Short answer: Trupanion, Nationwide and Petplan — now called Fetch — are built differently, not just priced differently. Trupanion pays 90% with a deductible you pay only once per condition and has no payout limits, but doesn’t cover exam fees. Nationwide uses an annual deductible, reimburses 50%–80% depending on the plan, and caps payouts at $2,500–$10,000 a year, but is the only one of the three that also insures birds and exotic pets. Fetch reimburses up to 90% with an annual deductible and covers sick-visit exam fees up to $250. The right choice depends on your pet’s age, health history and how you want to pay the vet.
All details below come from each insurer’s own website and policy documents, checked on September 21, 2026. Plans vary by state and change over time, so treat this as a starting point and confirm against the policy you’re offered.
Side-by-Side Comparison
| Trupanion | Nationwide | Fetch (formerly Petplan) | |
|---|---|---|---|
| Reimbursement | 90% | 50%–80%, by plan | Up to 90% |
| Deductible | Per condition, once per lifetime | Annual ($250 on current plans) | Annual |
| Annual payout limit | None (no lifetime limit either) | $2,500–$10,000, by plan | $5,000 / $10,000 / $15,000 options |
| Exam fees | Not covered | Wellness exams via add-on; check sick-visit terms | Sick-visit exams up to $250 |
| Pays vet directly | Yes, at participating hospitals | No | No |
| Hereditary conditions | Covered, no breed exclusions | Per plan terms | Covered |
| Wellness add-on | No routine-care plan found | On some plans (Modular: $450 or $800/yr); not on Whole Pet | Yes |
| Behavioral / alternative therapy | Via optional rider | Check plan | Included (behavioral up to $1,000/yr) |
| Enrollment age | Under 14 | Illness coverage up to 8–9, by plan | 6 weeks and up |
| Other species | Dogs, cats | Dogs, cats, birds, exotics | Dogs, cats |
| Underwriter | American Pet Insurance Co. / ZPIC | National Casualty / Veterinary Pet Insurance Co. | AXIS Insurance Co. |
Trupanion: One Deductible Per Condition, No Caps
Trupanion’s defining feature is its lifetime per-condition deductible. Once you’ve paid it for a condition, Trupanion says future costs for that same condition are covered without paying it again. Combined with 90% reimbursement and no annual or lifetime limits, that structure is strongest for a pet that develops one chronic, expensive problem — allergies, diabetes, arthritis — where an annual deductible would otherwise be charged every year.
The trade-offs: exam fees and taxes aren’t covered; alternative therapies and behavioral treatment need the optional Recovery & Complementary Care rider; and dental illness coverage requires your pet’s teeth to be examined by a vet at least once every 365 days. Its VetDirect Pay is a genuine advantage if your clinic uses it — you pay only your share at checkout instead of waiting for reimbursement.
On pricing, Trupanion’s policy disclosures state that premiums won’t increase because of your pet’s age or claim history. That doesn’t mean they never rise: Trupanion reprices through state rate filings when vet costs increase — see why pet insurance keeps going up.
Nationwide: Most Plan Choices, Including Birds and Exotics
Nationwide sells several distinct plans rather than one configurable policy, so “Nationwide coverage” depends heavily on which plan you pick. Reimbursement ranges from 50% to 80%, deductibles are annual, and every plan has a payout ceiling — from $2,500 up to $10,000 a year — while its Major Medical plan pays fixed benefits per condition instead of a percentage of the bill. It’s also the only one of the three with avian and exotic pet plans.
Two things to check before enrolling: its main plans only accept new illness coverage for pets up to age 8 or 9, and its waiting periods, which we couldn’t confirm from Nationwide’s public pages — ask for the policy’s waiting-period terms directly. For more, see our Nationwide coverage guide, whether Banfield accepts Nationwide, and Nationwide’s avian and exotic plans.
Nationwide has also been shrinking its pet business: it announced in 2024 that it would not renew about 100,000 policies, and S&P Global data show its direct premiums written fell 6.4% in 2025, while Trupanion’s grew 11.7% to become the largest US pet insurer by premiums.
