I use Pet's Best and it pays for itself in one appointment. I think I pay around $45/mo and it covers the exam portion of all visits as well as things like acupuncture and meds. One thing I didn't think to check was the limit on accidental ingestions per 18-month period. My dog met the limit of 3 in only 6 months.
Depends on a lot of factors really. I personally prefer to keep a 5k emergency fund and I know if I needed more I could borrow from my parents. Most insurance requires upfront payment anyway, there is only one company I know of that direct bills.
My dog was diagnosed with kidney failure at 8 months. I'm so glad I had Pet insurance prior to finding that out otherwise I'd probably have to be working a second job. I pay 42 a month with nationwide and it has covered quite a bit of his care. My parents carry it as well and have had 5 dogs have TPLO surgeries- very expensive- which was covered under their insurance.