Pet insurance can help pet owners with unexpected veterinarian costs from accidents, illnesses and in some cases even wellness care.

A few months after Penny, an adorable — and healthy — French bulldog puppy, joined the Nininger family, a small mass appeared on her eye.

And although most bulldogs have some breathing issues because of their short snouts, Penny’s seemed more pronounced, especially given her young age.

Bethany and Jonathan Nininger didn’t think twice when their veterinarian recommended that Penny, now 10 months, undergo eye surgery and at the same time open her airways to prevent future breathing problems.

The Niningers, of Gahanna, would do just about anything for their animals — they also have another French bulldog named Dolly, 3, and Minnie, a 3-year-old Sphynx cat — and their pet insurance allows them to act without having to think about their wallets.

“We would not have been able to pay for Penny to prevent these issues down the road,” said Bethany Nininger, adding that the procedure cost $3,500 and they were reimbursed $2,300 through their Embrace Pet Insurance policy. “You can pick any dollar amount to pay a month, and it might be the difference between life and death or a surgery your pet might need.”

The culture surrounding animals and their role in people’s lives has changed the past few decades, said Dr. Carol McConnell, chief veterinary medical officer for Nationwide, the largest provider of animal insurance in the United States with 725,000 pets covered: “They’ve gone from the barnyard to the backyard and from the backyard to the bedroom.”

Couple that with the advances in veterinary medicine that have occurred — pet owners spend roughly $17 billion in vet services annually, according to the American Pet Products Association — and more people are choosing to buy protection for their pets, whether it be for accidents (a torn ligament, swallowed items), illnesses (cancer, diabetes) or, in some policies, wellness care.

In the United States, over 1.8 million pets were insured in 2017, an increase of more than 17 percent reported by the North American Pet Health Insurance Association. But that remains a small portion of the nearly 90 million dogs and more than 94 million cats estimated by the APPA to be living as pets in the country.

Many pet owners can face difficult financial decisions if they lack coverage, said Anthony Sharett, president of Nationwide pet insurance, a division based in California.

“It’s to help offset these unexpected costs,” said Sharett, whose company was the first to offer pet insurance — in 1982 to a dog who played Lassie. “We never want a pet owner to say, ‘I can’t follow my veterinarian’s recommendations.’ ”

McConnell said that while the majority of pet owners want to do what’s best for their beloved animal, the decision often boils down to what they can afford. And many pet owners do not plan for the thousands of dollars it costs for abdominal surgery on a golden retriever who ate a pair of jeans.

“It’s something people pay with discretionary funds,” McConnell said. “That’s why insurance is such a financial tool to build it into our cost of living — the family budget.”

The cost of such protection ranges based on breed, age, pre-existing conditions and type of coverage wanted. For example, the price to insure a 1-year-old healthy golden retriever at Nationwide would start at approximately $28 a month while a 1-year-old Siamese cat would be $16. This amount increases if pet owners want a Whole Pet plan, which reimburses 90 percent of services, including wellness exams, dental and hospitalizations.

Unlike human health insurance, pet plans are generally reimbursement programs, meaning the owner pays up front.

Whether to buy pet insurance isn’t an easy yes-or-no answer, said Jack Advent, executive director of the Ohio Veterinary Medical Association, a professional organization in Powell that represents 2,700 vets statewide.

For that reason, Advent recommends people shop around for the best policy and to be aware of what it covers and doesn’t.

“Like any insurance, if you use it, it’s cost-effective,” Advent said.

Bethany Nininger insures her pets through Cleveland-based Embrace for about $40 a month for each dog and $20 for the cat. The bulldogs have wellness coverage.

“I pay more than most people would want, but my pets are my kids,” she said.

Most insurers offer plans to meet differing budgets and needs.

Some pet owners might choose a limited plan to insure a clumsy dog in case of an accident or if they simply want wellness checks covered, said McConnell. One pre-existing condition will not disqualify a pet, she said, and older rescue dogs can benefit from coverage, too.

The insurance company will have the pet’s vet sign off on its current condition. If a patient already has a major-organ disease, such as diabetes, anything related to that would not be covered.

“But we’ll cover anything else,” McConnell said. “The dog could still eat a rock or go up for a Frisbee, come down and tear a ligament.”