Fetch (Formerly Petplan): Exam Fees and Behavioral Care Included
Fetch reimburses up to 90% with an annual deductible and lets you choose a $5,000, $10,000 or $15,000 annual limit. Its most practical differences are coverage that others charge extra for or exclude: sick-visit exam fees up to $250, behavioral therapy up to $1,000 a year, dental disease, and alternative care such as acupuncture. It says it covers pets from 6 weeks with no stated upper age limit.
Waiting periods are published clearly: coverage can take up to 15 days to start after enrollment, and orthopedic conditions such as hip dysplasia, cruciate ligament tears and luxating kneecaps have a 6-month wait — which Fetch will waive if a vet exam within 180 days of enrolling finds no existing knee or joint problem.
The Same $3,000 Bill Under Each
An illustrative example — not a quote — for a first claim of the year with a $300 deductible on each plan (Trupanion at its standard 90%, Nationwide at 80%, Fetch at 90%), using the standard bill × percentage − deductible calculation:
| Plan | Math | Reimbursed | You pay |
|---|---|---|---|
| Trupanion (90%) | $3,000 × 90% − $300 | $2,400 | $600 |
| Nationwide (80%) | $3,000 × 80% − $300 | $2,100 | $900 |
| Fetch (90%) | $3,000 × 90% − $300 | $2,400 | $600 |
The difference shows up over time: a second, unrelated illness later that year would need a new deductible under Trupanion but not under the annual-deductible plans — while a chronic condition would cost a new deductible every year under Nationwide and Fetch but never again under Trupanion. Our reimbursement guide works through both cases in detail. Exam fees would add to your share under Trupanion but be covered under Fetch.
Which Fits Which Pet?
- A young, healthy dog or cat, likely to stay insured for life: Trupanion or Fetch. Trupanion’s structure pays off if a chronic condition develops; Fetch’s included exam fees and behavioral cover add value for everyday sick visits.
- A pet with a breed prone to one expensive condition (hips, heart, allergies): Trupanion’s per-condition deductible and lack of limits are built for this — see how breed changes the cost.
- You want direct payment at the clinic: Trupanion, if your vet uses VetDirect Pay.
- A bird or exotic pet: Nationwide is the only one of the three.
- An older pet: check enrollment age limits first, then pre-existing condition rules — see does pet insurance cover pre-existing conditions.
What About Price?
We couldn’t find published, comparable quotes from all three insurers for the same pet, and prices vary heavily by ZIP code, breed and age. Nationwide advertises a starting price of $11 a month, but that’s for accident-only coverage on a 1-year-old dog in Chicago with a $5,000 limit — not accident-and-illness coverage. Get quotes from each insurer’s own site for your pet, then compare them using the same deductible and reimbursement settings. Industry-wide, the average US accident-and-illness premium was about $70 a month for dogs and $36 for cats in 2025, according to NAPHIA — see how much pet insurance costs per month.
Customer Reviews (Snapshot)
On Trustpilot on September 21, 2026: Fetch 4.6★ (about 7,700 reviews), Trupanion 4.4★ (about 12,300), Nationwide 4.4★ (about 4,700). Praise across all three centers on fast claims; the most common complaints are rising premiums and claims denied as pre-existing. We couldn’t verify AM Best financial-strength ratings or BBB grades from their primary sources, so they aren’t included here.
The Bottom Line
None of the three is “best” in general. Trupanion is structurally strongest for long-term, chronic or hereditary conditions and pays the vet directly; Fetch includes more of the everyday extras; Nationwide offers the most plan variety and is the only choice here for birds and exotic pets, with lower payout ceilings. Match the structure to your pet — then compare real quotes.
This article is general information, not insurance advice. We have no affiliate relationship with these insurers. Terms vary by state and plan; your policy documents govern.
Sources
- Trupanion — homepage; How pet insurance works; What’s covered; What isn’t covered; Enrollment age; Policy disclosure
- Nationwide — All products; What’s covered
- Fetch — homepage; Is Petplan now Fetch?; Waiting periods; Annual limits; Exam fees
- S&P Global Market Intelligence — US pet insurance market growth slows in 2025, April 2026
- Trustpilot — Trupanion, Nationwide, Fetch, captured September 21, 2026
- NAPHIA — State of the Industry Report 2026
