I had to call several times and spoke to several people until an x-ray was included as part of the deductible. I brought a sick cat into vet's office and bloodwork and xray were ordered. Trupanion felt the xray was not necessary because it did not involve the eye even though the cat had respiratory symptoms as well as vomiting. Of course the xray would be ordered. I had to fight for that. It took 5-6 weeks after the first visit to receive reimbursement. Too long. But overall I am satisfied because in the end they paid what should have been paid.