific orthopedic waiting period can be reduced through an examination or waiver. |
| Pets Best | Eligible hereditary and congenital conditions can include hip and elbow dysplasia, Wobbler syndrome, and other conditions relevant to large dogs; customizable annual limits, deductibles, and reimbursement levels may be offered. | Conditions first showing signs before coverage or during an applicable waiting period can be treated as preexisting. Plan options and waiting periods vary by state, and benefit limits still apply to covered claims. |
| Healthy Paws | Accident-and-illness coverage includes eligible hereditary, congenital, chronic, and orthopedic conditions, with no annual or lifetime claim maximum advertised for covered care. | Hip-dysplasia eligibility can depend on enrollment before age six, and waiting periods are state-specific. Reimbursement and deductible choices may be more limited for older pets. Examination fees and preventive care are generally not part of the core plan. |
| ASPCA Pet Health Insurance | Complete Coverage can include eligible hereditary, congenital, chronic, alternative-therapy, behavioral, and dental-illness expenses; annual deductible, reimbursement, and annual-limit choices are available, including an unlimited option in some markets. | Accident and illness waiting periods apply and state terms control. A curable condition may cease to be preexisting after a symptom- and treatment-free period under applicable terms, but knee and ligament conditions are treated differently. |
Why giant-breed dogs require a different comparison
Giant breeds can be predisposed to expensive musculoskeletal and hereditary conditions, but predisposition alone does not determine whether a claim is covered. What matters is the policy language in force, the dog’s enrollment age and documented medical history, the date symptoms first appeared, and whether all waiting periods were completed.
For that reason, the most useful comparison is not “Which company mentions hip dysplasia?” All five providers discuss hereditary or congenital coverage in some form. Better questions are: When does that coverage begin? Is there an enrollment-age restriction? How is a prior limp or an undiagnosed symptom handled? Does a condition involving one knee affect future claims involving the other? Does the policy use an annual deductible or a separate deductible for each condition?
The six terms that change the value of a plan
1. Preexisting-condition definition
A condition may be considered preexisting even when it had not yet been formally diagnosed. Earlier symptoms, examination notes, treatment, or veterinary advice can matter. Ask the provider to review your dog’s medical records if a medical-history review is offered, and retain the resulting determination.
2. Orthopedic and illness waiting periods
Waiting periods are not uniform nationally. A provider may use different periods for accidents, illnesses, orthopedic conditions, cruciate ligaments, or hip dysplasia, and state law can change those rules. A symptom that first appears during a waiting period can affect later eligibility.
3. Hereditary and congenital coverage
The inclusion of hereditary conditions is valuable only when the particular condition is eligible under the policy. Check age restrictions, waiting periods, preexisting-condition rules, benefit limits, and whether coverage is part of the base plan or an optional feature.
4. Deductible structure
An annual deductible resets each policy year but normally applies across eligible conditions. A per-condition deductible can be attractive for one chronic condition because it may be satisfied only once, yet it can cost more when several unrelated conditions arise. Compare realistic scenarios rather than deductible numbers alone.
5. Reimbursement base
A “90% reimbursement” statement does not necessarily mean the insurer pays 90% of the full invoice. Noncovered items, the deductible, co-insurance, policy limits, and any excluded examination fee can reduce the payment. Ask whether reimbursement is based on the actual eligible veterinary bill or another schedule.
6. Annual and lifetime limits
Unlimited benefits can reduce the risk of reaching a payout ceiling, but they do not override exclusions or make noneligible expenses payable. A capped plan may still fit a household if the premium difference is meaningful and the owner understands the retained risk.
Questions to ask before enrolling
- May I see the current sample policy and endorsements for my state?
- What are the accident, illness, orthopedic, cruciate-ligament, and hip-dysplasia waiting periods?
- Does my dog’s age affect enrollment or coverage for hip dysplasia?
- How do you define a preexisting condition when symptoms existed without a diagnosis?
- Does a condition affecting one side of the body affect coverage on the other side?
- Is the deductible annual or per condition, and when does it reset?
- Are veterinary examination fees, rehabilitation, prescription food, supplements, and dental illness included?
- Are there annual, per-condition, or lifetime payout limits?
- Can you pay my veterinary hospital directly, or must I pay first and request reimbursement?
- Will you provide a written medical-history review after enrollment?
How to use this comparison
Begin with the medical records, age, breed, and ZIP code for the dog you intend to insure. Obtain quotes using the same reimbursement percentage, deductible, annual limit, and optional benefits wherever possible. Then compare the sample policies—not just the premiums or marketing summaries.
A lower premium can represent less coverage, a higher deductible, a lower reimbursement percentage, or a lower annual limit. A higher premium is not proof of better coverage. The best fit depends on the risks your household can comfortably retain and the exclusions that matter for your particular dog.
Sources and evidence limits
- Trupanion coverage information
- Embrace coverage information
- Pets Best coverage information
- Healthy Paws coverage and exclusions
- ASPCA Pet Health Insurance state documents and sample policies
These sources summarize current provider statements, but the issued policy and state-specific endorsements control. CompareDecisions.com is not an insurance producer, broker, veterinarian, or legal adviser. We do not sell insurance, provide personalized insurance advice, or guarantee claim eligibility. Providers may change terms after this page’s review date.
Affiliate disclosure: CompareDecisions.com may seek or maintain referral relationships with providers discussed here. Trupanion is currently under affiliate review, and this page contains no affiliate link. Commercial relationships do not determine inclusion, ranking, or editorial conclusions.