TL;DR
Seeking private medical insurance (PMI) in the UK without an excess is a popular goal for many. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we find this is a key question for those wanting complete financial peace of mind from their health cover. Pros, cons, and which providers offer zero-excess health insurance in the UK Choosing a private health insurance policy is a significant decision.
Key takeaways
- Excess per claim: You pay the excess for each separate claim you make. If you have a knee problem and then a separate heart-related issue in the same year, you would pay the excess twice.
- Excess per policy year: You pay the excess only once per policy year, regardless of how many claims you make. Once you've paid the agreed amount, all subsequent eligible claims in that year are covered in full by the insurer. This is the more common and generally more favourable option.
- The consultation with the orthopaedic specialist is covered.
- The subsequent MRI scan is covered.
- The keyhole surgery to repair a torn rotator cuff is covered.
Seeking private medical insurance (PMI) in the UK without an excess is a popular goal for many. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we find this is a key question for those wanting complete financial peace of mind from their health cover.
Pros, cons, and which providers offer zero-excess health insurance in the UK
Choosing a private health insurance policy is a significant decision. One of the most important variables you'll encounter is the 'excess'. While most people are familiar with it from car or home insurance, its role in PMI can be confusing. The idea of a policy with no excess at all – where the insurer pays for everything from the first pound – is highly appealing.
But is it possible? And is it the right choice for you?
This comprehensive guide breaks down everything you need to know about zero-excess private medical insurance in the UK. We'll explore the definition of an excess, the tangible benefits and drawbacks of removing it, which top UK providers offer this option, and how to decide if it aligns with your personal and financial circumstances.
What Exactly is an 'Excess' in Private Medical Insurance?
In the simplest terms, an excess is a fixed amount of money you agree to pay towards the cost of your medical treatment before your insurance policy starts to pay out. It's your contribution to a claim.
Think of it like the excess on your car insurance. If you have a £250 excess and the repairs cost £2,000, you pay the first £250, and your insurer pays the remaining £1,750. Health insurance excess works in a very similar way.
There are two common types of excess in the UK PMI market:
- Excess per claim: You pay the excess for each separate claim you make. If you have a knee problem and then a separate heart-related issue in the same year, you would pay the excess twice.
- Excess per policy year: You pay the excess only once per policy year, regardless of how many claims you make. Once you've paid the agreed amount, all subsequent eligible claims in that year are covered in full by the insurer. This is the more common and generally more favourable option.
Typical excess levels offered by UK insurers range from £100 up to £1,000 or even higher. A policy with a zero excess (£0) means you pay nothing towards the cost of your eligible treatment. Your insurer covers 100% of the cost from the very beginning.
The Allure of No-Excess Private Health Insurance
The primary appeal of a zero-excess policy is absolute financial certainty. When you're facing a health scare, the last thing you want to worry about is finding a lump sum of money to pay for your initial consultation or treatment.
With a no-excess policy, this worry is completely removed. Your monthly or annual premium is your only financial outlay for your health cover.
A Real-Life Example:
Imagine Sarah, a 45-year-old graphic designer, develops persistent shoulder pain. Her GP refers her to a specialist. With her zero-excess PMI policy, the process is seamless:
- The consultation with the orthopaedic specialist is covered.
- The subsequent MRI scan is covered.
- The keyhole surgery to repair a torn rotator cuff is covered.
- The post-operative physiotherapy sessions are covered.
Throughout this entire journey, Sarah does not have to pay a single penny out of her own pocket for the treatment itself. Her only cost is her regular insurance premium. This predictability provides enormous peace of mind during a stressful time.
The Pros of Choosing a Zero-Excess PMI Policy
Opting for a policy without an excess brings several powerful advantages that cater to those who prioritise simplicity and certainty.
1. Complete Financial Predictability
This is the number one benefit. You know exactly what your healthcare will cost you each month: your premium. There are no surprise bills or sudden demands for a £250 or £500 contribution before your care can proceed. This makes budgeting far simpler and eliminates the financial anxiety associated with falling ill.
2. Simplicity and Ease of Claiming
A zero-excess policy is the most straightforward option when it comes to making a claim. There's no need to handle payments to the hospital or clinic yourself, and you don't have to wait for your insurer to reimburse you minus the excess. The billing is handled directly between the provider and the insurer, making the process smooth and hassle-free for you, the patient.
3. Encourages Seeking Early Treatment
A financial barrier, even a relatively small one like a £100 excess, can sometimes cause people to delay seeking medical advice. We all lead busy lives, and the thought of having to pay for an initial consultation can lead to a "wait and see" approach. A zero-excess policy removes this hurdle. Knowing that a visit to a specialist won't cost you anything extra can encourage you to get symptoms checked out sooner, potentially leading to better health outcomes.
