We never would have imagined that our 4 1/2 year old French bulldog/boston terrier cross would be diagnosed with cancerous mast cell tumors . . . without the help of Trupanion we would not be able to afford life saving treatments. Trupanion now offers direct payment at most veterinary offices, which means that you pay your portion (Trupanion covers 90%)and the clinic collects the remainder directly from Trupanion. I believe that EVERY pet owner has a responsibility to provide the best care for their pet and pet insurance is the absolute best way to cover health issues.