I'm not sure I can vote on this ... I had Trupanion for Maggie. We did use it because she has some neurological problems, and they were very swift to pay the bill and I was so happy with them until a year had passed and they immediately doubled the premium. They came up with some garbage about rising vet costs was forcing them to increase the payments, but I honestly think it is just because the bulldog is a breed known for it's health problems. Anyway I cancelled my policy and when anything comes up in the future that is major we are planning to use the carecredit instead.
As far as the deductibles are concerned ... it's just like any other type of insurance. If you decide to have a $200 deductible it will lower your monthly premium payments. However, if something were to happen to your bully you would pay the first $200 of the vet bill and also the cost of the office visit (usually). After that the insurance company will tell you how much they are willing to pay of the balance. It is usually a set percentage of the balance. So if your deductible was $200 and the insurance company say they will pay out 80%. Then you would take your vet bill, minus the cost of the office visit. Then take $200 off what is left. The balance after that you would be liable for 20% and the insurance company would pay 80%.
From the total bill you would be paying the office visit plus $200 plus 20% of what is left. Hope that makes sense!!
Also, most insurance companies expect you to pay the vet bill first and then make a claim with the invoice and receipts which they will then reimburse you on once they have checked everything.
Trupanion did not have any limits as to how much they would pay out in a year, but I know other insurance companies do.