Insurance Calculator Health UK Excess Levels from £0–£1,000
Navigating the world of private medical insurance in the UK can feel complex, but understanding one key lever—your policy excess—can unlock significant savings. At WeCovr, an FCA-authorised broker that has helped arrange over 800,000 policies of various kinds, we believe in empowering you with clear, straightforward information.
See how picking a higher excess can reduce your monthly premiums
Choosing the right private medical insurance (PMI) is a balancing act. You want comprehensive cover for peace of mind, but you also need a monthly premium that fits your budget. The single most effective tool you have to control your premium is the excess.
In simple terms, an excess is the amount you agree to pay towards the cost of your treatment when you make a claim. Your insurer then pays the remaining balance, up to your policy limits.
Think of it like the excess on your car or home insurance. By agreeing to contribute a small portion of the cost yourself, you demonstrate a shared financial responsibility, which reduces the insurer's risk. In return, they offer you a lower monthly or annual premium. The higher the excess you choose, the lower your premium will be. This guide will walk you through everything you need to know about UK health insurance excess levels, from £0 to £1,000 and beyond.
What is an 'Excess' in Private Medical Insurance?
Understanding the term 'excess' is the first step to becoming a savvy health insurance buyer. It's a fundamental concept that directly impacts how much you pay and when.
A Plain English Definition
An excess is a pre-agreed, fixed amount of money you pay towards a claim on your health insurance policy. It's your contribution to the cost of your private medical care.
There are two main ways an excess can be applied:
- Per Claim/Per Condition: You pay the excess for each new, unrelated medical condition you claim for within a policy year.
- Per Policy Year: You pay the excess only once during a policy year, no matter how many separate claims you make.
Most UK insurers offer a range of excess options, typically starting from £0 and going up to £1,000 or even higher. This choice allows you to tailor your policy to your financial situation.
How Does Excess Work in Practice? A Real-World Example
Let's imagine a policyholder named David. He has a private health cover plan and needs a minor surgical procedure on his shoulder, which costs £3,500 in total at a private hospital.
Scenario 1: David has a £250 excess.
- David makes a claim through his insurer.
- He pays the first £250 of the hospital bill directly or reimburses his insurer.
- His insurance company pays the remaining £3,250.
- David's total out-of-pocket cost for the treatment is £250.
Scenario 2: David has a £1,000 excess.
- David makes the same claim for the same £3,500 procedure.
- He pays the first £1,000 of the hospital bill.
- His insurance company pays the remaining £2,500.
- David's total out-of-pocket cost is £1,000.
In Scenario 2, David pays more at the point of claiming, but his monthly premium would have been significantly lower all year compared to the premium for the £250 excess policy. The choice is about paying less now (in premiums) versus paying less later (at the point of a claim).
Exploring the UK Health Insurance Excess Levels: £0 to £1,000
Insurers provide a spectrum of excess choices to cater to different needs and budgets. Let's break down the common levels and who they are best suited for.
The £0 Excess Option: Maximum Convenience, Highest Premium
A zero-excess policy means that if you need to make a claim, you pay nothing towards the cost of your treatment. Your insurer covers 100% of the eligible costs from the very first pound.
- Who it's for: Individuals or families who prioritise complete financial predictability and want to avoid any unexpected bills when they need care. It's for those who are comfortable paying a higher monthly premium for total peace of mind.
- Pros: Absolutely no out-of-pocket costs when you claim for eligible treatment.
- Cons: This is the most expensive option, resulting in the highest possible monthly premiums.
The 'Sweet Spot': £250 to £500 Excess
This mid-range excess level is the most popular choice for UK policyholders. It strikes a sensible balance between a noticeable reduction in premiums and an excess amount that is still manageable for most people should they need to claim.
- Who it's for: The majority of individuals, couples, and families. A £250 or £500 contribution is typically affordable for a planned procedure and delivers substantial premium savings over a £0 excess plan.
- Pros: A significant discount on your monthly premiums compared to a zero-excess policy. The excess amount is not so high as to be prohibitive for most households.
- Cons: You still need to have the excess amount available if you need to make a claim.
The High Excess Option: £750 to £1,000+
Choosing a high excess dramatically reduces your monthly premiums. This effectively turns your policy into a form of 'catastrophic cover'—it’s there for major, expensive health issues, while you would likely cover smaller costs yourself.
- Who it's for: Younger, healthier individuals who are less likely to claim, or people with substantial savings who are comfortable self-funding minor treatments but want protection against large medical bills (e.g., for cancer treatment or major surgery).
- Pros: Offers the lowest possible monthly premiums, making private health cover highly affordable.
- Cons: Requires a significant upfront payment if you need to make a claim. You must be disciplined enough to have this amount saved and accessible.