4. Perfect for Those on a Fixed Budget
While it seems counterintuitive because the premiums are higher, a zero-excess policy can be ideal for individuals or families on a tight, fixed budget. It's often easier to budget for a slightly higher, predictable monthly expense than it is to find a sudden, unplanned lump sum of several hundred pounds when a health issue arises.
The Cons and Considerations of No-Excess Health Insurance
While the benefits are clear, a zero-excess policy isn't without its drawbacks. It's essential to weigh these carefully before making a decision.
1. Significantly Higher Premiums
This is the most critical trade-off. There is a direct and unavoidable correlation between the level of your excess and the cost of your premium. The lower your excess, the higher your premium will be. A zero-excess policy is the most expensive option in terms of your monthly or annual payments. You are essentially pre-paying for the peace of mind of not having to contribute at the point of claim.
2. Is It Always Good Value for Money?
If you are young, healthy, and rarely need to see a doctor, you could end up paying significantly more in premiums over the years for a zero-excess policy that you never use. In this scenario, opting for a modest excess of, say, £250 could save you hundreds of pounds a year in premiums. You could choose to put these savings aside into an emergency fund to cover the excess if you ever did need to claim.
3. Limited Flexibility
Once you've chosen a zero-excess policy, you are locked into those higher premiums for the policy year. While you can usually change your excess level at your annual renewal, you can't switch mid-term to save money if your financial circumstances change.
To understand the impact, let's look at some illustrative figures.
How Excess Impacts Your Monthly PMI Premiums: A Cost Comparison
The table below shows estimated monthly premiums for a comprehensive policy for a healthy, 40-year-old non-smoker living outside London. These are for illustrative purposes only; your actual quote will depend on your age, location, medical history, and chosen cover level.
| Excess Level | Estimated Monthly Premium* | Annual Premium Savings (vs. £0 Excess) | Potential Out-of-Pocket Cost (Per Year) |
|---|---|---|---|
| £0 | £115 | £0 | £0 |
| £100 | £108 | £84 | £100 |
| £250 | £98 | £204 | £250 |
| £500 | £85 | £360 | £500 |
| £1,000 | £70 | £540 | £1,000 |
Disclaimer: These are illustrative figures for comparison purposes only. For an accurate quote based on your personal circumstances, speak to an expert broker.
As you can see, choosing a £500 excess instead of zero could save this individual £360 per year in premiums. This is a significant saving that you must weigh against the risk of having to pay the £500 if you make a claim.
Which UK Providers Offer Zero-Excess Health Insurance?
The good news is that almost all major UK private medical insurance providers offer a £0 excess option. It is a standard feature across the market, allowing consumers to choose the level of risk they are comfortable with.
An expert PMI broker like WeCovr can provide a detailed comparison of these providers at no cost to you, ensuring you find the best policy for your specific needs.
Here’s a summary of the main providers and their zero-excess offerings for 2025:
| Provider | Offers £0 Excess Option? | Key Features & Notes |
|---|---|---|
| Bupa | Yes | One of the UK's most well-known health insurers. A £0 excess is available on their 'Bupa By You' comprehensive and treatment-and-care policies. They offer an extensive network of hospitals and specialists. |
| AXA Health | Yes | A leading global insurer with a strong UK presence. Their 'Personal Health' plan allows you to select a £0 excess. Known for excellent digital tools and a guided pathway for treatment. |
| Aviva | Yes | A major UK insurance brand offering the 'Healthier Solutions' policy. They provide a full range of excess options from £0 up to £5,000, giving customers maximum flexibility to balance cost and cover. |
| Vitality | Yes | Unique in the market, Vitality links your premium to how actively you engage with their wellness programme. A £0 excess is available, but your overall premium is also influenced by your healthy living choices. |
| The Exeter | Yes | A specialist friendly society known for its flexible underwriting, making it a strong choice for those with some prior medical history. Their 'Health+' policy offers a £0 excess option and is highly regarded for customer service. |
| WPA | Yes | A not-for-profit insurer with a strong reputation for customer care and straightforward claims. Their 'Flexible Health' policies allow for a £0 excess and offer unique benefits like shared responsibility options. |
The Crucial Point: What UK Private Health Insurance Doesn't Cover
This is arguably the most important section for any potential PMI customer to understand. A zero-excess policy does not mean every single medical cost is covered. The policy will only pay for eligible treatments as defined in your policy documents.
Standard UK private medical insurance is designed to cover acute conditions that arise after you take out the policy.
