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I've been looking at our household budget so that we can plan for 2025 and

This is a terrifying number but it might help others figure out costs of having senior pets in the Bay Area.

On vet bills alone, our 15 year old dog and 18 year old cat racked up US$19 419.77.
We paid US$1280 in pet insurance premiums, and got refunded US$11 162.42.

Like with most pet insurance, it's a pay first and reimbursed later. It took between 3 days and 30+ days to get paid back.