High Excess and Self-Pay Medical Insurance Policies

A number of the private medical insurance groups have responded to the growth in self-pay by developing new policies which combine elements of both self-pay and insurance. This approach, sometimes called "coinsurance", involves people agreeing to make a larger contribution towards any private medical treatment costs themselves than with traditional medical insurance. The benefit is that premiums are significantly lower. This means a wider range of people are able to afford a valuable level of private medical insurance cover.

There are currently two types of policy with a significant self-pay element. The first is high excess insurance policies. These charge significantly lower premiums than traditional policies offering comprehensive cover but impose a high excess. This means that subscribers have to pay themselves for typically the first £1500 to £5000 of their total private treatment costs in any year or, with some policies, in relation to each separate condition requiring treatment. These policies represent a powerful combination of self-pay and insurance elements.

Anyone with a high excess policy who falls ill and chooses to be treated privately will pay themselves for at least part of their treatment (the option of being treated by the NHS always remains). If the cost of treatment is below their excess level, they will bear the entire cost themselves and will need to organise and pay for it themselves. Above the excess level, these policies offer all the benefits of standard comprehensive insurance. Subscribers are protected from the real risk which causes people to buy medical insurance: the unlikely but genuine possibility that they will need major treatment costing many thousands or even tens of thousands of pounds.

The second type of policy has been designed specifically for people choosing the self-pay approach and refunds a percentage of hospital charges (options typically range from 30% to 75%, leaving the subscriber to pay between 25% and 70% of the cost). These policies also offer significantly lower premiums than traditional policies. Unlike high excess policies, these do not provide a definite cap on medical expenses.

One aspect of self-pay policies which contributes to their competitive premiums is that subscribers are required to make arrangements with their chosen private hospital directly and pay themselves. They claim back the insurance company's contribution after completion of treatment and typically receive a cheque within seven days. A number of new services have been launched recently to provide advice and assistance to people who are arranging their own treatment directly with hospitals (in conjunction with their specialist or consultant).

The main high excess and self-pay policies currently available are described in detail in the private medical insurance section of this site. The relevant links are given below.

High Excess and Self-pay Insurance Policies
High Excess Policies	Standard Life Healthcare Choices	click here
	WPA XS health	click here
Self-Pay Policies	WPA Self-Pay Protect	click here