What does excess mean in health insurance?

In health insurance, an excess (also known as a deductible) is the amount you agree to pay towards the cost of a claim before your insurer covers the remaining eligible costs. It is one of the most important terms to understand when choosing an international health insurance plan, as it directly affects both your premium and your out-of-pocket costs when you need treatment.

When you make a claim, the excess is the first portion of the cost that you are responsible for paying to the healthcare facility. Once your excess has been met, your insurer covers the remaining eligible costs up to the policy maximum. Under Expatriate Group’s international health insurance plans, the excess is applied per person, per policy year, and per new medical condition. This means that if you are treated for the same condition more than once within the same policy year, the excess is only applied once for that condition. All subsequent eligible costs for that condition within the same policy year are then covered up to the policy maximum.

Excess and deductible mean the same thing in health insurance. Excess is the term commonly used in the United Kingdom and across much of Europe and Asia, while deductible is the term more commonly used in the United States and Canada. If you are comparing international health insurance plans from different providers, you may see either term used depending on where the insurer is based. On Expatriate Group plans, the term excess is used, but it functions in exactly the same way as a deductible.

When you receive treatment that is covered by your policy, the excess is the amount you pay first before the insurer contributes. For example, if you receive outpatient treatment costing €/£/$800 and your policy has an excess of €/£/$250 for that condition in the current policy year, you would pay €/£/$250 and the insurer would cover the remaining €/£/$550, subject to the policy terms and any applicable co-insurance. If you later receive further treatment for the same condition in the same policy year, the excess has already been satisfied for that condition and the insurer would cover eligible costs from the first pound, euro or dollar.

It is important to note that the excess must be satisfied before any co-insurance becomes effective. Co-insurance is the percentage of costs you may be required to contribute after the excess has been met, on certain benefits.

Not all benefits under Expatriate Group’s international health insurance plans are subject to the policy excess. The following benefits are explicitly exempt from the excess:

This means that when you claim for these benefits, you do not need to meet your excess first. The insurer covers eligible costs from the first pound, euro or dollar up to the applicable benefit limit.

The excess applies across all Expatriate Group international health insurance plans: Primary, Primary+ Lite, Primary+ and Select. The specific excess applicable to your policy is detailed in your Policy Schedule, which is issued when you take out cover. The excess level may be selected at the time of application and affects your premium, with a higher excess typically resulting in a lower annual premium.

Choosing a higher excess reduces your annual premium because you are agreeing to cover a greater portion of any claim yourself. This can be a useful way to manage the cost of international health insurance if you are in good health and primarily want protection against significant or unexpected medical costs rather than routine treatment. Conversely, choosing a lower or zero excess means your insurer contributes from the first eligible cost, but your premium will be higher to reflect this.

For inpatient and day care treatment, and for any outpatient treatment likely to exceed €/£/$1,000, Expatriate Group requires pre-authorisation from the claims team at least seven days before admission where possible. Pre-authorisation does not affect the excess, but it is a separate requirement that must be met for the claim to be valid. When pre-authorisation is granted, it confirms that the condition is covered, the hospital and specialist are approved, and the proposed treatment is appropriate. Any excess applicable under your policy is then applied when the claim is processed.

The excess in international health insurance is the amount you pay towards a claim before your insurer covers the rest. Under Expatriate Group plans it applies per person, per policy year and per new medical condition, meaning you only pay it once per condition per year regardless of how many times you are treated for that condition. Certain benefits including maternity, dental, optical and preventative services are not subject to the excess. The excess level is confirmed in your Policy Schedule and choosing a higher excess is one of the most effective ways to reduce your annual premium.