I have had Pet Plan for the past seven years. I switched from Embrace when PP first became available in the US. Just recently I lost a dog who was insured with PP and adopted a puppy who is now on the same plan: Gold, 100% reimbursement after $200 deductible. I am in New York City where vet fees are very high and I am on a fixed income so I can't afford them without insurance.
Lately people who have decided not to go with Pet plan are pointing out to me that Healthy Paws and Trupanion do not increase premiums with age, as PP acknowledges they do, but "periodically" based on rising costs. It's true that PP's premiums start to go up rather dramatically after the dog is middle-aged, and in general increased when they switched underwriters a few years ago. However in researching increases from HP and TP here I learned that their increases were just as high or higher, less predictable and that many people felt misled about how much they would be when they first signed up.
So I did some math on my last PP policy. I insured Benji, a small mutt, at the age of 3 and premiums started at around $30/month. For the first four years the increases were probably 10% a year. After the age of 7 the premium went up by at least 20% (from 2012-2015): the total paid in premiums was $2298 or a fairly reasonable $55 average a month for 42 months.
Total reimbursement was $3192 or a "profit" of $893 during the most expensive years. I don't have records for the period from 2008-2012 but since the premiums were much lower and we made some claims I suspect that we more or less broke even. Despite the high cost of the last few years I can't really complain.
BTW for us, perhaps because we are in New York City, Trupanion is not at all a good value. The premiums start at more than twice that of Pet Plan or Healthy Paws, the reimbursement rate is 10% lower than Pet Plan, the deductible is higher and exams are not covered. "Alternative" treatments require a rider that adds almost $100 to the yearly premium. To put this in perspective I would be paying Trupanion as much in premiums the first year as I paid Pet Plan in the tenth year with significantly more out of pocket expense. And this of course does not take into account any premium increases from Trupanion, even if they were smaller than Pet Plan's and the jury is out on that.