It is definately worth it unless you are very good at saving. If you are, and you have the means, you could put away money in a dog bank account for emergency but some specialized surgeries and tests can go into the thousands. And not every pet insurerer is equal. PetSecure was good for me for many years with a yearly $300 deductible regardless of condition, once it was satisfied in a year the rest was covered but they cut me down to 50% coverage when one of my guys really needed it and I was broke. They also had a $2000 limit of pay outs per year so my Pippin couldn't get a $3500 surgery that he needed. I have Trupanion now because they always pay 90% less tax no matter what and you can choose your deductible. But it is really expensive. At $250 deductible per illness or injury (lifetime) I pay over $100/month per dog. The higher the deductible the less you pay. I just never want to have to choose between my rent and my dogs. I want to know that my dogs will have the best care without leaving me with an impossible choice.
We're in the 'save money for emergencies' camp. 16 years in the US, 3 dogs, 4 cats... the higher expense we've had was a $750 x-ray for one of the dogs (he swallowed a rope toy and a sock, wasn't sure he threw it all up, he was fine). Needless to say, we've saved a lot of money NOT having insurance during those years. All the other testing we've had to do cost probably as much as the deductible anyway...
After spending about $15,000 in two years on one dog, I wish we had insurance on him.
My daughter just got a new, young rescue and I've strongly encouraged her to get insurance. She spent about $12,000 treating a dog for lymphoma, so she understands that it makes sense. (BTW, that dog with lymphoma is doing fine today - six years later. The clinic that treated him calls him their miracle boy.)
Everyone has a different opinion on whether insurance is worth it or not. Really it just depends on your dog and your financial situation. Personally I don't think it's worth it, but my dogs haven't had any major issues.
I have insurance on my sport/competition dogs due to possible injury. I am also very realistic. Dogs retired from sport and competition do not have insurance (if I re-home a recently retired dog I keep insurance on until re-homed and allow the new owner to decide if they want to keep the policy).
Dogs retired and not trialing and in my house do not have insurance. I have an upper limit on what I will pay. If something happens (such as bloat, injury, cancer and so forth) and it is over that amount I elect to euthanize. If any dog gets a long term chronic (and expensive to treat issue), I choose to euthanize.
Dogs over 8 years old have an even smaller upper limit and less will be done past making the dog comfortable. I will not do major surgery/procedure on any dog that is a senior. A 9 year old dog or a 10 year old dog has been too good for too long for me to add suffering to the dog just to keep them here another year for me.
I have Healthy Paws insurance. Trupanion is better. It is also more expensive.
We have it for both dogs. We got the policy when we first got Annabel as a pup and then added Beckett when we got him. For us it's worth it with a giant breed dog because it covers issues like hip dysplasia. And treatments for the somewhat common ailments of giant breeds is EXPENSIVE. So even if we'd been putting aside what we were paying monthly for insurance, I don't think we would have saved up even half of what might be needed. It just worked out to give us more peace of mind.
If you can, get one that covers preventive care like neutering / spaying, flea and tick meds, vaccines and vet visits. I had Healthy Paws (which is pretty cheap), but I moved to AKC because for $10 more a month it had preventive care and now I get money back on all his preventative stuff.
That being said, I am switching to ASPCA because it has preventive care, but also filing a claim is super easy (AKC claims are a nightmare).
Dog insurance is problematic. It depends on the breed and if it has a known history of medical problems. Some breeds are healthier than others. The quality of food one gives their pet; some foods are much more healthier than others (do your research). How you care for your beloved pet. Exposure to dangerous elements indoors & out. That said, my personal opinion about animal insurance is that some companies are rip-offs; some okay, but most companies charge exorbitant fees when the animal gets older. They start reasonably when the animal is young, then as the pet gets older, rates start climbing until an older pet the rates are doubled when started. Example: my insurance started out about $400 a year which included 80% payment of many items, but at about 10 years of age the premium doubled and I had extreamly little uses for it other than normal office visits. (had to drop it ~ too ecxpensive) Luckly I had a very healthy girl. My other girl, I don't carry insurance, i pay out of pocket and its less than premiums ~ thank goodness I have another very healthy girl. BUT, if your pet is of the sickly nature background or is accident prone, then I'd suggest insurance. Remember: all insurance companies & what they do & do not cover vary (sometimes greatly) so do your homework if you decide to get insurance. It's a jungle out there & every 2/3 years check out the other companies just like car or home insurance. Oh, pre-existing problems are not covered so switching can be a huge problem. Pet insurance companies need much more regulation ~ it ain't like human health insurance.