Most pet owners think of their animals as family members and put considerable value on their health and well-being. But should they buy pet insurance? It’s an ongoing debate that often pits numbers against emotions.

“People must have pet insurance,” says Betsy Arthur, a veterinary surgeon with a Maryland practice. “People who can’t afford insurance are left without options, and heartbreaking decisions . . . especially when the problems are serious but fixable.”

Most pet owners don’t have it. There are about 179 million pets in North America; about 1.6 million of them are insured, according to 2014 statistics from the North American Pet Health Insurance Association.

Most calculations come down against it. A study of nine companies conducted by Consumers’ Checkbook concluded that, for most pet owners, it just isn’t worth it.

“We found that, overall, because the cost of insurance is so high, not all care is covered, and policyholders must contribute co-pays and deductibles, most pet owners will pay more out of pocket over the course of their pets’ lives with insurance than without it,” said Kevin Brasler, Checkbook’s executive editor. “There is a fundamental flaw in most pet insurance plans. Many pet insurers inadequately disclose that as pets age their monthly premiums increase substantially, eventually making their products extremely expensive.”

But these statistics may mean nothing to you if your dog or cat becomes seriously ill or injured. Insurance is a gamble, and if you are among those pet owners who want to be able to pay extraordinary costs to treat a pet, you may want to bet on having insurance.

Attitudes toward pets have been changing, and many dog or cat owners are willing to go to great expense for their pets. Millennials have embraced pet ownership more than marriage and children in recent years, spending an estimated $11 million on pet items such as toys, costumes and “strollers,” according to a 2015 survey. Pet health insurance would seem a logical investment for a generation willing to lavish so much on its four-legged companions.

The American Veterinary Medical Association endorses pet health insurance, saying it is a way to help pet owners meet the cost of vet bills and also encourages veterinarians to continue to practice high-quality care.

Some critics suggest putting money into a personal pet medical savings account as a better option. The money is still yours — not the insurance company’s — and it’s there when you need it. But this works only if you are disciplined enough to make deposits, and if there is enough in it for an expensive medical emergency.

They also argue that most pets don’t get sick until they are old. But that’s not always true.

A friend’s young Doberman, not yet 2, was diagnosed with osteosarcoma, an aggressive bone cancer, requiring a leg amputation and a course of chemotherapy. His owner — who gets pet insurance through her job — was happy she had it, as her bills were more than $5,000.

In another case, a healthy 2-year-old dog was hit by a car. His injuries were so bad “that most people would have euthanized him,” says Justine Polk, practice manager at the local Maryland clinic where he was treated. The dog was comatose and suffering from head trauma, lung injuries and internal bleeding, but “the family wanted to do everything they could,” Polk says.

His bills were more than $40,000, of which insurance paid $30,000. The owners still had a hefty bill, but the dog recovered completely and went home. Moreover, this “allowed us to practice some amazing medicine” that saved him, Polk says.

To be sure, some of us couldn’t afford a $10,000 co-pay, nor even monthly premiums. Others can’t pay the costs of routine vet care.

This doesn’t mean they shouldn’t have pets. A loving home is always better than an animal languishing in a shelter, or being euthanized there, especially since help — including financial assistance — is available for those who may need it.

“There are resources one could turn to for financial assistance, . . . for example CareCredit, ScratchPay, friends, family, crowdfunding,” says Jason Nicholas, president and chief medical officer for Preventive Vet, an educational resource for pet owners. “There’s even a new initiative being tested to increase access to care and lower financial roadblocks for people of limited financial means,” called AlignCare, at the University of Tennessee College of Social Work.

As the owner of six pets — four cats and two dogs — I’m aware of the debate. I have coverage for all of them, and am happy I do. I had to cope with a life-threatening urinary blockage in my youngest cat, and serious chronic gastrointestinal diseases (including one with cancer) in my two oldest cats. The cat in the middle has minor heart issues requiring periodic monitoring. With medications — including chemo — and screening tests, my vet bills have totaled in the thousands.

That’s not to say that the companies can’t be as annoying as human ones. A former plan paid for one cat’s periodontal disease treatment, but it later refused to cover another’s — even though the diagnosis and treatment were identical. Why? My vet wrote “routine dental cleaning” in his notes. This triggered a denial, since “preventive care” isn’t covered. I appealed, but they wouldn’t budge.

When considering a plan, make sure you are aware of exclusions and limitations. None of the plans cover preexisting conditions. Some won’t pay for physical exams, even if they are part of a covered disease treatment. Some won’t cover certain breed-specific conditions. Others may refuse to cover certain recurring situations, for example, a dog that repeatedly ingests foreign objects. Some companies view that as owner carelessness.

I have a high deductible, which keeps my monthly premiums low. Premium increases are based on the pet’s age at enrollment, so they typically are lower than other plans, which hike up costs as pets get older. The deductible applies only once per condition, then the plan covers 90 percent of the rest. It also has a direct-pay-to-vet option, if your veterinarian will agree to it.

My company also is flexible. When one of my dogs developed an allergy, the plan initially denied covering the cost of his medication. They assumed it was a preexisting condition because his medical records say he’s on fish oil, an allergy treatment. Once I explained that the vet didn’t prescribe fish oil — I did (it’s good for the coat) — the company reversed itself.

Pet health insurance may not be for everyone, but it works for me. Can pet health insurance companies be just as irritating as human ones? You bet. Would I ever be without it? Not in a million years.