An excess is the initial amount you pay for a treatment or service if you claim on your health insurance. Choosing a plan with a higher excess can usually lower the overall cost of your cover.

How much excess you pay depends on your level of cover and the treatment or service you’re claiming for.

There are two types of excess:

Out-patient excess explained:

An out-patient excess is deducted from what you claim back on visits to your GP, dentist, physio and other everyday treatments that don’t require a hospital bed.

Your Table of Benefits shows how much is payable to you as a benefit amount. An out-patient excess is deducted from the benefit amount when you claim.

Here’s how it works:

• Sarah has a doctor's appointment which costs €60.
• Sarah‘s Vhi health plan includes doctor visits with an eligible benefit amount of €45 per visit.
• There is also an excess of €1 per insurance year.
• Sarah can claim back the eligible €45 minus the €1 out-patient excess.
• Sarah will receive a €44 refund.

This example is based on a real application of excess.

Here’s another example:

• Paul has an X-ray and a physio appointment, costing €80 and €60 respectively.
• His Vhi health plan includes a €60 benefit for an x-ray and a €50 benefit for a physio appointment.
• In Paul’s Table of Benefits, X-rays and physio appointments are grouped together. He’ll need to pay an excess of €50 per insurance year.
• He can claim back the eligible €60 + €50 minus the €50 out-patient excess for the combined benefits.
• Paul will receive a refund of €60.

This example is based on a real application of excess.

In-patient excess explained:

An in-patient excess is an amount you pay when you claim on treatments in private hospitals. This includes hospital admissions that don’t require overnight stays.

You pay the in-patient excess directly to the hospital. The hospital will then send the bill directly to Vhi for the remaining amount.

You cannot claim a refund from Vhi for the in-patient excess amount.

Let's walk you through an example:

• David has a minor procedure scheduled at a private hospital costing €750 – it won’t require an overnight stay.
• Vhi will pay the eligible benefit amount in line with David’s plan which is 100% cover in a side room setting subject to an excess.
• He checks his plan and notes a €150 claim excess.
• David will need to pay an excess of €150 in relation to the hospital charges.

This example is based on a real application of excess.

Here’s another example

• Nicola has treatment scheduled at a private hospital costing €2,500 – it will require a 2-night stay.
• Vhi will pay the eligible benefit amount in line with Nicola’s plan which is 100% cover in a private room setting subject to an excess.
• She checks her plan and notes a €50 in-patient excess per night.
• Nicola will need to pay €100 (€50 x 2) in relation to the hospital charges.

This example is based on a real application of excess.