Per policy year on every policy we hold — which makes a higher excess cheaper than it first looks.

What the policy documents actually say

Bupa works the example through in its own guide: a member with a £100 excess has physiotherapy costing £250; Bupa pays the physiotherapist £150 and the member pays £100. If she needs further treatment in the same policy year, she does not pay another excess. Aviva applies its excess per member per policy year across six tiers — £100, £200, £500, £1,000, £3,000 and £5,000.

Freedom Private Health Insurance describes the mechanics differently: the excess is deducted from the first valid invoice and from subsequent invoices until it is used up, and the member then pays the provider directly rather than the insurer.

WPA offers something none of the others do — Shared Responsibility, where the member pays 25% of eligible claims up to a chosen ceiling instead of, or alongside, a flat excess.

Because the excess is annual rather than per claim, its real cost depends on how many claims you make in a year, not how large they are. One member claiming twice in a year pays a £1,000 excess once; the same person claiming once a year for two years pays it twice. That makes a high excess considerably better value for a condition needing several episodes of treatment than for occasional unrelated claims.

Some benefits sit outside it entirely. AXA Health does not apply the excess to dentist fees, to its external prosthesis payment, or to Doctor at Hand consultations, and claiming on those does not affect the no-claims discount. Aviva ring-fences dental and optical the same way. Those exemptions are worth reading before assuming a high excess makes small benefits worthless.

Questions to put to the insurer or broker

  • Does the excess reset at renewal or run with the condition?
  • Which benefits are exempt from it?
  • Do I pay the insurer or the hospital?

Related questions

Sources

  • Source: Aviva — Healthier Solutions Terms and conditions (2025-04), read 4 September 2026.
  • Source: AXA Health — Personal Health membership handbook, October 2024, read 4 September 2026.
  • Source: Bupa policy guide — Bupa By You health insurance (BINS 14718) (2024), read 4 September 2026.
  • Source: WPA — Private Medical Insurance — Insurance Product Information Document (Complete Health) (2025-11), read 4 September 2026.

The limit behind every answer here

None of this reaches a condition you already have. Cover is written for problems that arise after it starts, so anything you have symptoms of when you apply is excluded — permanently under full medical underwriting, or until a symptom-free period has passed under a moratorium. Chronic conditions are excluded by every insurer whose wording we hold. Figures quoted come from current policy documents and change at renewal, so check the document you are actually offered.

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