I have 4 pets insured by Trupanion, and early on realized that I didn't want to have deductible because the bills kept coming to just below the deductible amount. So I pay extra for zero deductible and get 90% reimbursement on everything but preexisting conditions and the standard exam costs. Covers illness and accident only, no preventive or routine care. I have filed numerous claims with them and their turnaround time is very reasonable. My oldest dog has cancer and the bill is already in $5000 range and overall reimbursement has been 85-90% of costs incurred to date.