|   Insurance 
  First, I'll admit that I'm a licensed vet tech and I work for a pet insurance company. If you message me I'll tell you who I work for, but I'm more here to educate than sell.
 I can tell you from some pretty extensive research into the 11 companies available in the US that the ones that offer routine and preventative care are usually not worth it for the dog owner. Personally, my vet does vaccines every three years, heartworm prevention monthly, and flea and tick topicals only as needed ( I haven't needed any yet this year), so it wouldn't be worth it for me to pay extra (and you will) for preventative care that I already know my dogs will need. What I think is more important are accidents and illnesses, especially congenital ones. If you have pet insurance already, please look at your policy closely, most will automatically exclude anything "hereditary or congenital". That includes luxating patellas, hip dysplasia, and Legg-Perthes. No matter the cause you may never get these conditions covered.
 
 I highly recommend insurance, but please research what you're buying. Covering a vaccine a year is far less important that covering things you can't see coming.
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