Most pet insurers completely exclude pre-existing medical conditions. Sometimes they remove the exclusion if the condition is curable, like an ear infection or a broken leg, but this doesn’t help you if your dog has kidney disease.

If your pet does have a condition that might cost a lot to treat, you may want to consider an alternative to insurance coverage. Pet Assure, for example, covers all pets, regardless of age or condition. It works like a discount dental network. You pay $99 per year for one pet or $149 for up to four, and save 25% on veterinary care, including office visits, shots, and surgery. There are no exclusions, no deductibles, and no waiting periods for reimbursement. The only limitation is that you must use a veterinarian within the network. Of course that’s just one-fourth of your bill. If surgery costs $2,000 you’ll still have to pay $1,500—but it’s better than having to pay it all!