Does Pet Insurance Cover TPLO Surgery?

If your dog has been diagnosed with a torn cranial cruciate ligament (CCL), you’re likely exploring every option to manage their care, especially when it comes to the financial side. TPLO surgery is a leading solution for this common orthopedic injury, but it’s also one of the most expensive. Understandably, many pet owners want to know: Does pet insurance cover TPLO surgery? The answer depends on your policy, your provider, and when you signed up. This blog breaks down how pet insurance works with TPLO surgery, what factors influence coverage, and how you can navigate the process. If you’re considering TPLO surgery for your dog in Winter Haven, FL, and want to learn more about financing options, this guide is for you.

 

 

What Is TPLO Surgery and Why Is It So Common?

Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure designed to stabilize the knee after a cranial cruciate ligament (CCL) tear. The CCL is similar to the ACL in humans, and when it’s damaged, it can significantly affect a dog’s ability to walk. Rather than replacing the torn ligament, TPLO surgery changes the geometry of the knee joint to eliminate the need for the ligament altogether. This technique provides lasting stability and allows for a faster return to mobility.

TPLO surgery is widely recommended for medium to large dog breeds and active pets because it offers superior long-term outcomes compared to other repair methods. However, the cost typically ranges from $3,000 to $5,000 or more, depending on your location and the specifics of your dog’s case.

How Pet Insurance Works for Orthopedic Surgeries

Pet insurance works on a reimbursement model. You pay the veterinary bill upfront, then submit a claim to your provider for partial reimbursement based on your coverage. For orthopedic surgeries like TPLO, reimbursement can be substantial, but several conditions must be met.

Waiting Periods and Pre-Existing Conditions

Most pet insurance providers have a waiting period for orthopedic conditions, often ranging from 6 months to a year. If your dog shows signs of a CCL tear during this time, or if the injury occurred before you enrolled, the surgery will likely be excluded from coverage. Even if your policy includes orthopedic procedures, providers often require a veterinary exam or orthopedic certification to confirm your pet was healthy before coverage begins. Be sure to read your policy closely and ask your provider about any orthopedic-specific requirements.

Which Pet Insurance Providers Cover TPLO Surgery?

The good news is that many pet insurance companies do cover TPLO surgery—as long as the condition is not pre-existing and you’ve met any required waiting periods. Coverage percentages and claim processes vary widely.

Common Providers That Offer Coverage

Here are a few companies that typically offer coverage for TPLO surgery, depending on the plan:

• Healthy Paws – Covers TPLO surgery if the injury occurs after the waiting period. Offers unlimited lifetime benefits with no caps.
• Trupanion – Known for direct payments to veterinary hospitals in some cases. Covers 90% of eligible costs if the injury is covered.
• Embrace – Covers orthopedic surgeries, including TPLO, but has a 6-month waiting period for orthopedic conditions (which can be waived with an orthopedic exam).
• Fetch by The Dodo – Offers comprehensive coverage with options to include orthopedic care.
• ASPCA Pet Health Insurance – Covers surgeries for non-pre-existing conditions, including TPLO.

It’s important to note that even if a company includes TPLO in their coverage, the specifics of your individual plan (deductible, reimbursement percentage, annual limits) will affect your out-of-pocket cost.

What Pet Insurance Typically Covers for TPLO Surgery

A TPLO procedure includes more than just the surgery itself. If you’re wondering whether pet insurance covers the full spectrum of care, here’s a breakdown of what’s usually included and what might not be.

Items Commonly Covered

• Surgical procedure itself
• Anesthesia and operating room costs
• X-rays and diagnostics related to the surgery
• Hospitalization and monitoring
• Post-surgical medications
• Follow-up visits and physical rehabilitation (with some policies)

Items That May Not Be Covered

• Initial exam fees
• Pre-existing ligament damage
• Preventive care or wellness visits
• Non-medical boarding
• Optional rehab or laser therapy (depending on the plan)

Always check the fine print of your plan or speak directly with a representative from your insurance provider. If you’re unsure about a specific charge, ask your veterinary care team for a detailed estimate so you can confirm what will be reimbursed.

Filing a Pet Insurance Claim for TPLO Surgery

After your dog receives TPLO surgery, you’ll need to file a claim with your pet insurance company. The process is relatively straightforward but can vary slightly depending on the provider.

Steps to Take

1. Get a detailed invoice from Veterinary Healthcare Associates that outlines all services and charges.
2. Download the claim form from your insurance provider’s website or submit it online, if available.
3. Include all supporting documentation, such as medical records, exam notes, and any required pre-authorization.
4. Submit the claim within the required time frame (usually within 90 days of treatment).
5. Monitor claim status through the provider’s online portal or customer service team.

Our team in Winter Haven is always happy to provide the documentation you need to support your claim.

Alternative Financing Options If TPLO Isn’t Covered

If your pet insurance doesn’t cover TPLO surgery, or if you haven’t enrolled yet, you still have several options to help manage the cost.

Third-Party Veterinary Financing

• CareCredit – A credit card designed specifically for medical expenses, including veterinary care. Offers interest-free payment plans for eligible applicants.
• Scratchpay – Offers short-term and long-term financing options with no hard credit check for pre-qualification.
• Payment plans through your vet – Some veterinary practices offer in-house payment plans or flexible billing. Ask our team what might be available.

Pet Insurance for Future Surgeries

If your dog is still young or has a history of orthopedic issues, enrolling in pet insurance now can help cover future incidents. Be proactive in getting coverage before any signs of injury appear, and keep up with annual wellness exams to maintain eligibility.

Choosing the Right Path for Your Dog’s Care

Making decisions about surgery and financial planning can feel overwhelming. But you’re not alone in this. At Veterinary Healthcare Associates in Winter Haven, we help pet owners every day who are navigating questions about pet insurance and TPLO surgery. We’re here to answer your questions, walk you through your estimate, and help you prepare any paperwork you need for your claim. If you’re exploring treatment options for your dog’s CCL tear or just want to learn more about what to expect, we invite you to call us at (863) 324-3340. Our team is ready to help guide you through the next steps in your dog’s care.