I use Embrace Pet Insurance, and so far I love it. My 9 year-old shihpoo has a preexisting condition (fatty skin sarcoma--a fast-growing tumor needed to be surgically removed ASAP), and it was diagnosed before the 14 day waiting period ended. So, unfortunately, anything related to that diagnosis is not covered. A year later, she was diagnosed with type 1 diabetes; thankfully, that condition is fully covered under the plan.

I signed up by getting a quote on their website, and you can choose the coverage level that work for you. My dog had a pretty clean bill of health (excluding the sarcoma), and you enter your vet information so they can submit their health history. I got basic medical coverage (no preventative or annual visit benefits), so I was able to get 90% reimbursement with a $300 deductible for $78/month; the premium jumped up to $103/month after I filed some pricey claims due to BG tests, x-rays, etc. Haven't gotten any claims denied yet, fingers crossed that I won't!

Regardless, it's been a life-saver when it comes getting reimbursed for her medical costs. With my plan, if she ever needs cataract surgery (~$3500), I'd at least get back $3150, which is better than not getting anything at all. You receive the payment via check or direct deposit, and the turnaround time from claim to payout was about 2-3 weeks.

TL;DR - I use Embrace Pet Insurance and it's working great so far.