CostByBreedThe two policies side by side, from each insurer's own documents, captured on October 27, 2026. This page does not crown a winner. It lines up the terms that decide claims, so the difference between the two is visible.
| Policy point | Trupanion | Healthy Paws |
|---|---|---|
| Accident waiting period | 5 days for injuries | 15 days in Healthy Paws' general descriptions, described on one page as a 15 to 30 day waiting period depending on the state. Note: the 2026 state insurer disclosures checked say there is no waiting period for illness, injury or orthopedic conditions resulting from an accident, and 15 days for illness or injury not resulting from an accident. |
| Illness waiting period | 30 days for illnesses | 15 days from the pet policy effective date for illness or injury not resulting from an accident, in the state disclosures checked. Healthy Paws' general pre-existing page describes the waiting period as 15 to 30 days depending on the state. |
| Orthopedic waiting period | No separate longer orthopedic period in the disclosure checked; illnesses are 30 days and injuries are 5 days, and Trupanion states it has no extended waiting periods in its comparison pages. | In the 2026 state disclosures checked: 15 days for orthopedic conditions other than hip dysplasia not resulting from an accident, and 30 days for hip dysplasia not resulting from an accident, with the waiting period waived on completion of a complete clinical examination. Note: other Healthy Paws material and its comparison footnote describe hip dysplasia differently, with a 12 month hip dysplasia wait and coverage only when the pet is enrolled before age 6. That 12 month figure was not in the state disclosures checked and is flagged as conflicting, state dependent material. |
| Hereditary and congenital conditions | Covered. Trupanion's puppy and coverage pages list hereditary and congenital conditions, including breed-specific conditions such as hip dysplasia, as covered like any other illness, if not pre-existing. | Covered. Healthy Paws' plan page says hereditary and congenital conditions are eligible for coverage so long as signs and symptoms first manifest after enrolling and after any applicable waiting periods, with no restrictions stated on that page. Hip dysplasia is an exception in practice: Healthy Paws' comparison footnote says it includes coverage for hip dysplasia when you enroll your pet before the age of six. |
| Two sided (bilateral) conditions | Trupanion's own cruciate FAQ says if a pet had cruciate problems on the same leg or the opposite leg 18 months prior to the policy effective date, they will be considered pre-existing and will not be covered. | Healthy Paws' coverage page says pre-existing cruciate ligament injuries are not covered, and if the cruciate ligament on one leg is injured prior to enrollment or during the 15 day waiting period, then the cruciate ligament on the other leg is excluded from coverage. It states this is the only bilateral exclusion in the policy. |
| Pre-existing conditions | Pre-existing conditions are excluded. Trupanion's disclosure defines them as conditions for which, before the policy effective date, a vet provided medical advice, the pet received previous treatment, or the pet had signs or symptoms directly related to the condition, from verifiable sources. No curable condition symptom-free re-instatement period was stated in the Trupanion policy disclosure or pages checked, so no cure window is recorded for Trupanion. | A pre-existing condition is a condition for which, before the policy effective date or during a waiting period, a vet provided medical advice, the pet received previous treatment, or the pet had signs or symptoms directly related to the condition, based on verifiable sources. Healthy Paws' coverage page says curable conditions that fully resolve and remain symptom free and treatment free for a continuous period of 365 days may be eligible for coverage again. |
| Exam fees | Not covered. Trupanion's what-is-not-covered page lists exam fees and taxes as not included in the plan. | Not covered. Healthy Paws' coverage page and its state pages state examination fees are not covered, and its North Carolina page lists exam fees among what the plan does not include. |
| Dental illness | Covered. Trupanion's puppy page lists dental coverage including tooth extractions, abscesses, fractures and gum disease. Its not-covered page says preventable dental problems that arise from missed routine cleanings are excluded. | Not covered as dental illness. Healthy Paws' coverage page excludes dental healthcare and periodontal disease claims, but says when teeth are injured due to an accident the plan covers extraction and/or reconstruction of damaged teeth. Its dental page says eligible dental accidents and illnesses are covered up to the chosen annual limit with no separate dental sub-limit, but does not cover the vet exam fee for dental treatment, which conflicts in wording with the periodontal exclusion and is flagged in the notes. |
| Age rules | Coverage can start at 8 weeks old, and pets can be enrolled at any time before their 14th birthday, according to Trupanion's age limits FAQ and kitten page. Once enrolled before 14, coverage continues for life. | Minimum age described in Healthy Paws own blog is 8 weeks, in the context of an 8-week-old puppy or kitten. No maximum enrollment age was stated in the Healthy Paws pages checked, except that hip dysplasia coverage requires enrollment before age 6. Reimbursement and deductible options available at enrollment can be more limited for older pets, but the specific age-based limits were not stated on the Healthy Paws pages checked. |
| How claims are paid | Actual cost of veterinary treatment, at 90 percent coinsurance in the disclosure checked, after a per-condition lifetime deductible. Trupanion describes this as a lifetime per condition deductible: the deductible is met only once per condition for the pet's entire life. There are no payout caps in the pages checked. | Actual vet bill. Healthy Paws' coverage page says it reimburses based on the actual vet bill, not a benefit schedule. Its terms page says the reimbursement percentage is applied to the covered claim first and the annual deductible is then subtracted, which is the reverse order from most other brands here. |
| Direct payment to the vet | Yes. Trupanion offers VetDirect Pay at participating veterinary hospitals, paying the vet directly at checkout when available, according to its how-it-works page, which says the system is available in over eleven thousand veterinary hospitals across North America. | Yes, by arrangement. Healthy Paws' plan page says it offers a Direct Pay option that lets you arrange to pay your reimbursable benefit to your vet before services are performed. |
Their own published examples
Healthy Paws: Healthy Paws' own 2026 puppy and kitten blog gives average monthly cost for a puppy (0 to 12 months) as $47.00 and for a kitten as $22.34, and lists the lowest monthly payments as $7.66 for a puppy and $2.84 for a kitten, noting those lowest premiums may not be available in all states.
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Read the full reviews: Trupanion and Healthy Paws.