What is medical excess?

Why the medical excess matters for your holiday

The medical excess is a fundamental part of most UK travel insurance policies, acting as a form of self-insurance. By agreeing to pay the first £50 to £250 of a medical claim, you help the insurer lower the overall premium price. For many travellers, a higher excess results in a cheaper policy upfront, but it requires you to have those funds available if an emergency occurs. If your medical bill is lower than the excess amount, you will have to pay the full cost yourself without reimbursement from the insurer.

• Determines your initial out-of-pocket cost during a crisis
• Directly influences the monthly or annual premium price
• Applies per person on multi-traveller policies
• May apply multiple times if you have two unrelated accidents
• Can be waived on some premium-tier insurance products

What is covered under the medical section

When you pay your medical excess, it unlocks the significant financial protection provided by the rest of the policy. Most UK policies provide between £2 million and £10 million in total medical cover. This includes emergency surgery, hospital stays, and the cost of prescription medication administered while abroad. Crucially for UK residents, it also covers the high cost of emergency repatriation back to a UK hospital if you are too unwell to fly on a standard commercial flight.

• Emergency dental treatment for immediate pain relief
• In-patient hospital certificates and daily ward fees
• Air ambulance or stretcher costs for UK return
• Reasonable transport costs for a companion to stay with you
• 24-hour medical emergency assistance helplines

Common exclusions and what is not covered

It is vital to remember that paying your medical excess does not mean every health-related cost is covered. Insurers will typically reject claims for treatment that can reasonably wait until you return to the UK. Private healthcare costs in countries where public facilities are available may also be restricted. Furthermore, if you travel against the advice of the Foreign, Commonwealth and Development Office (FCDO), your medical cover and the associated excess arrangements may be completely voided.

Typical costs and pricing factors for 2026

In the current UK market, medical excesses usually range from £0 to £250. A 'standard' policy often settles around the £100 to £150 mark. Factors that influence this include your age, your destination, and your pre-existing health conditions. For example, a policy for the USA may have a higher excess or a higher premium due to the extreme cost of American healthcare. Some specialist insurers for seniors may offer a 'double excess' for specific high-risk conditions to keep the policy affordable.

Choosing your excess and pre-existing conditions

When declaring pre-existing conditions through a medical screening service, you must be honest to ensure your cover is valid. If you have a chronic condition, you might prefer a lower excess or an 'excess waiver' so that frequent small treatments do not become a financial burden. For travellers going to the EU, using a Global Health Insurance Card (GHIC) can often result in the insurer waiving the medical excess entirely, as the card reduces the total bill the insurer has to pay.

• Check if your GHIC waives the excess in Europe
• Assess if you can afford the excess in a sudden emergency
• Review 'excess waiver' add-ons for total peace of mind
• Ensure all medical conditions are declared to avoid claim rejection
• Compare the premium saving against the potential excess cost

Claims evidence and the reimbursement process

To successfully claim back medical costs minus your excess, you must provide a clear paper trail. The Financial Ombudsman Service (FOS) often sees disputes where travellers failed to keep receipts or did not contact their insurer's emergency line immediately. Most UK insurers require you to call their 24-hour assistance team before undergoing major surgery or moving to a private clinic. This allows the insurer to guarantee payment directly to the hospital, often meaning you only have to pay the excess amount to the clinic locally.

The role of the GHIC and FCDO guidance

The UK government strongly recommends having travel insurance even if you hold a GHIC or EHIC. These cards only cover state-provided healthcare and do not cover mountain rescue or repatriation to the UK. The Association of British Insurers (ABI) notes that the GHIC is a complement to insurance, not a replacement. Always check the FCDO website for your destination to see if there are specific health risks or requirements that might affect your likelihood of needing to use your medical cover.

Practical checklist for managing medical costs

Before you depart the UK, ensure you have your insurance policy number and the emergency medical assistance phone number saved in your mobile and written on paper. Check the 'Summary of Cover' document to confirm the exact medical excess amount for every person in your party. If you are involved in an accident, keep every single receipt, even for small pharmacy purchases, as these can sometimes be bundled into a single claim to meet the excess threshold.