There are so many different companies and types of coverage. Consumer Reports said that Pet Insurance was not a good idea. But then again... it is not their dog... All I know is that I would sell my house or my blood for that matter to get my dog the care she needs. When I was interviewing vets, one of the questions that I asked was what if something happened and I didn't have the money right then, if she is an established patient, would you treat her? Of course if I had to I would use a credit card or something, I just wanted to see his commitment to my dog's well being.
I was surprised at how much vet care cost varies from state to state... almost like gas prices I guess. A friend needed a surgery for her dog. She was smart enough to do her homework first and found a good vet that did the same surgery, even used better suture material, for hundreds of dollars less, just by driving across the state line. (For us that is not that far) I recently learned of a neuter clinic that was a lot cheaper if you cross the state line. I just assumed that vet care cost the same everywhere.
I don't have pet health insurance because my animals were all re-homed and the cost to insure them was a stupidly high. However if you get the dog as a puppy and you shop around for good insurance, then it gives you a bit of security. If you have several dogs it is probably best to put the money aside and apply it to whichever dog needs the vet next,
In Michigan it is legal to give your dog all vaccines except rabies. I never give my dog any of her shots because I am afraid that I wouldn't do it right or that the serum would not be stored at the right temperature during shipping, I just don't feel at all qualified. I know some people do and they save a ton of money, it is just not right for me.