Physiotherapy
Understanding your excess and what you may need to pay
The following explains how excess payments, benefit limits, and other charges may apply
when using your private health insurance policy through HCML. It’s designed to make the key
points simple and clear – but remember:
• Your insurance policy schedule always takes precedence.
• For anything specific, please refer to your policy or contact your insurer.
What you need to know
You may need to pay an excess depending on your policy, and you may also be liable for any shortfalls,
missed appointment fees, or treatment that exceeds your policy limits.
While HCML can authorise treatment, we cannot confirm your remaining benefit limits or excess balance; only your insurer can provide this information. If treatment continues into a new policy year, a new excess may apply, and because invoices can be processed several months after treatment, excess charges may appear later.
What is an Excess?
Your excess is the amount you personally contribute towards your treatment each policy year. It is:
• Agreed between you and your insurer.
• Usually applied once per policy year, per insured member.
• Payable once authorised treatment has occurred.
If your treatment spans more than one policy year, your excess may apply more than once.
For example:
If your excess is £100 and your first treatment invoice is £150:
You pay £100
Your insurer pays the remaining £50
Other costs you may be responsible for:
You may need to cover:
• Your policy excess.
• Late cancellation or missed appointment charges.
• Treatment fees that exceed your outpatient or benefit limits.
• Treatment not authorised by HCML.
• Any treatment outside your policy’s active cover period, even if previously approved.
HCML is not responsible for excesses or shortfalls applied by your insurer. If you choose to continue with
treatment not covered by your policy, you may be personally liable.
Understanding your policy limits
Outpatient limits
Some policies cap the total amount your insurer will pay for all outpatient treatment in a policy year.
Once you reach this limit, you are responsible for any remaining costs.
Overall benefit limits
Some policies include an annual maximum across all treatment. Once reached, your insurer may not
pay further expenses.
Important: HCML cannot monitor your remaining entitlement or see all processed claims. Always check
with your insurer.
Authorising your treatment
To ensure your treatment is covered:
• All treatment must be authorised in advance.
• Authorisation is based on information available to HCML.
• Any changes to the treatment plan must be discussed with HCML first.
Treatment without authorisation may not be covered.
Your policy must be active for treatment to be authorised. If you proceed while your policy is inactive,
you are responsible for all costs. If your policy is cancelled or becomes inactive after treatment has
been authorised, any further treatment will no longer be covered, and you will be liable for those costs.
How payment works
Excess is usually triggered by the first invoices processed in your policy year, including those from other
providers outside HCML, and because invoices can take up to six months to be fully processed, excess
charges may appear later.
HCML pays clinics directly, but if your insurer does not cover the full amount, HCML will invoice you for any outstanding balance, while shortfalls charged by treatment providers
may be invoiced to you by them directly.
Payments for any HCML-related excess or shortfalls are collected via a secure PayPal link emailed to you, so please check all email folders, including junk, for
payment notices.
How to avoid unexpected charges
- Review your policy documents carefully.
- Confirm your excess and benefit limits with your insurer.
- Ensure treatment is authorised before attending appointments.
- Inform HCML and your provider if your policy changes or ends.
- Give more than 24 hours’ notice for cancellations when required.
If your policy changes or ends
Your treatment can only be covered while you have an active insurance policy. Your cover may end or change for a number of reasons, including:
- Leaving your employer (if covered under a corporate scheme).
- Changing job role or employment benefits.
- Your employer moving to a different healthcare insurer or benefits provider.
- Choosing not to renew your individual policy.
- Changes made to your policy at renewal.
- Your insurer cancelling or ending your cover.
If your policy ends or changes after treatment has been authorised, any appointments that take place after the policy end date may no longer be covered, even if they were approved in advance.
If you obtain cover with a new insurer or benefits provider, you may be able to continue treatment under your new policy. However:
- HCML cannot transfer authorisations between insurers.
- HCML cannot confirm whether a new insurer will accept ongoing treatment.
- It is your responsibility to contact your new insurer and arrange any new authorisations required.
- If you continue treatment without insurance cover in place, you may be responsible for the full cost of that treatment.
Contact us
For treatment, authorisation or invoice queries:
HCML Customer Support
0333 023 0155
hcmlclinical.assistants@hcml.co.uk
For questions about your policy, excess or benefits, please contact your healthcare insurer.
