Private Health Insurance Excess Explained
A private health insurance excess is the amount you agree to pay towards eligible treatment before or when your insurer contributes. How it is applied varies between insurers and policies.
A higher excess may reduce the premium, but it should remain affordable if you need to claim. Always check the policy wording and how often the excess applies. Content reviewed 11 September 2026 by the Covered Today team.
How private health insurance excesses work
Excess feature
What it means
What to check
Excess amount
Your contribution to a claim
Could you pay it comfortably?
Payment frequency
Per year or per claim
Check each insurer’s rules
Who pays
Per person
Check individual and family terms
When it is paid
Often when treatment begins
Payment method can vary
Eligible treatment
Applies only to covered claims
Exclusions still apply
At renewal
Excess options may be reviewed
Compare the total cost
Choosing an excess that suits your budget
Available savings
Compare quotations with the same benefits at different excess levels. A higher excess is only useful if the premium saving justifies the extra amount you may pay.
Claim-time affordability
Choose an amount you could pay without financial strain if treatment were needed unexpectedly.
How often it applies
An excess may apply once per policy year, per claim or under different rules. Confirm the frequency before comparing prices.
People covered
On couple or family policies, an excess may apply separately to each insured person. Check the maximum possible contribution.
Policy benefits
Compare excess options using otherwise similar cover so a cheaper premium is not confused with reduced benefits.
Insurer wording
Definitions and payment arrangements differ. Read the policy documents and ask the insurer or adviser to explain anything unclear.
Do I pay the excess every time I claim?
Not always. Some excesses apply once per policy year, while others may apply per claim, condition or person. The exact rule depends on the insurer and policy.
Does a higher excess always reduce the premium?
A higher excess commonly lowers the premium, but the saving varies. Compare the full annual cost and make sure the excess remains affordable.
Can I change my excess later?
You can usually review available excess options at renewal, subject to the insurer’s terms. Changing it during a policy year may not be possible.