A £0 excess typically costs around 10–20% more than the same policy with a £250 excess. All major UK insurers offer it as a standard option. It's rational for frequent claimers, families facing multiplied per-person excesses, and outpatient-heavy users — and poor value for healthy adults insuring mainly against rare, big events.
- ✓£0 excess typically adds 10–20% versus a £250 excess on the same policy.
- ✓It suits frequent claimers, families and outpatient-heavy users — not big-event-only buyers.
- ✓All major insurers offer £0 excess; the structure around it decides whether it works.
What £0 excess really costs
The excess ladder works in both directions. Just as stepping up from £0 to £250 typically saves 10–20%, staying at £0 means paying that margin — call it roughly £8–£16/month on an £80 average premium — for the right never to contribute to a claim. Over a claim-free decade that's four figures handed over for peace of mind you never cashed.
That framing sounds like an argument against £0 excess, and for the median buyer it is. But averages hide the point of this post: excess economics depend entirely on claim frequency, and for some households the frequencies flip the answer completely.
Who £0 excess is actually rational for
Ranked by strength of case — the people for whom no-excess policies genuinely make sense.
- Frequent claimers. Ongoing physio, regular dermatology, annual consultations: if you'd pay the excess most years, the £0 premium loading is cheaper than the excess it replaces. The clearest win on the list.
- Families with per-person excesses. Where the excess applies per person per year, a family of four's worst case is four excesses. Zeroing it caps the household's claim-time cost at exactly nothing — worth more to a family than to any single adult.
- Outpatient-heavy users. A £250 excess swallows a £150–£300 consultation whole, quietly deterring the small claims outpatient cover exists for. £0 excess keeps every benefit usable.
- People who hate claim-time friction. A softer case, but real: some buyers will pay 10–20% for the certainty that authorised treatment costs them nothing further. That's a preference, not an error — as long as it's priced knowingly.
- Corporate-scheme habits. Many workplace schemes run £0 excess, and leavers continuing cover often keep it. Rational if you used the scheme often; worth re-pricing if you didn't.
Quote it both ways
Who offers it, and what to check
In general terms, every major UK insurer — Bupa, AXA Health, Aviva, Vitality, WPA and The Exeter — offers £0 excess as a standard choice on personal policies; it's a pricing option, not a special product. The differences that matter are around it, not in it.
| What to check | Why it matters on a £0-excess policy |
|---|---|
| Outpatient limits | First-pound cover on a capped outpatient benefit still runs out — £0 excess doesn't mean unlimited |
| Per-person vs per-policy excess (on the alternative) | Decides how much the £0 option is really saving a family |
| Shortfall risk | Consultant fees above insurer rates can still leave a bill — £0 excess doesn't guarantee £0 out of pocket |
| Renewal drift | The £0-excess loading compounds as age-driven premiums rise; re-check the maths at every renewal |
The verdict
No-excess health insurance works when the structure matches the buyer: frequent claimers, families and outpatient-heavy users are often better off at £0, and every major insurer will happily quote it. For the healthy adult insuring against the rare big event, the same 10–20% buys more useful things — a wider hospital list, a higher outpatient cap, or simply a smaller premium.
The test costs nothing: get your shortlisted policy quoted at £0 and £250 and compare the real pound gap against how often you honestly expect to claim. For the full mechanics, see our guide to health insurance with no excess — and its mirror image, the excess sweet spot.
Frequently asked questions
How much more does no-excess health insurance cost?
Typically around 10–20% more than the same policy with a £250 excess — roughly £8–£16/month against the £80 UK average adult premium. The exact loading varies by insurer and age, so quote your shortlisted policy at both £0 and £250 and compare the real pound gap before deciding.
Who should choose a no-excess health insurance policy?
Three groups clearly: frequent claimers (ongoing physio, regular consultations), families where a per-person excess could be paid several times a year, and outpatient-heavy users whose typical claim is smaller than the excess would be. For healthy adults insuring against rare big events, the loading usually isn't worth it.
Which insurers offer £0 excess health insurance?
All the majors — Bupa, AXA Health, Aviva, Vitality, WPA and The Exeter — offer £0 excess as a standard pricing option on personal policies rather than a separate product. The real differences lie in outpatient limits, hospital lists and fee arrangements, which decide what you actually pay at claim time.
Does no-excess health insurance mean I pay nothing when I claim?
Not necessarily. £0 excess removes your contribution to eligible costs, but capped benefits can run out, treatment outside your hospital list isn't covered, and consultant fees above the insurer's rates can leave a shortfall. Read the outpatient limits and fee schedule — the excess is only one source of out-of-pocket cost.
Is no-excess cover worth it on a family policy?
It's strongest exactly there. Most insurers apply the excess per person per policy year, so a family of four could face it multiple times in a bad year — a multiplied worst case that £0 excess eliminates entirely. Compare the family premium at £0 and £250 and weigh the gap against several children's worth of claim risk.