One of the most common areas of confusion in understanding equine insurance centers around the deductible, how it's applied, when it's used and why. A deductible is often defined as the amount of money that must be paid out of pocket before an insurer will pay any expenses. While deductibles are often used by human medical and automobile insurance companies to prevent trivial claims, for equine major medical insurance that's not quite how they work.  

In this article, EMO President E. Sue Bopp answers some of your frequently asked questions surrounding equine major medical insurance deductibles.

Q: I'm not sure how a deductible works for my horse's major medical policy. Is it a one-time, annual payment or do I pay a deductible each time I file a claim?

A: Deductibles for human medical insurance and equine medical insurance are different. Unlike human insurance, there's no annual deductible you must reach to receive reimbursement. Each claim is treated individually, and a deductible applies. The amount of the deductible varies with the different underwriters, but it's typically no more than $275 per injury or illness and that's standard. 

Q: My horse just pulled his suspensory ligament and requires ongoing treatment. Do I pay a deductible each time my veterinarian visits? 

A: No, you would only pay a deductible for each sickness or injury your horse incurs. If it takes six months for the suspensory injury to heal, with multiple veterinary visits and treatments, you would still pay just the one deductible.

Q: How does the process work? Do I submit each bill for the insurance company to pay?

A: No, this is one of the major differences between human and equine medical insurance. Once your horse's treatment is finished, you'll submit all of the bills that you already paid, and the insurance adjuster will apply the deductible and reimburse you set amounts for treatments, medications, diagnostics and other covered expenses. 

Each type of service, i.e., diagnostics, treatments, call fees, have different levels of coverage and limits, so make sure to read your policy thoroughly and contact your insurance agent if you have further questions.

Q: If I pay a deductible for each injury or illness, why are pre-existing conditions excluded when I renew?

A: Humans live a lot longer than horses and we pay much more on an annual basis for insurance. On average, a horse owner keeps and insures a horse for three years, so the insurance companies can't collect enough money on the premiums to make up for any long-term loss. All policies have a limit on the amount of coverage per incident and per horse.

Therefore, equine major medical insurance has a deductible per injury or illness and also excludes pre-existing conditions in order to keep the major medical insurance affordable. That's why you'll pay upwards of $10,000 per year for human medical insurance and often under $500 for equine major medical coverage.   

Q: My horse cut his leg and required stitches. The injury was relatively minor, but I'm told I need to report this to my insurance agent and pay the deductible. Why?

A: That's a good question! A lot of people wonder about making a claim when the cost is below the deductible. It's important to report the injury because sometimes even minor problems turn into major ones, and if that happens you might not be covered if the original injury wasn't reported in a timely fashion. 

The most important advice I can give you in regards to insurance, deductibles and your horse's health and well being is to pick up the phone and call us if you have any questions or would like further clarification. We are always here to help! 

 EMO Meet The Staff: Chrissy Ward

Chrissy Ward joined The EMO Agency's Farm Department in April after eight years spent working for the Puffenbarger Insurance Agency as a commercial customer service representative.  

"I've been with EMO Agency for a month now and love it," said Chrissy, a Fauquier County Virginia native who grew up on a dairy farm in Remington.  "I loved helping out on the farm as a child." 

Chrissy graduated from Liberty High School in Bealeton, Virginia, in 1997. She's been married for 15 years and lives in Culpeper Virginia, with her husband, their 3-year-old daughter and two Pugs. 

In her spare time, she enjoys traveling to Nags Head, North Carolina, shopping and spending time with her family.