I got this insurance when my dog was about 8 months old. I added the hip dysplasia coverage and my total premium per month is $39.25. Thank god I did. Shortly after signing my pup up for Trupanion, we noticed she was walking a little funny and seemed to be having pain. My vet examined her and strongly suspected hip dysplasia but wanted an x-ray to verify. The x-rays were about $220 and she also had bloodwork done prior to the x-rays and sedation. Trupanion paid 90% of all the costs for this to diagnose the dysplasia. I then took her to the vet hospital at Michigan State University to see a specialist. We decided to get a total hip replacement. My pup had her right hip replaced two weeks ago by the best surgeon in the world (literally, the world) and the cost of the surgery and all of the meds, hospital stay, pre-op blood work, and x-rays of her elbows and hips came to just under $5000. Trupanion processed my claim in under a week. I already have my check and they paid 90%, almost $4500. I've had the policy for only 4 months and have paid under $200 in premiums. Trupanion has paid me close to $4800 already for her surgery, diagnostics, and medications for an ear infection and allergies. I couldn't ask for more. Truly amazing!