The first thing to do is check with your vet to make sure they accept pet
insurance.  Not all of them do.  Persia's vet cites excessive paperwork as a
reason not to.  Peaches' avian vet encourages it.

There are also other considerations... just like with people, the insurance
folks gauge the age of your pets, past medical history, etc.

Jill

At one time we had VPI with the vaccination rider.  The rider wasn't worth
it because our vet charged less than the cost of the rider. So we dropped
the rider but kept the insurance.  When Moxie came down with pancreas and
liver problems, the insurance did cover some of our costs.
They do offer group rates, which might help you some.  You do have to file
claims, and that is a hassle.  You also have to be aware of deductibles and
limits on certain conditions.
We now have the catastrophic insurance for Cinder and Rosie (Moxie
eventually died).  Cinder costs $13.34 and Rosie costs $10.57 a month.  I'm
still not convinced it is worth it.  I think that the suggestion to set
aside a certain amount to cover those things could be a better idea.
Annie

Although I'm not in the US, we have pet insurance here in the UK and to a
certain extent I'm sure insurance companies are pretty much the same all
over the world, i.e. they like to take your premiums but try their best to
find good reasons not to pay out ;-)
So here is my two cents worth, in case any of it is relevent.

Vet treatment has always been expensive here.  Many years ago when I had a
horse, I got her insured.  Treatment for horses seemed particularly
expensive but I only claimed once and the cost of the premiums far
outweighed the cost of the treatment.  I guess I was lucky.
I was once a multi-dog household.  I had 11.  I wondered whether to get
medical insurance for them, but the monthly premium for all these proved to
be quite high.  I weighed up the ifs and buts.
I decided to set up a bank account named "Whippets"  that's what they
were;-) and set up a direct debit to pay in per month one third of what the
insurance company was asking.
I did not have to use it for ages when most of them were young, only for the
occasional stitch up when they hooked themselves up - their skin is
tissue-thin.
It built up over the years, their bank account, I mean.  By the time they
started to need it as they aged, there was quite a fair sum in there.
There was enough to treat Pearl aged 13 who collapsed suddenly on a bank
holiday, having been quite well.  Saturday, Sundays are holidays are way
more expensive.   She had a ruptured spleen, had to have a body scan and,
her spleen removed, and was saved.

I could go on.  I won't. ;-)   There was always enough in the fund for
whatever happened, and lots did as they all got older.

I never touched the whippet money, although sometimes it would have helped
me out a bit and I'm glad I didn't.

KFC & BF have a similar account.  They have been lucky to be fairly healthy
up until now, although Kitty dented the fund last year when she was missing
and found injured...
They have seven hundred pounds in their account, just by transferring a
third of the premium an insurance company would have asked per month.

Routine exams and vaccinations are not covered by pet insurance here and the
insurance company also sets an excess which the owner must pay before they
kick in.

For an appointment and examination for something not too serious which might
need a course of antibiotics, let's say it costs 30 quid, or if you're
lucky, 20.  That's when you find out that your insurance company only pays
bills of £31 or more.  You get my drift..

Tweed

Don't know what its like in the USA, but pet insurance here doesn't seem to
be worth it. Its something like $30 a month per pet, and they'll only pay
out $500 a year, total, per pet, not to mention all the hassle of meeting
the insurer's requirements and going through the whole claim process.
Indeed, I had a friend who had beeing paying her insurance without as much
as a late payment, and then the poor doggy got ran over. The insurance said
that the dog had to be put down and would only pay for the costs of being
put to sleep, but after extensive surgery (~$3000) the dog made a full
recovery.

So I figure if you are prepared to "pay" a bank account your insurance
premium, in less than two years, you've already got more than what the
insurance company would pay out, its earning interest for you, not hte
insurance company, and its htere for you to use as you see fit rather than
having to negotiate with an insurance company.

Personally, thats what I have credit cards for.

YMMV, of course.

Yowie

Scout and Silver came with one month of free pet insurance that was
supposed to cover them for any illnesses they brought home with
them... we had to take both of them to the vet but we never used the
insurance because it was too much hassle.

After Silver had a potentially serious health problem (we thought it
was an obstruction but it was just a hairball) we bought them both
insurance. Theirs only costs $10 a month each and it will cover them
for emergencies... it doesn't cover routine vet visits or shots but
our vet's pretty cheap. We only bought it 'in case of emergency'
because we can't afford a big bill.

Just an FYI, some insurance companies offer discount rates for indoor
only cats.  The also have higher coverage amounts for injuries typical
to indoor only cats such as asthma or a fall from a high place.  May be
worth looking in to if your cats don't go out.
Jemfur