Here are the key exclusions to be aware of:
- Pre-existing Conditions: This refers to any disease, illness, or injury for which you have experienced symptoms, received medication, advice, or treatment before your policy start date. For example, if you've had treatment for back pain in the two years before buying a policy, that specific back pain will not be covered.
- Chronic Conditions: This includes long-term conditions that cannot be cured but can be managed, such as diabetes, hypertension (high blood pressure), asthma, and multiple sclerosis. The day-to-day management of these conditions remains the responsibility of the NHS. PMI may sometimes cover an acute flare-up of a chronic condition, but not the ongoing monitoring and treatment.
- Other Common Exclusions:
- Visits to Accident & Emergency (A&E)
- Routine pregnancy and childbirth
- Cosmetic surgery (unless for reconstruction after an accident or eligible surgery)
- Treatment for drug and alcohol abuse
- Experimental or unproven treatments
Is a No-Excess Policy Right for You? Key Questions to Ask Yourself
To decide, you need to honestly assess your own situation. Here are the key questions to consider:
- What is my financial situation? Can I comfortably afford the higher monthly premiums associated with a £0 excess policy without it straining my budget?
- How much do I have in accessible savings? Could I easily pay a £250, £500, or even £1,000 excess tomorrow if a health issue arose? If the answer is yes, you may get better value from a policy with an excess.
- What is my attitude towards risk? Do I sleep better at night knowing all my costs are covered, and I'll never face an unexpected medical bill? Or am I comfortable taking a small financial risk (the excess) in exchange for lower regular payments?
- What is my personal and family medical history? While PMI doesn't cover pre-existing conditions, if you have a family history of certain issues or a lifestyle that might lead to future problems, the peace of mind of a zero-excess policy might be more valuable to you.
Your answer to these questions will point you towards the right solution for your individual needs. There is no single "best" answer; it's about what provides the right balance of protection and affordability for you.
Beyond the Excess: Other Powerful Ways to Manage Your PMI Costs
The excess is just one lever you can pull to control the cost of your private health cover. If a zero-excess policy is too expensive, but you still want comprehensive protection, consider these other options:
- The 6-Week Option: This is a very popular cost-saving feature. With this option, your PMI will only cover your treatment if the waiting list for that same treatment on the NHS is longer than six weeks. Given that NHS waiting times for many elective procedures are currently much longer than this (the median waiting time was 14.5 weeks in July 2024, according to NHS England data), this option can provide significant premium savings while still offering a valuable safety net.
- Guided Hospital Lists: Most insurers offer different tiers of hospital lists. Choosing a more restricted list (for example, excluding the most expensive central London hospitals) can dramatically reduce your premium while still giving you access to excellent private facilities.
- Reduced Outpatient Cover: You can choose to limit the financial cover for diagnostic tests and specialist consultations that happen before a hospital stay. You could, for example, cap this at £500 or £1,000 per year to lower your premium.
- Embrace a Healthier Lifestyle: Many of us could benefit from a little more activity, better nutrition, and more sleep. Some insurers, like Vitality, actively reward you for this with premium discounts and other perks. At WeCovr, we support our clients' health journeys by providing complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, helping you build and maintain healthy habits.
Furthermore, when you purchase a PMI or Life Insurance policy through WeCovr, we're pleased to offer discounts on other types of insurance you may need, providing even greater value.
How WeCovr Makes Choosing Simple
Navigating the world of excess levels, hospital lists, and outpatient limits can be overwhelming. This is where an independent, expert broker becomes invaluable.
At WeCovr, our role is to make this process simple and transparent for you.
- We're Independent Experts: As an FCA-authorised broker, we are not tied to any single insurer. We compare policies from across the market to find the one that truly fits your needs and budget.
- We Do the Hard Work: We'll take the time to understand your requirements, ask the right questions, and then present you with clear, easy-to-understand options – including a full comparison of how different excess levels impact your price.
- Our Service is Free: You don't pay us a penny for our advice and support. We receive a commission from the insurer if you decide to go ahead with a policy.
- We're Highly-Rated: Our clients consistently give us high satisfaction ratings because we prioritise clear communication and finding the right long-term solution, not just the quickest sale.
Whether you're certain you want a zero-excess policy or you want to explore all the options, our friendly team is here to help.
Can I change my PMI excess level whenever I want?
Does a zero-excess policy mean every possible medical treatment is covered for free?
What happens if my treatment costs less than my excess?
Is it better to choose a high excess and save the premium difference myself?
Ready to find out if a zero-excess private medical insurance policy is the right fit for you? Get a clear, personalised comparison from the experts.
[Contact WeCovr today for your free, no-obligation PMI quote and let us help you find the perfect cover.]










