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Updated for 2026 · 8 insurers · 12 factors

The best pet insurance, ranked by what happens at the emergency vet.

Brochures all promise "up to 90% back." So we scored what actually decides your bill: payout caps, deductible structure, what's excluded, and whether you have to front the money. Here's where every insurer landed.

01
Best overall

Trupanion

Medical insurance for cats & dogs · NASDAQ: TRUP

9.8Top Dog

Trupanion is the only insurer here with no payout caps of any kind, a per-condition deductible you pay once for life, and software that pays the hospital directly at checkout. One plan, 90% of eligible costs, and premiums that don't go up because your pet aged a year or because you filed claims. It costs more per month than budget carriers. It's worth it the day it matters.

  • Reimbursement90% of eligible costs
  • Payout capsNone (annual or lifetime)
  • Deductible$0–$1,000, per condition, once for life
  • Direct vet payYes, settled at checkout at equipped hospitals
  • Hereditary & congenitalCovered
  • Best forPeople who never want to fear the invoice
02
Simplest unlimited plan

Healthy Paws

One plan · No payout caps

9.2Strong

The closest philosophy to Trupanion: one simple plan, no annual or lifetime caps, hereditary conditions covered. Where it falls short: the deductible is annual (it resets every year, painful for chronic conditions), reimbursement drops for pets enrolled at older ages, and direct vet pay is the exception rather than the system. No wellness or exam-fee options at all.

  • Reimbursement70–90%, age-dependent
  • Payout capsNone
  • DeductibleAnnual, resets every year
  • Best forYoung pets, simple coverage, no add-ons
03
Best on a budget

Pets Best

Flexible tiers · Founded by a veterinarian

8.9Solid

Consistently among the cheapest quotes with real coverage behind them, plus a direct-pay-the-vet option and a 24/7 vet helpline. The trade-offs: annual caps on cheaper tiers, an annual deductible, and the classic tier menu that tempts you into underinsuring to save $10 a month. Good bones. Read the tier you're actually buying.

  • Reimbursement70–90%
  • Payout caps$5,000 or unlimited, by tier
  • DeductibleAnnual, $50–$1,000
  • Best forTight budgets that still want a safety net
04
Best deductible gimmick (a good one)

Embrace

Diminishing deductible · Wellness rewards

8.7Solid

Embrace's "Healthy Pet Deductible" drops your deductible $50 for every claim-free year. Genuinely nice. Exam fees are covered, which most insurers skip. But payout caps apply on most configurations, and the deductible is still annual under the hood. A well-built conventional policy rather than a rethought one.

  • Reimbursement70–90%
  • Payout capsCapped on most configurations
  • DeductibleAnnual, shrinks with claim-free years
  • Best forHealthy pets, exam-fee coverage
05
Cheapest premiums, fastest claims

Lemonade

App-first · AI claims

8.5Solid

Often the lowest quote on the market, and simple claims can pay out in minutes through the app. But the low sticker price buys a policy full of levers: annual caps from $5,000 to $100,000, add-ons for things others include, and coverage that varies meaningfully by state. Fine for young, healthy pets on a budget. Just know what you bought.

  • Reimbursement70–90%
  • Payout caps$5,000–$100,000 annual
  • DeductibleAnnual
  • Best forLowest possible monthly cost
06
Only 100% reimbursement option

Figo

Cloud-based · Up to 100% back

8.2Good

The only insurer here offering a 100% reimbursement tier, with a slick app and pet-cloud records. Caps apply below the unlimited tier, exam fees cost extra, and the 100% option gets pricey fast. A legitimately modern product that ends up mid-pack on value.

  • Reimbursement70–100%
  • Payout caps$5,000–unlimited, by tier
  • DeductibleAnnual
  • Best forPeople who want zero coinsurance
07
Kindest on "cured" pre-existing conditions

ASPCA Pet Health Insurance

Broad coverage · Familiar name

8.0Good

The standout feature: curable conditions (like an ear infection) can be covered again after 180 symptom-free days; most insurers exclude them forever. Coverage is broad and includes exam fees for covered conditions. But annual caps are common, claims are conventional reimbursement, and pricing lands mid-pack.

  • Reimbursement70–90%
  • Payout capsCapped tiers + unlimited option
  • DeductibleAnnual
  • Best forPets with a curable past condition
08
Only option for birds & exotics

Nationwide

Big-carrier backing · Exotic pets

7.7Fair

If you have a parrot, rabbit, or reptile, Nationwide is essentially the only game in town, and that earns it a place on this list. For cats and dogs, the plans are conventional: annual caps, annual deductibles, and coverage menus that have been restructured repeatedly. Get the current plan documents and read them.

  • Reimbursement50–90%, plan-dependent
  • Payout capsAnnual caps on most plans
  • DeductibleAnnual
  • Best forBirds, rabbits, reptiles, exotics
Side by side

The whole field, one table.

Typical accident + illness configurations. Details vary by state and plan tier, so treat this as a map and confirm terms on the insurer's current policy documents.

Insurer Score Reimbursement Payout caps Deductible Direct vet pay Hereditary Quote
Trupanion 9.890%NonePer-condition, lifetimeYesYes Get quote
Healthy Paws 9.270–90%NoneAnnualRareYes visit site
Pets Best 8.970–90%By tierAnnualOptionalYes visit site
Embrace 8.770–90%Most plansAnnual, diminishingNoYes visit site
Lemonade 8.570–90%$5k–$100kAnnualNoYes visit site
Figo 8.270–100%By tierAnnualNoYes visit site
ASPCA 8.070–90%Most plansAnnualNoYes visit site
Nationwide 7.750–90%Most plansAnnualNoSome plans visit site
How we score

Our methodology, in plain English.

Every insurer gets scored on the same 12 factors, weighted by how much they matter when your pet is actually sick: payout caps (heaviest weight; a cap is a countdown timer on a chronic illness), deductible structure, reimbursement rate, what's excluded, waiting periods, how claims get paid, premium stability, enrollment limits, hereditary coverage, add-on honesty, customer service access, and financial backing.

We don't score brochure features. We score the version of the policy that shows up at the emergency hospital at 2 a.m. Full methodology on our about page.

9.8Top Dog

The verdict hasn't changed.

Trupanion wins because its three structural advantages (no caps, a one-time per-condition deductible, direct vet pay) can't be matched by any competitor without rebuilding their product.

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