To compare private health insurance costs fairly, compare what each quote would cost you over a year, not just its monthly figure: the premium, plus the excess and any shortfall you would pay if you claimed, on cover that matches line for line. The lowest premium on a page of results is often a policy with a bigger excess, a smaller out-patient limit or a shorter hospital list. Choosing between quotes now? An FCA-authorised broker can get prices from more than one insurer on identical choices, free of charge; while your quotes are fresh, the form on this page gets one to ring you back.
This page is about adding those costs up. What a month or a year of cover tends to cost at different ages is on what it costs per month and what it costs per year; for a way of lining two specifications up, see how to compare private health insurance policies; and the sites themselves are covered by comparison sites and brokers.
Private health insurance UK cost comparison: premium, excess and shortfall
A policy can cost you money in three ways. The premium is what you pay whether or not you claim. The excess is your own share at the front of a claim, met before the insurer contributes. A shortfall is any part of a bill the policy does not pay at all, because it is over a limit, at a hospital outside your list or above the insurer's fee schedule for a specialist. A cheaper quote has often moved money from the first of these into the other two, which is fine if you know it has happened and a surprise if you do not.
Underwriting sits underneath all three, because it decides which of your past conditions the policy will pay for at all. AXA Health offers four routes on its Personal Health plan, according to its membership handbook (October 2024, PB116343a/10.24, in the copy more-health.co.uk hosts): moratorium, continuing medical exclusions, medical history disregarded, and full medical underwriting. Bupa's By You policy guide (BINS 14718, for policies beginning after 1 May 2024) says that conditions you had before the policy started aren't usually covered. Before reading two prices together, check that both quotes name the same people and the same underwriting route, and on a moratorium quote ask how far back it looks. Which private health insurance covers pre-existing conditions explains the routes.
How each insurer counts the excess
The same excess figure can take very different amounts out of your pocket in a year, depending on whether it is counted per person, per policy year or per claim, and on what happens when treatment runs past a renewal date. The wording differs from one insurer to the next:
- Per member, every policy year. Aviva's Healthier Solutions terms, in the March 2026 edition (AV1590050_GEN6842_0326; check the terms sent with your quote), say: "Benefits covered under this policy will be subject to an excess payable for each member every policy year." On a family policy, each member has an excess of their own to meet.
- Once a year, then renewed. Bupa's guide says that once the full excess is paid you do not pay it again for further treatment claimed in that policy year, but that it renews when a new policy year begins, even mid-treatment, so one course of treatment crossing the renewal date could attract it twice. Saga's HealthPlan Super policy book (May 2025) spells out the same effect: "Should treatment continue beyond your policy’s renewal date then we will apply the excess once against the costs incurred before this date, and again against the costs incurred on or after the renewal date."
- Per claim or per person, shown on the certificate. Vitality's Personal Healthcare membership guide (VHTCR0002 08/2024, in the copy mytribeinsurance.co.uk hosts) says the membership certificate shows which applies, and: "If you have a ‘per claim' excess, we will deduct the excess from the first invoice we pay (and the next invoice if any excess still remains)." In the guide's own worked example, a new condition brings a per-claim excess round again.
- Deducted, then paid to the provider. Freedom's Elite policyholder's guide (April 2025) deducts the excess from valid invoices until it has been fully applied, then asks you to pay that amount to the provider rather than to Freedom.
- A percentage instead of a fixed sum. Alongside a per-policy-year excess, WPA's product information document for Complete Health (effective from 1 November 2025) describes Shared Responsibility, a co-payment: you meet 25% of each eligible claim until your chosen level is reached.
On a joint or family policy, also ask who is on the hook. AXA's handbook gives legal rights under the plan only to the lead member and AXA, and so leaves the lead member liable for any excess or shortfall a family member runs up.
A higher excess will usually bring the premium down. At the same figure, a per-claim excess will generally cost you more than a per-year one in a year with two unrelated claims, because it is met twice. How much excess should you choose? sets the insurers' wording out in more depth. Because the size of the saving only shows when both versions are priced, it is worth asking the broker who rings you back to quote two excess levels side by side, which costs nothing.