Indicative Premium Savings with a Higher Excess
To illustrate the powerful effect of your excess choice, let's look at some example figures. The table below shows how premiums for a typical 40-year-old non-smoker on a mid-range policy might change.
| Excess Level | Indicative Monthly Premium | Indicative Annual Premium | Potential Annual Saving (vs. £0 Excess) |
|---|---|---|---|
| £0 | £85 | £1,020 | £0 |
| £250 | £70 | £840 | £180 |
| £500 | £60 | £720 | £300 |
| £1,000 | £48 | £576 | £444 |
Disclaimer: These figures are for illustrative purposes only. Your actual quote will depend on your age, location, lifestyle, chosen insurer, and level of cover. For a precise quote, it's best to speak with an expert PMI broker.
As you can see, simply by opting for a £1,000 excess instead of £0, our example individual could save over £440 a year. This saving could be used to pay for other things, or even cover the excess itself more than twice over if a claim were never made.
Per Claim vs. Per Year Excess: Which is Right for You?
Beyond the amount, it's crucial to understand how your excess is applied. This is a detail that can make a big difference to your out-of-pocket costs.
'Per Claim' or 'Per Condition' Excess
This is the most common structure. With this type, you must pay your excess for each separate medical condition you claim for during your policy year.
- Example: You have a £250 excess per claim.
- In March, you claim for physiotherapy for a bad back. You pay the £250 excess.
- In September, you develop an unrelated gallbladder issue requiring surgery. You must pay the £250 excess again for this new claim.
- Total excess paid in the year: £500.
This type of excess is often slightly cheaper in terms of premium because the potential for you to pay multiple times in a year exists, which lowers the insurer's risk.
'Per Policy Year' Excess
With a 'per policy year' excess, you pay your chosen excess amount only once during your policy year, regardless of how many claims you make for different, unrelated conditions.
- Example: You have a £250 excess per policy year.
- In March, you claim for physiotherapy for a bad back. You pay the £250 excess.
- In September, you need gallbladder surgery. As you have already paid your annual excess, you pay £0 towards this new claim.
- Total excess paid in the year: £250.
This option provides greater cost certainty. While the premium may be marginally higher than a 'per claim' policy, you know that your maximum out-of-pocket spend on excess for any given year is capped at your chosen level. An expert advisor at WeCovr can help you compare policies from different insurers to see which excess structure they use and which one best suits your personal circumstances.
Comparison Table: Per Claim vs. Per Year Excess
| Feature | Per Claim / Per Condition Excess | Per Policy Year Excess |
|---|---|---|
| When you pay | For each new, unrelated claim made within the policy year. | Only on your first claim of the policy year. |
| Best for... | Those who are generally very healthy and anticipate making, at most, one claim per year. | Anyone who prefers financial predictability or has a history of multiple, minor, unrelated issues. |
| Cost implication | Can become more expensive if you are unlucky and need to claim for several different conditions. | Your total excess cost is capped for the year, providing a clear budget. |
Critical Information: What UK Private Health Cover Does Not Include
Private medical insurance is an invaluable tool for managing your health, but it's essential to understand its purpose and its limitations. PMI is not a replacement for the NHS; it is designed to work alongside it.
Pre-existing and Chronic Conditions: The Golden Rule
This is the single most important concept to understand about standard private medical insurance in the UK:
PMI is designed to cover acute conditions that arise after you have taken out the policy.
It does not typically cover:
- Pre-existing Conditions: Any disease, illness, or injury for which you have experienced symptoms, received medication, advice, or treatment in the years before your policy began (usually the last 5 years).
- Chronic Conditions: A condition that is long-lasting, has no definitive cure, and requires ongoing or long-term monitoring and management.
Let's define these terms clearly:
- Acute Condition: A condition that is short-lived and likely to respond quickly to treatment, leading to a return to your previous state of health. Examples include cataracts, joint replacements, hernias, and appendicitis. This is what PMI is for.
- Chronic Condition: A condition that needs continuous management over a long period. Examples include diabetes, asthma, high blood pressure, and Crohn's disease. The day-to-day management of these conditions remains the responsibility of the NHS.
Insurers exclude these to keep premiums affordable and to ensure the system remains sustainable. If insurers were to cover all long-term and pre-existing ailments, the cost of private medical insurance UK-wide would become unaffordable for most people.
Other Common Exclusions
Beyond chronic and pre-existing conditions, most standard PMI policies will also exclude:
- Emergency and A&E visits (these should always be handled by the NHS)
- Normal pregnancy and childbirth (though complications may be covered by some plans)
- Cosmetic surgery (unless it is for reconstruction after an accident or eligible surgery)
- Treatment for addiction (e.g., alcohol or drugs)
- Self-inflicted injuries
- Professional sports injuries
- Organ transplants
- Dialysis for kidney failure
Always read your policy documents carefully to understand the full list of exclusions.
How Your Personal Profile Affects Your PMI Premium
While your chosen excess is a major factor in determining your premium, insurers look at several other details to calculate your specific price.
- Age: This is the most significant factor after excess. The statistical likelihood of needing medical treatment increases with age, so premiums are higher for older applicants.
