Patellar luxation appears by name in the exclusion clauses of policies that name almost nothing else. Trupanion lists luxating patella both in its definition of a bilateral condition and as an example in the exclusion for the second side. Spot folds the patella into Ligament and Knee Conditions, which it treats as bilateral regardless of cause. So an early note in the record about a skipping step, written before cover began, can close both knees at once.
What is slipping kneecap, in plain terms?
The kneecap sits in a groove at the front of the knee. When that groove is too shallow the kneecap slips sideways, the leg locks for a step or two, and the dog skips and then carries on as though nothing happened. Small breeds are affected most. Mild cases are managed rather than operated on, but a kneecap that dislocates repeatedly wears the joint and ends in surgery, and the skipping gait that owners find endearing in a puppy is usually the first sign.
At what age does it usually appear?
Very early. Many small-breed puppies have a detectable luxation at their first or second vaccination visit, and vets routinely grade it during a general examination whether or not the owner has noticed anything. That is unusual among the conditions here: it is often written into the record before there are any symptoms at all. A grade noted at eight weeks, months before a policy exists, is enough to make both knees pre-existing at most insurers.
Which clause should you check before you buy?
Ask for your dog's full clinical history before you buy, not after. Patellar grading is so routine in small breeds that most owners do not know it has been recorded, and a grade one noted at a puppy check is enough to make both knees pre-existing. In the policy itself, check whether patella is named in the bilateral definition, and separately whether it is folded into a knee and ligament category with its own rules. At two of the three insurers here it is both, which means two clauses point at the same joint.
Do insurers treat both sides of the body as one condition?
Named as a bilateral condition in Trupanion policy form TRU-00001 (08/11), Definitions 7.c and Exclusions 5.c(2); read 2026-09-01
Patellar luxation: how long before an insurer will pay for it?
Also called slipping kneecap. Each insurer's waiting period and second-side rule below, from its own policy document.
Which insurer covers slipping kneecap soonest, and which makes you wait?
Patellar luxation falls under the orthopedic class at most US insurers. The table below gives each insurer's waiting period and its rule for the second side of the body, taken from the insurer's own policy document.
| Insurer | Waiting period | Second side of the body | Hereditary and congenital | Where it says so |
|---|---|---|---|---|
| Spot | 14 days One 14 day waiting period, the same as for any illness. The bilateral clause in this policy is written by named condition rather than by class: it covers ligament, patella, meniscus and soft tissue disorders of the knee, and calls them bilateral and related regardless of cause. Of the orthopedic conditions in this register only patellar luxation falls inside that wording; hip dysplasia, elbow dysplasia and panosteitis are not named there. | Second side counts as pre-existing | Covered | Definitions, Ligament and Knee Conditions, page 2, which names ligament, patella, meniscus and soft tissue disorders of the knee and calls them bilateral and related regardless of cause; Definitions, Bilateral Condition, page 2; Exclusions c and o |
| Lemonade | 30 days 30 days for orthopedic conditions, which this policy defines as including elbow dysplasia, hip dysplasia, intervertebral disc degeneration, patellar luxation and ruptured cranial cruciate ligaments. The second-side rule comes from the definition of a Bilateral Condition rather than from the orthopedic clause: it is a test on the condition, which has to be chronic and affect both sides, and not on the class. | Second side counts as pre-existing | Covered | Waiting periods; Definitions, Orthopedic Conditions, page 14, which names elbow dysplasia, hip dysplasia, intervertebral disc degeneration, patellar luxation and ruptured cranial cruciate ligaments; Definitions, Bilateral Condition, page 14: "a chronic condition that affects both sides of your pet's body, even if clinical signs or symptoms do not present at the same time"; Pre-existing conditions, which excludes bilateral conditions whose signs were present before the start date or before the end of a waiting period |
| Trupanion | 30 days No separate orthopedic waiting period is stated in this specimen; orthopedic illness falls under the general 30 day illness waiting period. | Second side counts as pre-existing | Not stated in the document | Waiting period at 5.b(2), page 3 of 9; bilateral exclusion at 5.c(2), page 3 of 9, which names luxating patella by example; definition of a bilateral condition at 7.c, page 6 of 9, which names elbow dysplasia including fragmented coronoid process, ununited anconeal process and osteochondritis dissecans, cruciate issues, luxating patella, hip dysplasia, cherry eye, entropion/ectropion, panosteitis and cataracts |
| Figo | 180 days Six months from the original start date, and it applies to orthopedic illnesses and to orthopedic conditions caused by an accident alike. That is the longest wait of any insurer in this register. It can be waived, but only actively: an orthopedic examination by a veterinary provider plus the Orthopedic Waiver Form submitted within thirty days of the policy taking effect. The bilateral rule in this policy is written for knee and ligament conditions by name, so it does not reach hip or elbow. | Second side counts as pre-existing | Covered | Definitions 44, Waiting Period, page 3 of 13, which sets the orthopedic waiting period for dogs at six months; Definitions 28, Orthopedic; General Conditions 6, page 4 of 13, on the Orthopedic Waiver Form |
The waiting period for slipping kneecap is the number that decides whether a claim in the first year is paid at all, and it is the figure insurers vary most quietly. Each row below states the section of the policy it came from.
Every row cites the policy form code and the section it was read from, with the date we read it. Oldest check date on this page: .