I think we just save the money every month so we can pay for it when needed.
Pet insurance has been worth every penny for me. In six years, they have paid out far more than I have paid in. (I did the math.) But you are basically betting on your pet being ill.
I am very low income (under $20,000) and there is no way I could come up with the $2,000+ my pet needed multiple times. So I feel that as someone who knows that paying $2,000 or even $500 would be very big financial blow, that for me to be a responsible pet owner I needed insurance. I can come up with that monthly fee. But even if I had put that amount in an account from the moment my dog came home, I would be nowhere near what they've paid out for me. It would be different if you had a larger income and significant savings.
The savings account is a common argument, but all it takes is one incident to deplete it. (If I had put $28 a month in his account it would be negative so many dollars now, LOL) I also never want to have to make a decision regarding the welfare of my pet based on cost. That's an emotional thing, but it's worth the money to me to go to the vet and say, "Do whatever is necessary." If we were purely logical we'd let them go if treatment cost more than euthanasia, and adopt another dog as there are many who need homes, but most of us don't think that way.
I have had Nationwide pet insurance (used to be VPI) for his entire life. He is six now. You can choose from a $100 or $250 deducible. I always choose $100 because we go often enough and the difference is about $7 a month. (7x12 = $84 annually vs $150 in deductible, made sense to go with lower deductible to me,) with 100% payout up to the limit of the policy. I have the Major Medical policy. They usually reimburse within two weeks. They will not drop you no matter how many claims you make, and your rates will not increase based on claims. Rates only go up as your pet ages. There are age brackets. No lifetime limits, but $15,000 annual.
You basically either end up super grateful you have it after a chronic illness or expensive incident, or resentful because you have a healthy dog that doesn't need vet care.
I attached an overview of my claims just to give you an idea. The amount on the left is what I submitted. The amount on the right is what they reimbursed.