- Location: Where you live in the UK matters. Private hospital costs vary by region, with treatment in Central London and the South East being the most expensive. Having a policy that includes these high-cost hospitals will increase your premium.
- Lifestyle: Specifically, smoking. Insurers view smoking as a major health risk. Non-smokers (typically defined as not using any nicotine products for at least 12 months) receive significantly lower premiums.
- Level of Cover: Policies can be customised. A basic plan might only cover inpatient treatment (when you need a hospital bed overnight). A comprehensive plan will include outpatient cover (consultations, diagnostics), therapies (physio, osteopathy), and mental health support, all of which will increase the cost.
- Hospital List: Insurers offer different tiers of hospital lists. A plan with access to a nationwide network including premium London hospitals will cost more than a plan with a more restricted local list.
- Underwriting Type: You'll choose between 'Moratorium' underwriting (simpler, no initial medical questionnaire) and 'Full Medical Underwriting' (requires you to disclose your full medical history). The choice can affect what's covered and your premium.
Proactive Health Management: A Partner to Your Insurance
Your health insurance policy is there for you when you need treatment. But an even better strategy is to invest in your health every day to reduce your chances of needing to claim in the first place. A healthy lifestyle is your first and best line of defence.
The Power of Prevention
According to NHS data, leading a healthy lifestyle can prevent a large proportion of many of the UK's biggest killers. For example, a significant number of cases of heart disease, stroke, and type 2 diabetes are considered preventable through diet and exercise. Taking small, consistent steps can have a huge impact on your long-term wellbeing.
Your Daily Health Checklist
Integrating these habits into your life can improve your physical and mental resilience.
- Nourish Your Body: Aim for a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Staying hydrated is also key. To help you on this journey, WeCovr provides all its Health and Life Insurance customers with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app.
- Stay Active: The NHS recommends adults get at least 150 minutes of moderate-intensity activity (like brisk walking or cycling) or 75 minutes of vigorous-intensity activity (like running or tennis) a week.
- Prioritise Sleep: Most adults need 7-9 hours of quality sleep per night. Poor sleep is linked to a range of health issues, from a weakened immune system to poor mental health.
- Manage Stress: Chronic stress can take a toll on your body. Practices like mindfulness, meditation, yoga, or simply spending time in nature can help manage stress levels effectively.
Leveraging Policy Perks
Many of the best PMI providers actively encourage healthy living by offering a range of wellness benefits, such as:
- Discounted gym memberships
- Reduced prices on fitness trackers and smartwatches
- Access to digital GP services
- Rewards for hitting activity goals
Engaging with these programmes can not only improve your health but may also lead to lower renewal premiums with some insurers.
How to Choose the Best PMI Provider and Policy in the UK
With so many variables, choosing the right private health cover can feel daunting. Following a structured approach can simplify the process.
Step 1: Assess Your Needs and Budget Before you start looking, be honest with yourself. How much can you comfortably afford to spend each month? What is most important to you—access to cancer care, mental health support, or quick access to diagnostics? Do you have savings you could use for a higher excess?
Step 2: Understand the Key Policy Levers Familiarise yourself with the main customisation options:
- Excess: (£0 - £1,000+)
- Outpatient Cover: (None, limited, or full)
- Hospital List: (Local, national, or premium)
- Extra Therapies: (Physiotherapy, mental health, etc.)
Step 3: Compare the Market Never accept the first quote you see. The UK private medical insurance market is highly competitive, and prices and features vary significantly between providers like Bupa, Aviva, AXA Health, and Vitality.
Step 4: Use an Independent PMI Broker This is the most efficient and effective way to find the right policy. A specialist broker works for you, not the insurance companies. Based on high customer satisfaction ratings, clients appreciate the clarity and support provided by brokers.
The benefits of using an expert broker like WeCovr include:
- Expert Knowledge: We live and breathe the PMI market and understand the intricate differences between policies.
- Time-Saving: We do the hard work of gathering quotes and comparing complex policy documents for you.
- No Cost to You: Our service is free for customers. We receive a commission from the insurer if you decide to purchase a policy, which doesn't affect the price you pay.
- Impartial Advice: As an FCA-authorised broker, our duty is to you. We'll help you find the policy that genuinely meets your needs and budget.
- Added Value: When you buy a PMI or Life Insurance policy through WeCovr, you also receive discounts on other types of cover, from home to travel insurance.
Our goal is to demystify the process, explain your options in plain English, and give you the confidence that you've made the best possible choice for your health and finances.
Do I have to pay the excess for every single consultation?
Can I change my excess level after my policy has started?
What happens if my medical treatment costs less than my excess?
Is private medical insurance worth it in the UK?
Does private medical insurance cover pre-existing conditions?
Ready to find the perfect balance between comprehensive cover and an affordable premium? The expert team at WeCovr is here to help you navigate your options with clarity and confidence.
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Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!