Fortunately my vet office was offering a free 30 day promotional trial for trupanion pet insurance and the front desk person lectured me about signing up because it wouldn't work if I didn't go on line and register. Usually I would ignore and not follow through, but I took her advise. I honestly never believed in pet insurance - always thought it was a scam. My 3 1/2 month old Great Dane puppy got really sick quickly. She wasn't eating, extremely weak with 105 temp. She got referred to the Emergency/specialist vet and was kept overnight for observation testing, IV etc. The bill was about $2,200 and I got back $1,600 from trupanion in about 2 weeks!!! I am still going to submit the prescription medication receipts which I think will also be covered. Communication and follow through were great. I have read reviews that their costs increases after the first year even though they claim they don't do that, so time will tell. The only thing that I was disappointed in was that they didn't cover the specialists office visit. So I had already paid my regular vet visit and then got referred to the specialist, they charged me another office visit 10 minutes later. So even though it was a referral they didn't cover that office visit. All XRAYS, overnight care, IV etc were all covered. I am "sold" and have signed on for a year!