Health Insurance Excess UK (2026 Guide): What It Is, How It Works & How to Save Money
Your excess is one of the biggest levers you have to control the price of private health insurance in the UK. Set it right and you can cut premiums without leaving yourself exposed; set it wrong and you may avoid claiming when you really need care.
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What Is Health Insurance Excess?
In UK private health insurance, your excess is the amount you agree to pay towards eligible treatment before your insurer pays the rest. It’s written into your policy schedule and applies whenever you make a claim (subject to your insurer’s rules).
Example: You have a £250 excess and make a claim for £1,000 of eligible treatment. You pay £250, and the insurer pays the remaining £750 (subject to policy limits and exclusions).
If you’re new to private cover, it can help to read this alongside our wider guide: Is Private Health Insurance Worth It in the UK?
Types of Health Insurance Excess in the UK
1. Voluntary vs compulsory excess
- Voluntary excess – the amount you choose to add. A higher voluntary excess usually means a lower premium.
- Compulsory excess – set by the insurer. Some insurers add a small compulsory excess on certain benefits (e.g. some outpatient or mental-health claims).
2. Per-claim vs per-policy-year excess
- Per claim excess – you pay the excess every time you start a new claim episode.
- Per policy year excess – you pay the excess once per policy year, no matter how many times you claim.
Many people prefer a per-policy-year excess because it gives more predictable costs if you need several appointments or scans. This is especially relevant if you have ongoing issues or a family policy. For more on structuring cover for households, see Family Health Insurance in the UK.
How Excess Affects Your Monthly Premium
As a rule of thumb, higher excess = lower monthly premium. But pushing the excess too high can backfire if you need to claim even once or twice.
| Excess Amount | Typical Monthly Premium (Age 35) | Approx. Annual Saving vs £0 Excess |
|---|---|---|
| £0 | £82 | — |
| £250 | £70 | £144 per year |
| £500 | £61 | £252 per year |
| £1,000 | £53 | £348 per year |
Figures are illustrative only and vary by age, postcode, insurer and hospital list. They show the trade-off: at some point, extra excess doesn’t justify the saving.
For more ways to reduce premiums beyond excess alone, see Cheapest Way to Go Private in the UK and Private Healthcare Monthly Cost UK.
- Excess: fixed amount you pay towards a claim.
- Co-payment / shared responsibility: you pay a percentage of the bill (e.g. 10%), often capped.
- Outpatient limit: cap on what the insurer will pay for consultations and diagnostics each year.
Per Claim vs Per Year Excess: Which Is Best?
Per claim excess
- Excess applied every time you start a new treatment episode.
- Can be cheaper monthly, but adds up if you have several issues in a year.
Per policy year excess
- Excess charged once per policy year, even if you claim multiple times.
- More predictable — popular with people who expect to use the policy.
If you anticipate more than one claim in a year (for example, ongoing physio, repeated scans or chronic issues), per-year excess is often better value. For how this works alongside outpatient limits, read: Health Insurance Outpatient Limits: £0, £500, £1,000 or Unlimited?
How to Choose the Right Excess Level
1. Look at your past usage
- If you rarely see doctors or have scans, a moderate to high excess can make sense.
- If you have ongoing conditions or expect to use cover regularly, consider a lower excess or per-year excess.
2. Check your savings buffer
- Ask yourself honestly: “If I needed treatment tomorrow, how much could I comfortably afford upfront?”
- That number is a good ceiling for your excess.
3. Balance saving now vs stress later
- Huge excesses look attractive on quotes but can put you off claiming.
- A sensible middle ground (e.g. £250–£500) often gives a good discount without scary bills.
If you’re reviewing your cover at renewal, our guide How to Negotiate Your Health Insurance Renewal shows how to combine excess, hospital list and outpatient tweaks to get a better deal.
Not sure which excess level to pick?
Ask for quotes at £0, £250, £500 and £1,000 excess and compare the difference in black and white.
Can You Change Your Excess Later?
Yes — but usually:
- Changes are easiest at renewal.
- Lowering your excess will increase your premium.
- Some insurers will not let you reduce excess immediately after a large claim.
If you’re switching insurer entirely, you can reset your structure. See How to Switch Health Insurance in the UK and CPME Health Insurance Explained for how to keep continuity of cover while changing terms.
How Excess Interacts With Other Costs
Your excess sits alongside other cost controls on a policy:
- Co-payments/shared responsibility: you pay a percentage of each claim (e.g. 10%) up to a cap per year.
- Exclusions: cosmetic, routine pregnancy and pre-existing conditions are often outside cover.
- NHS cash benefit: if you choose NHS treatment instead of private, some insurers pay you a cash benefit — the excess usually does not apply to this.
For more on how NHS cash benefits work, see NHS Cash Benefit Health Insurance UK.
Does Excess Apply If You Use the NHS?
No. If your treatment is carried out entirely on the NHS, then you’re not claiming under your private health insurance, so excess does not apply. In fact, many policies pay you a small cash amount if you opt for NHS treatment instead of going private.
If you’re wondering whether to mix NHS and private care, read: Can You Mix NHS and Private Treatment?
FAQs: Health Insurance Excess UK
Is it better to have a high or low excess?
Neither is “best” for everyone. A higher excess cuts your premiums but increases what you pay when you claim. A lower excess costs more monthly but reduces bill shock if something happens. The right answer is what you can comfortably afford if you need treatment.
Does excess apply to all claims?
In most policies, yes — but some insurers don’t charge excess on specific benefits (for example, some virtual GP services or limited physiotherapy sessions). Always check your policy wording or speak to the insurer or broker.
Can I have no excess at all?
Yes, many UK insurers offer £0 excess options, especially on comprehensive plans. You’ll pay more each month, but nothing upfront for eligible claims. See our Best Health Insurance UK comparison for examples.
Will excess apply if I only use my policy for diagnostics?
Yes, diagnostics like MRI or CT scans will usually trigger your excess if they’re being claimed under the policy. For more context, see Does Health Insurance Cover Diagnostics in the UK?.
Does excess reset each year?
If you have a per-policy-year excess, it resets at renewal. For per-claim excess, it applies each time you start a new claim episode regardless of the policy year.
Ready to see real prices with different excess levels?
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This article is for general information only and does not constitute financial, tax or medical advice. Policy terms vary by insurer and product. Always check your own documents and, if you’re unsure, speak with an FCA-regulated adviser before making changes to your health insurance.
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