Key takeaways: What is an excess?

A health insurance excess is the amount you pay towards treatment each year if you claim. Unlike home or car insurance, once you’ve paid the full amount of your health insurance excess, you won’t pay it again that policy year no matter how many times you claim that year. You usually pay it directly to your healthcare provider.

The higher your excess, the lower your premiums will be. When your plan is due to renew, you can usually change the amount of your excess if you want to.

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What is an excess?

With an excess, you agree to pay an amount each year towards the cost of any claims you make. The higher your excess, the lower your premium will be, but you’ll pay more if you need to claim.

How does a health insurance excess work?

A health insurance excess works a bit differently from the excess you might be used to having on your car or home insurance.

With a health insurance excess, you normally pay an amount towards the cost of treatment each policy year. Once you’ve paid your total excess in a policy year, you won’t have to pay it again if you have more treatment in that policy year, no matter how many other claims you make that policy year. It doesn’t matter if the treatment is for different conditions either.

Some health insurance plans charge an excess every time you make a claim instead of each policy year, so it's worth keeping that in mind when you're choosing health insurance.

chart

What’s the right level of excess for you?

Choosing the right level of excess is a personal decision as it depends on your own individual circumstances. When your plan is due for renewal, it’s a good idea to review your excess to make sure it’s still at the right level for your needs and you’ll be able to pay it if you need treatment. 

Low excess

£0, £100

Medium excess

£250, £500

High excess

£1,000, £2,000, £5,000
  • Your premiums will be higher than if you have a higher excess.

  • Your insurer will pay for more of any treatment you need.

  • An option if your health insurance is affordable – for example if you’re younger, as you're likely to use your plan less.
  • Your premiums will be lower than if you have a low excess.

  • You’ll pay for more of your treatment yourself.

  • If you only have a little treatment – for example a single specialist consultation – you may choose not to claim as you’ll pay for it yourself anyway.

  • An option if your health insurance is starting to get expensive as you get older.
  • Your premiums will be lower – a lot lower with a very high excess.

  • You’ll pay for a lot of treatment yourself.

  • However, if you need significant treatment, such as for cancer, you’ll still be able to access this privately and not worry about high costs.

  • An option if your health insurance is expensive, but you’d still like cover in case of major health problem, such as cancer.

What happens if my treatment continues after I renew my plan? 

For many health insurance plans, your excess renews each policy year. So, if you pay an excess for treatment that starts in one policy year, and the treatment continues into the next, you’d need to pay the excess again in the second year. This can mean you pay your excess twice for a short course of treatment. 

diagram showing when you'll pay your excess

However, if you buy a new AXA Health plan, we’ve changed how the excess works. Instead of resetting on your renewal date, your excess resets a year after your first treatment. This means it’s much less likely that you’ll pay your excess twice for the same course of treatment. 

when you pay excess chart

Here’s an example of how it works. Both plans have the same excess and the treatment is the same. 

Rhea has torn a ligament in her knee. She needs an MRI to see what’s going on, and then a keyhole operation to fix the problem.

Date

Typical annual excess

AXA Health Plan excess

15 February

Rhea has her MRI.
She pays her excess of £250 towards the cost/p>

Rhea has her MRI.
She pays her excess of £250 towards the cost

1 March

Rhea’s health insurance renews

Rhea’s health insurance renews

29 March

Rhea has her operation.
She pays another £250 towards this, because her excess reset on her renewal date

Rhea has her operation.
She doesn’t need to pay her excess again, because it’s less than 12 months since her first treatment.

 

Rhea has paid £500 towards her treatment

Rhea has paid £250 towards her treatment.

Who do I pay my healthcare insurance excess to? 

You’ll usually pay your excess directly to the healthcare provider – for example, the specialist or the hospital. Your insurer will explain how to do this when you make the claim.

The rest will be covered by your insurer, unless the bill is for treatment that isn't covered by your plan.

If you used a private hospital, they may have asked to scan your credit card when you checked in, and will then ask you if you want to use this card to pay your excess.

Will I have to pay a separate health insurance excess for each condition I claim for?

Normally a health insurance excess is per member per policy year, so if you claim for several conditions, you’ll still only pay the same amount of excess that policy year.  

However, some health insurance plans charge an excess every time you make a claim instead of each policy year, so it's worth keeping that in mind when you're choosing insurance.

Does each person insured on my plan have their own excess? 

If there’s more than one person insured on your plan, they’ll usually each have their own excess. So, if there are two people on your plan, and you both claim, you’ll pay an excess for each person claiming.

Depending on your health insurer and plan, each person on your plan may have the same amount of excess, or different amounts.

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