Insu›Explainers›Excess and co-payment
Explainer
Excess and co-payment in pet insurance.
Excess is what you pay before the insurer pays anything. Co-payment is your share of what's left after the insurer applies the reimbursement percentage. They're two separate levers that combine to determine your total out-of-pocket cost on every covered claim — and they often confuse new buyers because the marketing copy treats them as one number.
The difference, in one example
Imagine a $4,000 vet bill that's fully covered under your policy. With $200 excess and 80% reimbursement, your share of the cost looks like this:
The excess is fixed at $200. The co-payment is variable — it scales with the claim size. On a small $300 claim, the same $200 excess + 80% reimbursement combination still leaves you paying $200 excess plus $20 co-payment ($220 total, of which the insurer reimburses $80). On a $20,000 claim, the same setup means $200 excess + $3,960 co-payment ($4,160 out of pocket, with the insurer reimbursing $15,840). Excess is always the same dollar value; co-payment grows with the claim.
Excess is chosen at signup. Co-payment is set by reimbursement %.
You pick your excess from a tier list when you sign up — Australian pet insurance excess options typically range from $0 to $300, sometimes higher. A lower excess means a higher annual premium (because the insurer absorbs more of each claim). A higher excess means a lower premium and more out-of-pocket per claim.
Co-payment isn't selected directly — it's whatever percentage of the post-excess claim isn't covered by your reimbursement %. Choose 80% reimbursement and your co-payment is 20%. Choose 90% reimbursement and your co-payment is 10%. The reimbursement % at signup determines the co-payment by mathematical complement.
| Reimbursement chosen | Your co-payment |
|---|---|
| 60% | 40% |
| 70% | 30% |
| 80% | 20% |
| 90% | 10% |
| 100% (Coles Ultimate only) | 0% |
Per-claim excess vs per-condition excess
This is the most important PDS detail most buyers don't notice. Some brands apply excess per claim (every individual treatment incurs the excess again). Others apply excess per condition per policy year — the first claim for a condition triggers the excess, and subsequent claims for the same condition in the same policy year are excess-free. The difference matters enormously for chronic conditions or any treatment requiring multiple visits:
The Pacific International family (Knose, Pet Circle Insurance, RSPCA PetFlex, PetsOnMe, Fetch) and the PetSure-administered brands (BWM, PIA) generally use the per-condition annual excess model — verify the exact model in the current PDS, in the Excess section. The per-claim excess model is less common in Australian pet insurance now than a decade ago, but it still exists in some legacy products and lower-cost tiers.
Excess tier options at each AU pet insurer
Excess tiers vary by brand and by product tier within a brand. The exact tiers move between PDS revisions — the values below are taken from each brand's most recent PDS audit but should be confirmed in the current PDS at signup.
| Brand | Excess tier options | Default tier |
|---|---|---|
| RSPCA PetFlex | $0 / $80 / $200 / others per Cert | Quoted from $0 base |
| Knose | $0 / $100 only | $100 |
| Pet Circle Insurance | $100 default · others verify in PDS | $100 |
| Petsy | Standard tiered options per Cert | $150 in our quote sample |
| Coles Pet Insurance | Multiple tiers across 5 plans | Verify in PDS |
| Bow Wow Meow | $0 / $100 / $200 / $250 typical | $250 in our quote sample |
| Pet Insurance Australia | $200 default · tiered per Cert | $200 / $300 in our quote sample |
| PetsOnMe | Tiered per current PDS | Verify in PDS |
Knose has the narrowest excess flexibility — $0 or $100, no higher tier for premium reduction. RSPCA PetFlex has the widest range visible in our PDS audit. Most brands cluster their default offerings between $100 and $300; the headline premium quoted on a marketing page typically uses the brand's default excess (which varies — verify what excess the headline price assumes before comparing across brands).
How to choose your excess
The excess decision is essentially the same trade-off as the reimbursement % decision: pay more in premium for less out-of-pocket per claim, or pay less in premium for more out-of-pocket. The key difference is that excess is a fixed dollar value per claim (or per condition), where reimbursement is a percentage.
For a healthy young pet you expect to claim from infrequently, the higher excess option is usually right — the premium savings compound across multiple healthy years and the occasional bad year still doesn't lose enough to outweigh the savings. For an older pet or one with known issues, the lower excess option transfers more cost certainty to the insurer at higher premium.
Why excess and reimbursement % matter together
The two levers compound — both lever the same direction (toward your wallet on each claim). A "cheap policy" with $300 excess and 70% reimbursement looks fine until a single $5,000 claim leaves you out $300 + (30% × $4,700) = $1,710. A "premium policy" with $0 excess and 90% reimbursement on the same claim leaves you out $0 + (10% × $5,000) = $500 — a $1,210 swing.
Across multiple claims in a single year, the swing widens. Choose your excess and reimbursement % together rather than in isolation, and base both on a realistic worst-year scenario rather than a typical-year scenario. Insurance is a tool for the bad years; the math should reflect that.
This article is general information based on publicly available data. It doesn't constitute personal financial advice and isn't a recommendation about any particular pet insurance product. Excess tiers, reimbursement options, and per-claim vs per-condition excess models change between PDS revisions — always read the current Product Disclosure Statement before purchasing. Published 1 May 2026.