Trupanion

I have two large dogs who are 8 and 9 years old and I’m looking into pet insurance. I was really interested in Trupanion because they advertise paying the vet directly at checkout, which would be a huge relief in an emergency.

But when I called several 24 hour animal hospitals, they told me they accept Trupanion but don’t process the same day direct pay feature. That confused me because that seems like the main benefit of the higher premium.

Should I also be calling regular local vets to ask about this, or only emergency hospitals? In a true emergency, do regular vets handle surgeries or is that usually only done at animal hospitals? I’ve never owned dogs before and haven’t experienced an emergency, so I’m just trying to understand how it all works before choosing a plan.