The Health Guide

Shortfall

The part of a private medical bill your policy does not pay, leaving you to settle it.

A shortfall happens when the fee charged is higher than the amount your insurer will pay, when a limit has been reached, or when part of the treatment is not covered. Insurers publish fee schedules for recognised consultants, and using a consultant who charges within them is the usual way to avoid one. Asking the hospital and the consultant for the full cost in writing before treatment is the simplest protection.

Guides that use this term