Pet Insurance for Maltese: Is It Worth It?

Maltese are small, long-lived, and generally healthy dogs with a familiar toy-breed set of problems. For most owners the question isn’t whether something will go wrong, it’s whether the steady trickle of smaller bills, plus one or two possible large ones, adds up to more than the premium. Often it does, as long as the policy is set up for how this breed actually gets sick.

A tiny dog with a long list of small claims

Dental tops the list by a wide margin. A Maltese mouth is small, the teeth are crowded, and retained baby teeth are common. Tartar and gum disease follow, and by middle age most of them have had at least one cleaning under anesthesia with extractions. Each one is a moderate bill. Over a 13 to 15 year lifespan, they’re a significant total.

The one big bill: the liver shunt

A portosystemic shunt is a blood vessel that routes blood around the liver instead of through it, so toxins build up. Maltese are one of the breeds with a known predisposition. Signs show up early, often in the first year or two: stunted growth, odd behavior after meals, drooling, seizures in bad cases.

Diagnosis takes bloodwork and imaging, and the fix for many dogs is surgery to close the shunt, which is specialist work. The total can run to several thousand dollars, sometimes more, and dogs that aren’t surgical candidates need lifelong diet and medication. Two things follow for the policy. It has to cover congenital and hereditary conditions, since a shunt is present from birth. And it needs an annual limit high enough that one shunt case doesn’t empty it. Our guide to surgery coverage walks through how these claims get paid.

Knees, windpipes, and the bilateral clause

Patellar luxation and collapsing trachea are shared with most toy breeds, and we cover both in the Yorkshire Terrier guide. The Maltese-specific note is the same one that applies to every small dog with loose kneecaps: once one knee is claimed, the other is usually treated as pre-existing under the bilateral clause. Orthopedic conditions also commonly sit behind a six-month waiting period that some insurers will waive after an early vet exam. Get the exam done.

Collapsing trachea is chronic, which means you want a policy that covers a condition for life rather than for one policy year. It’s one of the quieter differences between cheap and good policies, and it’s where a Maltese owner feels the gap.

What a Maltese premium looks like next to the average

The US average accident-and-illness premium is about $70 a month for dogs, per NAPHIA’s 2026 report. Maltese usually come in around or a little under that, call it $40 to $70 a month for an adult on mid settings, because small dogs cost less to treat and the breed doesn’t carry a Cavalier-style catastrophic risk. The cost-by-breed tool shows where it lands relative to other toys.

Settings for a frequent-claimer breed lean toward a lower deductible, since you’ll likely hit it most years, and 80% reimbursement as a middle ground. Keep the annual limit at least in the five-figure range so a shunt or a double patellar surgery is covered in full. There are cheaper ways to cut the premium than capping the payout.

So, does a Maltese policy pay off?

For most owners, yes, but the math is different from a big breed. You’re not insuring against one $15,000 emergency so much as against a decade of dental work, a knee or two, and ongoing trachea meds, with the shunt as the outside chance that justifies the hereditary clause. Add those up over the dog’s life and a policy that covers dental illness, hereditary conditions, and chronic care usually comes out ahead or close to it, with the peace of mind thrown in.

The catch, as with every breed, is timing. Retained baby teeth, a vet’s note about a loose kneecap, or a cough logged at a puppy visit all become pre-existing conditions if they predate the policy. Insure the puppy, keep the dental exam current, and the policy does what you bought it for. Wait until the first extraction and you’ve insured a dog whose most common problem is already excluded.

The Havanese shares most of this profile; see pet insurance for Havanese.

See also does pet insurance cover liver shunt surgery, the Maltese congenital condition most likely to end in a specialist bill.

This article is general information, not insurance or veterinary advice. Coverage, prices, and terms vary by insurer, pet, and location. Always read the policy and confirm details with the provider before buying.