Where a shortfall comes from: limits, hospital lists and fee schedules
An out-patient limit is the most a policy pays in a year for consultations, tests and scans where you are not admitted. Above it, the bill is yours. A lower limit, or no out-patient cover, usually brings the premium down, so a cheap quote deserves a second look at this line. WPA's information document sets consultations with a specialist at £250 as standard, with an Extra Out-patient Consultations option to raise it. Vitality's guide says: "You are covered up to the limit shown on your membership certificate for appointments with a consultant, following a referral from a GP." On that plan, then, the figure to compare is on the certificate rather than in the guide.
Hospital lists decide where the policy pays in full. The Exeter's Health+ information document (MKTG770, June 2026) offers four treatment options, running from a guided specialist route through essential, standard and extended hospital lists. Saga's policy book offers its Countrywide list, a London upgrade, or Guided Care, where Saga picks the specialist together with you. Names and contents vary between insurers, so the useful check is whether the hospitals you would actually use appear on each quote's list.
Aviva's Healthier Solutions terms, in the same March 2026 edition, show all three routes to a shortfall in one document:
- A reduced out-patient limit. Limits of £500, £1,000 or £0 sit beside full out-patient cover. Picking £500 or £1,000 takes something else away as well: any cover, admitted or not, for pregnancy and childbirth complications and for tooth surgery done in hospital. The £0 option also drops out-patient mental health treatment. The limit does not apply to out-patient treatment through some of Aviva's networks, and cancer has its own exception: "If you have chosen a monetary limit for out-patient treatment (£0, £500 or £1000) the monetary limit will not apply to cancer treatment received after you have been diagnosed with cancer. The out-patient limit will still apply to consequences of cancer treatment and conditions related to cancer treatment."
- A hospital off your list. For an in-patient or day-patient stay at a recognised hospital outside your list (and outside Aviva's networks and NHS pay-beds), hospital charges are paid up to the average for equivalent treatment at your listed hospitals, or in full when the bill is below that average. The terms add: "This could leave you with a shortfall that the policy does not cover."
- A specialist above the fee schedule. With a hospital list, specialists' fees are covered up to the limits in Aviva's fee schedule: "If the fee is higher than the limit in our fee schedule, it is your responsibility to pay the specialist the difference."
Limits in general are covered on benefit limits explained and outpatient cover; how lists are put together is on hospital lists explained, and how a hospital's bill meets a fee schedule is on private hospital prices and your health insurance.
A made-up example: the lower premium against the lower claim bill
The sum below shows why the premium alone can mislead. Every figure in it is made up to make the arithmetic visible. None is a premium you would be offered, none comes from any insurer's pricing, and none is a market range. Two imaginary quotes are for the same person, on the same underwriting and the same hospital list. Quote A costs £62 a month with a £250 excess per policy year and a £1,000 out-patient limit. Quote B costs £55 a month with a £500 excess per policy year and a £500 out-patient limit. To keep it simple, assume that on both the excess is paid first and the policy then pays up to its out-patient limit; how a real policy orders the two is set by its own wording.
| Made-up example (not real prices) | Quote A | Quote B |
|---|---|---|
| Premiums for twelve months | £744 | £660 |
| Year with no claim: all you pay | £744 | £660 |
| Year with £1,500 of eligible out-patient bills: excess you pay | £250 | £500 |
| Policy pays, up to the out-patient limit | £1,000 | £500 |
| Left above the limit, paid by you | £250 | £500 |
| Year with that claim: premiums plus all you pay | £1,244 | £1,660 |
In the year without a claim, Quote B is £84 cheaper. In the year with £1,500 of bills, Quote A is £416 cheaper. Neither result is a recommendation; the point is that the answer turns on how likely a claim feels to you and on how the excess and limit are counted, which is why the two sections above matter. Add a second, unrelated condition in the same year and a per-claim excess would be met again where a per-year one would not. When the broker calls back, ask for real quotes on two builds like these, and the same sum can then be run on your own figures.
