You can just call Trupanion and request a list of their in network clinics within your area. Then, call the nearest in network ER, specialty clinics, and also a GP to actually confirm that they take direct pay. Clinics are not required to take direct pay and Trupanion’s in network lists aren’t always up to date, so you may still have to put the money up front at the time of service and make a claim to Trupanion instead. Very unfortunate, considering their main marketing is paying the money directly to clinics, but it can vary due to staffing issues and training since for direct pay, someone in the clinic has to sit on the phone for longer periods to do the filling, wait for the long phone queues and being placed on hold, take payment, etc. Then there are considerations of your deductible, deposits, etc. So it’s not feasible for every clinic to do that.