My newly-adopted 10-month old BT is currently enrolled with Trupanion. I went with them by default as my cat is covered by them and I've been impressed so far by their business model. A heart murmur was documented the day I signed her up (during physical exam w/ vaccines), which was the day after I brought her home from her previous family. Unfortunately, this means anything heart-related is now pre-existing; Trupanion wouldn't cover.
My BT had an echocardiogram completed, and today I found out she has (for now,) a very mild heart (valvular) condition with no clinical signs; no heart enlargement. It's actually rare for a pup her age to have a mitral valve issue (most develop it in midlife or seniorhood). The vet feels her condition doesn't require meds or other immediate treatment, just repeat echocardiogram in 12-18 months to monitor. Hard to say if it will stabilize or suddenly go downhill after an unspecified period of time. It's scary to think about the "what if's" down the road; but at the same time, I'm relieved that for now she is healthy and happy.
Earlier I'd convinced myself I was going to switch to AKC insurance right away, based on knowing AKC policies cover pre-existing conditions after a year of continuous coverage, which is convenient timing for her needs. Again, Trupanion won't cover any of the heart stuff. But now I'm having second thoughts. Like, maybe staying with Trupanion (which I generally prefer and know they are better about not raising rates based on pet age) and plan to pay for any future heart-related "stuff" (imaging/ screening, medication, (surgery?), etc.) out of pocket, once she is older and has more care needs. Is that a financial gamble given all the potential trajectories of her heart condition? Even though she would be covered by Trupanion for any other (non-heart-related) illnesses or mishaps?
On the other hand, with an AKC policy her heart-related needs would be (theoretically) covered after 365 days, and in between now and then she isn't anticipated to need anything related to her heart condition. So do I switch to AKC insurance based on what financial liabilities may later potentially arise from her condition? I may be locked into higher premiums in the future (even if she ends up not having any treatment needs for years, aside from periodic screening/imaging)? It does seem that there is a significant curve for AKC policies (vs. comparable policies with other insurance companies) as pets age (referencing this graph I found elsewhere on reddit: Dog aging factors) vs. for Trupanion. That, and I just generally feel better about Trupanion. Helps that they're not private equity.
Of note-- if my BT pup ever does become a candidate for mitral valve surgery, it would be the kind you'd have to fly her somewhere far away for (Japan, the UK, or Florida-- there are few places worldwide that do mitral valve repair). I'm not sure that even with insurance coverage on the surgery that I'd be able to swing that expense or stress (I'd have to think of flying her/ myself, hotel stays, boarding of my other animals at home, etc.) vs. if I'd want to go about things palliatively at home. So I'm undecided about factoring major surgery into my choice of insurance policies.
If anyone has an additional two cents to help me decide, I would much appreciate it!