Major Medical Horse Insurance: Costs & Workings

Equine mortality insurance pays if your horse dies. Major medical insurance pays while your horse is alive, covering vet bills for illness, injury, and surgery. They are separate coverages that work together, and most horse owners need both.

This guide covers exactly what major medical horse insurance includes, how much it costs, how deductibles and co-pays work, and how to choose the right coverage limit for your horse.

What Major Medical Horse Insurance Covers?

Major medical (also called "surgical and major medical" or "extended major medical") covers non-elective veterinary care for illness and injury. Covered expenses typically include:

• Diagnostic costs — imaging, bloodwork, ultrasound, endoscopy

• Hospitalization — daily hospital fees at equine veterinary facilities

• Surgical procedures — including colic surgery, orthopedic surgery, and soft tissue repair

• Post-surgical care — follow-up treatment, medications, and rehabilitation

• Treatment for illness — EPM, laminitis, respiratory conditions, and other medical conditions

• Emergency vet calls — after-hours and emergency examination fees

What Major Medical Does NOT Cover?

• Routine and preventive care — vaccines, deworming, routine dental, routine farrier

• Pre-existing conditions — any condition diagnosed or treated before the policy was bound

• Elective procedures — procedures not medically necessary

• Breeding-related costs — reproductive veterinary care

• Cosmetic procedures

• Care beyond your policy limit — insurance pays up to the annual limit; you pay the rest

How Much Does Major Medical Horse Insurance Cost?

Major medical is purchased alongside a mortality policy, it is not available as a standalone coverage. The cost depends on the coverage limit selected and the horse's value. For a full cost breakdown including mortality rates, see our guide on how much horse insurance costs.

Deductibles and Co-Pays — How They Work

Major medical policies at Remuda Insurance Group have both a deductible. Understanding is essential to knowing what you will actually pay at claim time.

Deductible

The deductible is the amount you pay before insurance begins. Most major medical policies have a per-claim deductible of $425–$600. The deductible applies once per claim, not per vet visit within a single claim.

Per-Claim vs Per-Condition

Some policies reset the deductible per-claim — others apply it per-condition. A per-condition policy means a recurring condition (like chronic laminitis) counts as one deductible event, even if treated multiple times. Read your policy carefully.

Major Medical and Colic Surgery — The Most Important Connection

Colic surgery is the most common large-dollar equine claim. Most full mortality policies include a free Emergency Colic Surgery (ECS) endorsement, up to $5,000 in colic surgery coverage at no extra premium. When stacked with a $10,000 major medical policy, your total colic surgery protection reaches $15,000. For the full explanation of how this works, see our guide: does horse insurance cover colic surgery?

Choosing the Right Coverage Limit

Major medical must be purchased alongside a mortality policy. It is not available standalone. To see all equine coverage options, mortality, major medical, ECS, loss of use, visit our equine insurance page.

For a complete breakdown of what equine mortality insurance covers, and the 5 mistakes owners make when buying it, see our guide: equine mortality insurance explained.

Frequently Asked Questions

Does major medical cover routine vet care?

No, major medical covers non-elective veterinary care for illness and injury. Routine care, vaccines, deworming, annual dental, routine farrier visits, is not covered. Major medical is designed for unexpected illness and injury, not maintenance care.

Can I add major medical to an existing mortality policy mid-term?

In most cases, no, major medical must be added at the time of purchase or at renewal. Some carriers may allow mid-term endorsement additions if the horse has had no recent health issues. Contact your agent to confirm.

Does major medical cover pre-existing conditions?

No, any condition diagnosed or treated before the policy was bound is considered pre-existing and is typically excluded. Disclose all known health history when applying, undisclosed conditions can result in claim denial.

What is the difference between surgical coverage and major medical?

Surgical coverage covers surgery specifically, it does not cover diagnostics, hospitalization outside of surgery, or treatment for illness. Major medical is broader, it covers surgery plus diagnostics, hospitalization, treatment, and post-surgical care. Major medical provides significantly more protection for the same price range.