Excellent plan overall. Bought pet insurance when our dog was >3 months of age, as a "safety net" in event of accidents/illnesses. He is now almost 7 and this plan has literally saved us in excess of $10,000 worth of claims on our dog, who has suffered from ingesting toxic foods/substances, GI issues, underactive thyroid and most recently, a torn CCL/ligament - which cost over $4000 for surgery etc. alone for TTA/TPLO surgery. Petplan has reimbursed us 90% of almost all the costs (with the exception of his rehab/physio bills - due to a prior misdiagnosis by our vet and plan stating this was a "pre-existing condition" and they wouldn't cover rehab portion). Our vet, and ourselves, have appealed this decision and are hopefully awaiting a positive outcome. Premiums don't increase as your pet ages (which is excellent), however, they do not cover the examination fees of your vet visits, which, at $70 per visit, can add up quickly for a pet with long term/chronic care/illnesses. Petplan (our other dogs insurance) - covers ALL costs with annual $100 deductible - so Trupanion - offer this type of plan as an option for those who want that additional coverage (since you can customize your plans). We'd be willing to pay for it. The plan can be costly based on what type of coverage you take (we have zero deductible, 90% unlimited coverage with additional rider for rehab, physio, accupuncture etc) and pay $95 per month. Benefit is you can change/customize your coverage at any time as well. Claims have been promptly paid out and rep's we've spoken to have always been excellent. Overall I'd give them a 9/10 due to lack of them covering examination fees on visits and them occasionally looking for "pre-existing" conditions to not pay out a claim.