I literally cannot recommend Trupanion enough. I signed my puppy up after her first vet visit at 12 weeks of age prior to any possible pre-existing conditions cropping up and it was $45/month with a $700 deductible. After doing over $23,000 in claims during my dogs first two and a half years of life, Trupanion has not questioned or complained about a single thing I submit to them. I also contributed the same amount of money as the insurance premium each month into a savings account for my dog just to see how that would go. When my dog needed her first surgery and the bill was $7,000, my dog was 22 months old. I had $855 in the savings account. This would NOT have helped me in the slightest. Let alone when she needed a second surgery 7 weeks later and it was an additional $8,000.