About a year after I insured my adopted, young, rescue dog, my dog was found to have soft tissue sarcoma. She has periodic x-rays and lab tests, and is on fairly expensive daily medication. Although Trupanion does not reimburse for the vet visits, they reimburse for all the related tests and medications. They pay the claims quickly, usually responding within a day and paying within a week. Because they pay based on condition, not the calendar, once I met the deductible, all covered expenses are paid, even across year-end.
Being semi-retired, I don't know how i would manage without this coverage.