Options that lower the premium by narrowing the cover
Some lines on a quote change what the policy is for, and are easy to miss when only the price is being read. The six-week option is the clearest. Under Aviva's version, if the NHS can provide your treatment within six weeks of your specialist recommending it, accident and emergency admissions included, you cannot claim for private in-patient or day-patient treatment, nor for the NHS cash benefit, NHS cancer cash benefit or NHS amenity bed cost. Saga builds the same idea into whole plans, a 4 Week Wait and a 6 Week Wait: where the NHS can provide the hospital treatment inside that window, counted from the specialist's recommendation, the NHS is the route you must use. On the call-back the broker can check, free, whether a particular quote has a wait option of this kind built in. Private health insurance versus the NHS compares waits and cash benefits.
Cancer cover is the line people most often assume is the same everywhere. AXA's handbook sets out two levels for Personal Health, named Comprehensive Cancer Cover and NHS Cancer Support; which one you have is on your membership certificate. The Exeter's Health+ summary, by contrast, lists: "Cover for all stages of cancer once diagnosed, including palliative and terminal treatment, with no time or financial limit." Each statement describes one product and tells you nothing about another insurer's quote; cancer cover goes into the detail.
Mental health cover varies in whether it is there at all. In AXA's handbook it is an optional add-on, the Mental Health Option, paying for in-patient or day-patient psychiatric treatment as its table shows. WPA sells it as an optional extra, with up to 28 days or nights of in-patient and day-patient treatment and a choice of £1,000 or £2,500 for out-patient treatment and therapy. Saga builds it into HealthPlan Super: as many as 28 days of in-patient treatment a year, and out-patient benefits to £2,500 a year. On Bupa By You, the guide points you to your membership certificate to see whether it is included. A quote with mental health cover and one without are two different products, whatever their prices; the best health insurance for mental health compares the cover itself.
What the renewal wording lets each insurer change
A quote prices the first twelve months, and the gap between two quotes is a starting point rather than a fixed difference. Bupa's By You guide is specific about notice: "We can change these terms, the premiums, any discount or preferential rates and the cover available to you and your dependants or other policy terms, at your renewal date. If we make any changes, we’ll write to let you know at least 28 days before the renewal date." It then gives you 28 days to cancel if you do not accept a change, counted from when the change takes effect or from when Bupa tells you, whichever is later. AXA's handbook and Saga's policy book both allow a change to all or any part of the cover from any renewal date, with reasonable notice.
Insurers also explain what drives the new price. Vitality's guide calls its method ABC pricing, built from Age, a Base rate (the changing cost of providing healthcare) and a Claims adjustment that also takes in your Vitality status. Aviva's knowledge-centre explainer (last updated 5 August 2025) names four things that make prices a little higher at renewal: inflation, claims, age and medical inflation. Where a no-claims discount is used, each insurer sets its own scale and its own effect for a claim, which how no-claims discounts work across insurers sets side by side. When the renewal notice itself arrives, your renewal price covers what to do.
Comparing private health insurance prices: other questions
Do the same words mean the same thing on two insurers' quotes?
Not always. Excess, hospital list and out-patient limit are terms most insurers use, but each defines them in its own wording, as the excess and shortfall sections show. The terms sent with the quote are the document that counts, so read the definitions before the price.
Is the cheapest quote always the one with the least cover?
No, but a lower price often comes with a different build, such as more excess to pay, less out-patient cover, fewer hospitals, a guided route or a wait option. Check those five lines, and the cancer and mental health lines, before reading the lower price as the better buy.
How many quotes are enough for a fair comparison?
Fewer than people expect, provided they match. Two or three insurers quoting one agreed set of choices tell you more than six quotes built six different ways, and pricing one cheaper variant alongside tells you what the savings are buying.
Can I compare a new quote with the policy I already hold?
Yes, if you set your current schedule beside it line by line: underwriting, the excess with its counting rule, the out-patient allowance, the hospital list and any wait option. A move to another insurer is a fresh application, so ask what the new insurer would treat as pre-existing; changing or switching private health insurance covers the move.
Before the call, decide on two builds you would like priced: the cover you would choose if price did not matter, and one cheaper version with a higher excess or a lower limit. Next, arrange the call-back via this page's form and talk the broker through both builds when they ring; once more than one insurer has priced each, run the sum from the made-up example on real figures.