Private Medical Insurance — Explained
What is an excess?
An excess is the amount you agree to pay towards a claim before your insurer contributes to the remaining cost of treatment. It is one of the main ways private medical insurance (PMI) policies can be tailored to suit different budgets and premium levels.
Choosing a higher excess will usually reduce the monthly cost of your policy, while a lower excess generally increases premiums in exchange for lower upfront costs when making a claim.
WHAT IS IT?
Excess at a glance
When you make a claim on your health insurance policy, the excess is the portion you pay yourself before the insurer begins covering eligible treatment costs.
For example, if your policy has a £250 excess and you undergo eligible treatment costing £5,000, you would normally pay the first £250 and the insurer would cover the remaining approved costs.
Excesses are commonly applied once per policy year, per person, or per claim depending on how the insurer structures the policy. Some providers also allow you to choose from multiple excess levels when setting up cover.
Higher excesses are often chosen by people who want protection against larger or unexpected medical costs, while keeping ongoing premiums more affordable. Lower excesses are typically preferred by those expecting to use the policy more regularly.
Some insurers also offer flexible or percentage-based excess structures, although fixed excesses remain the most common arrangement in the UK PMI market.
IN PLAIN ENGLISH
An excess is the amount you agree to contribute towards treatment costs before your insurer pays the rest. Generally, the higher the excess you choose, the lower your monthly premium will be.
How it fits into your policy
The excess directly affects the overall cost of your policy and is one of the key balancing tools when building cover.
A higher excess can make comprehensive cover significantly more affordable, particularly when combined with strong inpatient or cancer benefits. Because of this, many people use excesses strategically — accepting a manageable upfront contribution in exchange for lower long-term premiums.
It is important to remember that the excess only applies when you claim. If no claims are made during the policy year, you would not pay the excess at all.
Certain benefits or services may also be exempt from the excess depending on the insurer and policy structure.
Common Excess Options
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£0 excess
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£100 excess
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£250 excess
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£500 excess
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£1,000+ excess options
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Per person or per policy structures
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Annual or per-claim excess arrangements