We took a chance on an older pet when we adopted Josie from our local SPCA shelter. She has developed quite a few medical issues in the 3 years we have had her, including inflammatory bowel disease, a seizure disorder for which we had to get an MRI to determine whether a brain tumor was the cause, Luckily, it wasn't a tumor, and we manage her seizures with some pretty expensive compounded medicine. The MRI was over $3,000, and her meds in total are over$250/month. Although the premiums are on the high side (and increase every year), 24 PetWatch has been really helpful in meeting these expenses. They paid most of the cost of the MRI, a significant portion of the meds, and they pay a portion of the prescription diet she is on. The only thing they don't pay for is anything to do with Josie's arthritis, as this was a condition she had when we adopted her, so is outside coverage (which is fair, and spelled out in the terms). I will say the submission process could be improved by allowing more characters for notes/comments.... 250 characters is not enough. Also, you need to be careful to submit claims at least every 6 months, as they can and do refuse to pay claimed costs that are older than 6 months. Otherwise, no complaints-- we would be quite a bit poorer without this insurance.