Major medical horse insurance — sometimes called surgical and major medical, or just "medical coverage" — is the coverage that pays for the cost of treating a sick or injured horse that survives its medical event. While mortality insurance covers the loss of the horse, major medical covers the veterinary bills that can accumulate rapidly when a horse requires emergency surgery, hospitalization, diagnostic imaging, or intensive care. For any horse owner who would pursue aggressive treatment for a seriously ill horse, major medical coverage is an essential complement to mortality insurance.
Major medical coverage is structured around an annual benefit limit — the maximum the insurer will pay for covered medical expenses during a policy year. Common annual limits are $5,000, $7,500, $10,000, and $15,000, with higher limits available for high-value horses where treatment costs may routinely exceed standard limits. Colic surgery at a well-equipped equine hospital typically runs $5,000 to $15,000 depending on the type of surgery and the facility, which means a $5,000 annual limit may cover most but not all of a single colic surgery in a high-cost market.
Coverage under a major medical policy typically includes surgical procedures, hospitalization fees, diagnostic imaging (radiographs, ultrasound, MRI), laboratory fees, and post-surgical care during the treatment period. It generally does not include routine veterinary care, preventive treatments, elective procedures, pre-existing condition treatment, or conditions excluded at underwriting. The distinction between "treatment" covered under major medical and "maintenance" not covered is sometimes a source of dispute — routine joint injections are generally not covered, while an acute joint infection requiring surgical joint lavage would be.
Major medical coverage is subject to a deductible — typically $200 to $1,000 per incident or per year — before coverage activates. Some policies use an 80/20 co-insurance structure where the insurer pays 80% of covered expenses above the deductible. Understanding these cost-sharing provisions is important when evaluating the effective coverage a policy provides at different claim levels.