General & Medical caps what it will pay towards a consultation, a surgeon or an anaesthetist, and the cap comes from a published reimbursement table rather than from the bill you are handed. Its published maximums run from £200 for a first consultation and £100 for the smallest surgeon's fee up to £2,233 for a surgeon on the most complex band. If you are weighing up this insurer, or already hold a policy, that table is worth understanding before treatment. For questions about these maximums, the form on this page gives you an FCA-authorised broker on the phone, at no charge.
General & Medical's fee limits, band by band
General & Medical's published reimbursement table (reference GMFS-A-V2.9) gives one pair of figures for consultations: medical or surgical, initial £200.00 and follow up £150.00. For procedures it sets maximum amounts in five procedure bands, with five columns numbered 1 to 5 under each. The table does not say what the numbers 1 to 5 stand for, so ask General & Medical which column your procedure falls in. These are the maximum contributions as printed.
| Procedure band | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| Minor | £100.00 | £117.00 | £128.00 | £150.00 | £183.00 |
| Inter | £228.00 | £273.00 | £317.00 | £368.50 | £424.00 |
| Major | £497.00 | £558.00 | £602.00 | £648.00 | £681.00 |
| Major Plus | £731.50 | £759.00 | £787.00 | £815.00 | £860.00 |
| Complex Major | £921.00 | £1,144.00 | £1,507.00 | £1,897.50 | £2,233.00 |
| Procedure band | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| Minor | £117.00 | £117.00 | £117.00 | £117.00 | £117.00 |
| Inter | £117.00 | £132.00 | £144.00 | £144.00 | £167.00 |
| Major | £190.00 | £207.00 | £224.00 | £253.00 | £270.00 |
| Major Plus | £304.50 | £320.00 | £366.50 | £429.50 | £504.00 |
| Complex Major | £589.50 | £687.00 | £868.00 | £1,048.50 | £1,184.00 |
These are the insurer's maximum contributions, not cash prices, and not an indication of what your own consultant will charge or what any hospital bill will total. The document adds that a surgeon's fee "should include all preoperative and post operative care", for in-patient and day-case surgery, including common post-operative complications. So the surgeon's fee for an operation is meant to cover the care before and after it, rather than being billed as separate items.
Where the figures come from, and how firm they are
General & Medical publishes a one-page document on its healthcare professionals page, headed "General & Medical Group maximum Reimbursement table for Consultations and Surgeons, Physicians and Anaesthetists fees" (document reference GMFS-A-V2.9; it prints no date, and we read it on 2 November 2026). It does the job of a fee schedule, and it opens with this rule for consultations: "the amounts below indicate our maximum reimbursement levels for consultation and session fees".
Two points about its status matter to a policyholder. First, the figures are described as "a summarised guide to reimbursement limits we consider are reasonable and customary costs", and the document adds that "a full version of this is available to registered Healthcare Professionals upon registration with us". So the version you can read is a summary. Second, the opening line is qualified: "Unless agreed separately (subject to annual review) on an individual basis". A consultant can therefore have a separate arrangement with the insurer, and the summary does not show those.
The table is not a list of what consultants charge. It sets the most General & Medical contributes, and the document itself says: "We do not expect to be charged the maximum in every case".
Which consultants General & Medical recognises
Cover depends on the practitioner being recognised. General & Medical's jargon buster defines a consultant as "a General Medical Council (G.M.C.) registered medical practitioner under the age of 70 who holds or has held, a substantive consultants post in the NHS and who is recognised by us". Its FAQ says policies cover eligible treatment "by our recognised consultants, medical practitioners or therapists".
The healthcare professionals page describes two steps. A professional is recognised once General & Medical has checked the GMC or HCPC registers and its own internal data and is satisfied. To become registered, a recognised professional must also agree to the G&M Terms of Business and give "Full disclosure of their fees which must be agreed between G&M and the HP". Registration, the page says, lets General & Medical give policyholders accurate information for claims and invoice processing. The same page adds a caution: "Recognising and/or Registering as an HP with G&M does not imply that G&M endorse the service provided by the HP". Recognition is a check on registration, not a quality mark.
Recognised and registered are therefore separate things, and only the second involves fees agreed in advance with the insurer. The glossary also invites you to ask: "You may phone or write to us if you wish to ascertain whether a practitioner is recognised by us as a consultant."
If a consultant charges more than the table
The document's wording on this is short. It calls the figures "maximum contributions for each category of complexity" and says "patients must be advised of any potential costs outside of these limits before proceeding with treatment". The first phrase tells you G&M's payment stops at the figure. The second tells you the document expects some consultants to charge above it, and expects you to be told before treatment, not after. Who covers that gap under your own policy, and whether a plan benefit limit also bites, are fair questions for the broker phoning you back once you send the form; their answer is free.
A bill above the table is what the trade calls a shortfall. It is not your excess, which is an amount you choose at the start; the page on how an excess works covers that. For how shortfalls, fee-assured consultants and separate surgeon, anaesthetist and hospital bills work across insurers, see consultant fees, shortfalls and fee-assured labels.
The table also says General & Medical does not expect to be billed for combinations of procedures that the Clinical Coding & Schedule Development (CCSD) Group treats as unacceptable, so a bill that adds separate codes for what is one operation is worth querying.
Checking before treatment
The fee-schedule risk is cheapest to deal with before you book. In order:
- Ask your GP or consultant for the name of the specialist and the procedure, and, if it is known, the procedure code, before you are booked in.
- Ring General & Medical's claims line, 0800 970 9442 (the table gives hours of 08:45 to 17:15, Monday to Friday), and ask whether that practitioner is recognised and whether they are registered.
- Ask the consultant's secretary for a written estimate that splits the surgeon's fee, the anaesthetist's fee and any consultation fees. The table sets a different maximum for the surgeon and the anaesthetist.
- Ask General & Medical how those figures compare with its maximum for that procedure, and whether you need pre-authorisation. Check the hospital is on the list for your plan too: see General & Medical's hospital list explained.
- If the estimate is above the maximum, decide with the consultant's office before treatment whether to proceed, ask for a different quote, or choose another specialist.
Out-patient consultation and specialist fees also sit under a benefit limit for your plan, shown in the cover comparison on General & Medical's out-patient page. That is separate from the per-fee table above, so check both.
Fee schedule questions
Why does General & Medical publish only a summary table?
The published table calls itself a summarised guide and says the full version goes to healthcare professionals who register with the insurer. For the limit on your own procedure, ring General & Medical with the procedure code your consultant gives you.
Is there an age limit for the consultants General & Medical recognises?
Its glossary defines a consultant as someone under the age of 70 with an NHS substantive consultant post, past or present, who is recognised by the insurer. A practitioner who has passed 70 does not meet that definition as printed, so ask the insurer about your own case.
Is the table the same as my policy's benefit limit?
No. The table sets maximum reimbursements for consultation, surgeon and anaesthetist fees. Benefit limits for a plan, such as the out-patient amounts, sit in the cover comparison for that plan, and both can apply to the same claim.
If you are considering General & Medical, or want to see how it sits beside other insurers, the form here arranges a free phone call, and the person calling can show how consultant fee limits would sit within a quote.