I don't use pet insurance, but all my pets are on wellness plans from Banfield. It's more for maintenance vs emergency, but for $30/mth I can go to the vet anytime I want, get all shots, dental cleanings, and more. Plus you get discounts on things like surgery, prescriptions and other things you need to buy through the vet. the nice thing about Banfield is that they are all over the country. I was in MD recently (live in FL now) and 2 of my dogs got into a tussle and I took one into the vet to get him checked out. I was able to go to the local Banfield at no charge and have him taken care of. The only thing I paid for was some anti-biotics.
I've considered getting insurance plans for the what if, but I've saved thousands of dollars between 4 dogs and a cat over the last 16 years using Banfield. The odds of something major happening that require giant expenses is low, so I roll the dice and tick with maintenance vs emergency. I also figure that the money I've saved over the years will balance out if I have something major go wrong. (Knock on Wood)