It starts with the little things: the way your dog waits by the door like you’ve been gone for years, or how your cat cuddles in your lap. Pets can be companions, comedians, therapists with fur — and for many people, they’re family. They can become the center of emotional lives.

But this love comes with responsibility. As veterinary care grows more advanced –and more expensive — many devoted pet owners are asking a practical question: how do you protect the ones who depend on you, no matter what happens?

Is Pet Insurance Worth It?

Roughly 65 million U.S. households have a dog, and 46 million have a cat, but according to Consumer Reports, fewer than 5 million of them are insured.

Most of us wouldn’t consider going without car insurance, a homeowner’s policy, or healthcare coverage, but is a policy on Max or Charlie necessary? Like so many other decisions, it comes down to dollars and cents, but there’s also the peace of mind you get from not having to worry about unexpected, high-cost emergencies.

Pet insurance is generally considered worth the expense if a sudden emergency bill of $1,500 to more than $5,000 would cause financial hardship. Most owners pay more in premiums over a lifetime than they receive in payouts, but insurance serves as a safety net for catastrophic events like cancer or major surgery, which can cost more than $10,000.

Dogs are consistently more expensive to insure. The national average premium for accident and illness coverage is approximately $62 per month for dogs, compared to $32 per month for cats. The reason is that dogs often have more health needs, everything from skin allergies and ear infections to ACL surgeries that can cost $5,000 or more per knee.

Just like policies for humans, you have to consider what type of coverage you want or can afford.

Know What You’re Buying

The most popular policy starts with accident coverage, which usually covers care for injuries, including surgery and hospitalization.

You will also want to check whether your policy covers routine health check-ups, preventive care and vaccinations, medication, X-rays, access to telehealth, and behavioral and alternative therapies.

In addition to checking on what’s covered, look for exclusions and waiting periods. Some policies exclude pre-existing or chronic conditions. Many policies also have coverage limits on how much you can receive in benefits each year, while others are unlimited.

Many insurers have waiting periods before their coverage kicks in – anywhere from a week to six months or more. Many policies also require co-pays and deductibles, so you have to do some math to figure out the breakeven point.

Pet insurance is usually designed to cover major events, such as surgery. Many policies also offer add-on features, which increase the coverage and the cost.

Some of these add-ons are referred to as “pet wellness” plans, covering expenses incurred during routine vet visits – everything from annual blood tests to dental cleanings and flea and tick prevention.

Just like our own health policies, the cheaper premium is not always the most cost-effective policy. It may depend on what’s covered and what’s not covered.

What Else Should You Consider?

Your pet’s age is also an important factor in determining how much a policy will cost and what it will cover. The older the animal is, the higher the premium.

Older animals may even be denied coverage or have pre-existing conditions excluded. That could mean insurance is not worth the expense.

A recent Wall Street Journal article found that Pets Best and Spot were the top-rated insurers. Consumer Reports gave high marks to Lemonade and Liberty Mutual Pet Insurance.

Insurance is also available for pets beyond dogs and cats. Policies are available for birds, reptiles, rabbits, lizards, snakes, guinea pigs, and more.

The cost of pet insurance can put a dent in your monthly budget, but it can also help you manage big bills and allow you to make decisions about your pet’s care based on the best medical treatment, not just the cost.

Disclaimer: The insurance providers mentioned are for illustrative purposes only and are not recommendations or endorsements. EKS Associates is not affiliated with, compensated by, or in any way connected to these companies.