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When choosing an expat medical insurance policy, one of the key factors to consider is the policy excess, sometimes called a deductible. The type and structure of the excess can significantly influence how your claims are processed and the reimbursement you receive. This article delves into the nuances of 'per annum' and 'per claim' excesses, helping you make an informed decision.

An excess is the portion of any claim that you agree to pay out of your own pocket before the insurance company covers the remaining costs. The excess can be structured in various ways, primarily as 'per claim' or 'per annum'. Understanding these structures is crucial as they affect your out-of-pocket expenses and overall financial planning for medical costs.

A 'per claim' excess is the amount you pay for each individual claim you make. Here’s a detailed breakdown:

• Definition of a Claim: A 'claim' typically refers to a course of medical treatment rather than individual bills. For instance, if you undergo a surgery followed by a series of post-operative consultations, this entire sequence is considered one claim.
• Payment Structure: You are required to pay the excess amount once for the entire course of treatment. This means if your policy has a $200 per claim excess, you pay this amount once for the surgery and subsequent consultations combined.
• Implications: This structure can be beneficial if you have multiple treatments or visits related to a single medical condition, as you only pay the excess once for that particular course of treatment. However, if you have multiple unrelated treatments, you will need to pay the excess for each separate claim.

A 'per annum' excess, on the other hand, is the amount you pay towards your medical expenses over the course of a policy year. Here’s how it works:

• Annual Limit: The 'per annum' excess is a cumulative amount that applies to all claims made within the policy year. For example, if your policy has a $500 per annum excess, you will need to cover the first $500 of your medical costs in that year.
• Once Met, Fully Covered: Once you have paid the total excess amount for the year, your insurance will cover subsequent medical costs in full, subject to the policy terms and coverage limits.
• Financial Planning: This can be advantageous for those who anticipate multiple claims throughout the year, as it caps the maximum amount you need to pay. It provides more predictability in managing your medical expenses over time.

To illustrate the difference, let’s consider a scenario where you need several medical treatments in a year:

Scenario 1: Per Claim Excess

• You have three separate medical treatments, each costing $1,000.
• With a $200 per claim excess, you pay $200 for each treatment, totalling $600 for the year.

• You have the same three treatments.
• With a $500 per annum excess, you pay the first $500 of your medical expenses. Once this amount is reached, your insurance covers the remaining costs for any additional treatments that year.

When selecting a policy, consider your medical needs and financial situation:

• Frequent Treatments: If you expect frequent medical visits or treatments, a 'per annum' excess might be more cost-effective and provide financial predictability.
• Infrequent Claims: If you generally have few medical needs but want to ensure coverage for major treatments, a 'per claim' excess could minimise your costs per individual treatment.

Understanding the differences between 'per claim' and 'per annum' excesses is vital for managing your healthcare expenses effectively. By carefully considering your medical needs and financial situation, you can choose a policy that provides the best balance of coverage and cost. Always review the terms of the policy and consult with an insurance advisor to ensure that your chosen plan aligns with your healthcare requirements and budget.

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