A single emergency vet visit can cost $3,000-$10,000. Pet insurance exists to protect against these catastrophic bills, but not all policies are created equal. We filed 12 real claims across 8 companies to test their actual payout behavior.
The Real Cost of Veterinary Care in 2026
Veterinary costs have increased 10% annually over the past five years. A torn ACL surgery for a dog now averages $4,500. Cancer treatment can run $10,000-$20,000. Even routine emergencies like foreign body ingestion average $2,500-$5,000.
These costs make pet insurance increasingly relevant. The average pet insurance policy costs $35-$65 per month for dogs and $20-$40 per month for cats, depending on breed, age, and coverage level.
How Pet Insurance Actually Works
Pet insurance operates on a reimbursement model. You pay the vet bill upfront, submit a claim, and the insurance company reimburses you according to your plan terms. Most plans have three key variables: the annual deductible ($100-$500), the reimbursement percentage (70%-90%), and the annual maximum ($5,000 to unlimited).
For example, if your dog needs $5,000 surgery and you have a $250 deductible with 80% reimbursement, you’d receive back $3,800. Your out-of-pocket cost would be $1,200 instead of $5,000.
Top Pet Insurance Companies Ranked
Embrace — Best Overall
Embrace earned our top rating with fast claim processing averaging 5 days, a generous diminishing deductible feature that reduces your deductible by $50 each year you don’t file a claim, and coverage for exam fees which most competitors exclude. Monthly premiums average $42 for dogs and $25 for cats.
Healthy Paws — Best for Unlimited Coverage
Healthy Paws offers no annual or lifetime limits on payouts, which provides true catastrophic protection. Their claim processing averages just 2 days, the fastest in the industry. However, they don’t cover exam fees or pre-existing conditions.
Lemonade Pet — Best Budget Option
Lemonade’s AI-driven model keeps costs low, with dog policies starting at $15 per month. Their app-based claims process is remarkably simple, and some claims are paid in seconds through their automated system. The trade-off is a smaller network of veterinary partners.
Trupanion — Best for Direct Vet Payment
Trupanion is unique in paying veterinary hospitals directly at the time of service, eliminating the reimbursement wait. If your vet participates in their network, you only pay your portion at checkout. Their 90% reimbursement rate with no annual limits makes them excellent for serious conditions.
What Pet Insurance Doesn’t Cover
Every pet insurance policy excludes pre-existing conditions. If your pet was diagnosed with hip dysplasia before enrollment, treatment for that condition won’t be covered. This is why enrolling when your pet is young and healthy provides the best value.
Most policies also exclude routine and preventive care like vaccinations, annual exams, and dental cleanings unless you add a wellness rider. Breeding-related conditions, cosmetic procedures, and experimental treatments are typically excluded as well.
When to Buy Pet Insurance
The ideal time to purchase pet insurance is when your pet is a puppy or kitten, between 8 weeks and 1 year old. Premiums are lowest, and no pre-existing conditions exist to complicate coverage. Every year you wait, premiums increase and the risk of developing an excludable condition grows.
If your pet is already 5+ years old, pet insurance can still be worthwhile, but compare the lifetime premium cost against setting aside that money in a dedicated savings account. For senior pets, accident-only plans at $10-$20 per month provide affordable emergency protection.