Equine medical insurance has been available for decades and is designed to assist horse owners with the cost of health conditions and potential loss associated with their horses. Owners obtain medical insurance coverage for a multitude of reasons, including:
- To provide a portion of financial security on an investment;
- To be able to afford future medical diagnostics and procedures; and
- To limit some of the financial hardship associated with a major medical condition or potential loss.
For these reasons and others, equine medical insurance has proven extremely beneficial for some horse owners. From a veterinarian’s perspective, equine insurance has afforded both the owner and the veterinarian the ability to pursue certain medical and surgical procedures. While the veterinarian does not have a vested interest in owners maintaining medical insurance, there are many situations in which the owner could not have afforded life-saving therapies and might have considered euthanasia if the horse had not been insured. Consequently, many veterinarians advocate for securing insurance policies if appropriate for the horse owner.
Those in the industry have witnessed considerable changes in equine insurance and the policies available. In the past two to three years, insurance plans have started to mirror many of the human insurance industry’s business models. For instance, major medical policies require the policy owner to assume more financial responsibility than previously. Some of the changes include higher deductibles, co-payments (which vary from a flat fee to a percentage of the total claim), and a cost-sharing split on specifically covered procedures (i.e., 70% covered by insurance, 30% by the policy holder). Additionally, the age at which a horse is no longer insurable has lowered over the years. Most policies limit coverage to horses 15-18 years of age. Some companies also don’t insure particular types of horses, such as racehorses.
When evaluating a medical condition, the veterinarian’s role is to provide an owner the ideal medical/surgical treatment options for the horse. The horse owner must decide what option is best for his or her individual situation and if it is within their financial limits. Veterinarians, given their frequent interactions with insurance companies, are familiar with the various insurance plans on the market and the current policy trends that influence horse owners’ decisions. Consequently, it is extremely helpful for owners to ask their veterinarians about their policy options and know, specifically, which out-of-pocket expenses they can expect. Most owners who have obtained major medical equine insurance assume “everything is covered” in that policy. Below is a list of items not covered on some policies:
- Farm call fees;
- Post-mortem examinations, or necropsy (note, however, that most mortality claims require this exam);
- Transportation fees to a vet clinic;
- Any undisclosed pre-existing condition, including congenital conditions;
- Any procedures deemed “experimental” by the underwriter;
- Routine maintenance procedures such as deworming, vaccinations, and farrier services. Farrier services are sometimes covered by policies in laminitis cases. Joint injections are often categorized as “maintenance” procedures and are not covered except in cases of regenerative therapy injections (interleukin-1 receptor antagonist protein, stem cell, platelet-rich plasma, etc.);
- Dental procedures;
- Any elective surgery such as castration or cosmetic surgery;
- Chiropractic, massage, or acupuncture;
- Rehabilitation center procedures such as aqua-treadmills, whirlpools, traditional treadmills, therapeutic lasers, and magnetic therapies; and
- Intentional injury or gross neglect.
Over the past five years insurance companies have increased their scrutiny of policy values on major medical and mortality insurance. They base both policies’ financial limits upon the horse’s fair market value, which the company must substantiate. This is determined on a case-by-case basis and often not influenced by independent appraisal values. The value limit is typically based on a purchase price in the first year of ownership or performance (horse show) records, breeding records, and/or professional/training fees paid in future years of coverage.
Maintaining an open dialogue with your veterinarian regarding these insurance policies can be helpful. Additionally, horse owners should communicate with their insurance broker when policies seem unclear or confusing. Understanding the scope of coverage is important when making medical decisions with your veterinarian. Due to changes within the insurance industry, horse owners must be more aware than ever of their insurance policies’ limits and what they might be required to pay beyond the policy coverage.