Navigating UK Private Health Insurance: What You Need to Know About Moratorium and Full Medical Underwriting
UK Private Health Insurance Moratorium vs. Full Medical Underwriting Explained
Navigating the world of private medical insurance (PMI) in the UK can feel like deciphering a complex medical textbook written in a foreign language. Amidst the various policy types, benefits, and exclusions, two terms often stand out, causing confusion for many: Moratorium underwriting and Full Medical Underwriting. These are the two primary methods insurers use to assess your health history and determine what your policy will – and won't – cover.
Choosing the right underwriting method is not merely a formality; it's a decision that profoundly impacts your peace of mind, the clarity of your coverage, and crucially, your experience at the point of making a claim. A misstep here can lead to unexpected exclusions, denied claims, and significant financial or emotional stress precisely when you need your insurance most.
This comprehensive guide aims to demystify Moratorium and Full Medical Underwriting, explaining their intricacies, advantages, disadvantages, and how they relate to the crucial aspects of pre-existing and chronic conditions. By the end, you'll have a clear understanding of which method might be best suited for your individual needs, empowering you to make an informed decision about your health protection.
The Core Purpose of Private Health Insurance in the UK
Before diving into the specifics of underwriting, it's essential to understand why private health insurance is a valuable consideration for many in the UK. While the National Health Service (NHS) provides excellent care, it faces immense pressures, leading to longer waiting lists for consultations, diagnostic tests, and treatments, especially for non-emergency conditions.
Private medical insurance offers an alternative pathway, providing:
- Faster Access to Treatment: Significantly reduced waiting times for specialist appointments, diagnostics (MRI, CT scans, etc.), and surgeries.
- Choice and Control: The ability to choose your consultant, hospital, and often the timing of your appointments, giving you greater control over your healthcare journey.
- Comfort and Privacy: Access to private rooms, often with en-suite facilities, flexible visiting hours, and a generally more comfortable hospital experience.
- Specialised Care: Access to the latest treatments, drugs, and technologies that may not be immediately or widely available on the NHS.
- Peace of Mind: Knowing that if a new acute condition arises, you have a clear path to prompt and high-quality medical attention.
However, it's equally important to clarify what private health insurance typically doesn't cover. Policies are generally designed for acute conditions – illnesses or injuries that are sudden in onset and short-lived, with the aim of restoring you to your previous state of health. They usually do not cover:
- Chronic Conditions: Long-term illnesses that cannot be cured, such as diabetes, asthma, hypertension, or multiple sclerosis. While private insurance may cover acute flare-ups or diagnostic tests for such conditions, ongoing management, medication, or routine monitoring falls outside the scope.
- Pre-existing Conditions: Conditions you've had symptoms, advice, or treatment for before taking out the policy. The extent to which these are excluded is precisely what underwriting methods determine.
- Emergency Care: A&E visits or emergency services are generally handled by the NHS.
- Routine Care: GP appointments (unless an add-on), dental check-ups, eye tests, or cosmetic procedures.
- Pregnancy and Childbirth: Unless specifically added, these are often excluded or have long waiting periods.
Understanding this fundamental distinction between acute and chronic conditions, and what constitutes a pre-existing condition, is paramount before you even consider underwriting.
Understanding Medical Underwriting: Why It Matters
At its heart, medical underwriting is the process by which an insurer assesses your health risks. Think of it as the insurer's way of understanding your potential future claims based on your past and current health status. This assessment allows them to:
- Determine Eligibility: Decide whether to offer you cover at all.
- Set Premiums: Calculate a fair price for your policy, reflecting your individual risk profile.
- Define Exclusions: Specify any conditions that will not be covered by your policy.
Without underwriting, insurers would be taking on unknown risks, which would make private health insurance unsustainable. It ensures that the premiums paid by the majority are sufficient to cover the claims of those who fall ill, without being disproportionately burdened by individuals with significant pre-existing health issues.
The two main methods of underwriting in the UK are Moratorium and Full Medical Underwriting. While both serve the same purpose – risk assessment – they approach it in fundamentally different ways, impacting your upfront experience and, more critically, your claims journey.
Deep Dive: Moratorium Underwriting (Mori)
Moratorium underwriting, often simply referred to as 'Mori', is a popular choice for its simplicity and immediate activation. It's designed to be straightforward at the application stage, but it shifts the burden of proof regarding pre-existing conditions to the point of claim.
What it is
With Moratorium underwriting, you generally do not have to provide a detailed medical history upfront. The insurer asks very few, if any, medical questions during the application process. Instead, they apply a 'moratorium' – a temporary exclusion – to any medical condition you've experienced or received advice/treatment for within a specific period before the policy starts. This period is known as the 'qualifying period' or 'pre-moratorium period'.
The "Qualifying Period"
This is typically the 5 years immediately preceding the start date of your policy. Any condition you've had in those five years will be automatically excluded at the policy's inception.
The "Exclusion Period" / "Waiting Period"
For a condition to potentially become covered under a moratorium policy, you typically need to experience a period of time, usually two consecutive years, without any symptoms, treatment, medication, or advice for that specific condition after your policy starts. This is often referred to as the 'claim-free period' or 'waiting period' for that specific pre-existing condition.
How it Works in Practice
Let's illustrate with some scenarios:
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Scenario A: New Condition Post-Policy Start (Covered)
- You take out a moratorium policy. Six months later, you develop sudden, severe back pain for the first time in your life.
- Outcome: As this is a new, acute condition that arose after your policy started and isn't related to any prior history in the qualifying period, it will typically be covered.
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Scenario B: Old Condition Reappears (Excluded Initially)
- Five years ago, you had a brief bout of mild eczema on your arm, which cleared up quickly and you haven't had any issues since. You take out a moratorium policy today. One year into your policy, the eczema flares up again.
- Outcome: Because you had symptoms of eczema within the 5-year qualifying period, it is automatically excluded. When it flares up, it will not be covered, as you have not yet completed two consecutive years claim-free since the policy started.
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Scenario C: Old Condition Becomes Covered (After the "All-Clear")
- Two years ago, you had a single episode of gastritis (stomach inflammation) that was treated and resolved. You haven't had any symptoms or treatment for it since. You take out a moratorium policy today.
- Outcome: The gastritis is automatically excluded at the start of your policy. However, if you complete two full, consecutive years of your policy without any symptoms, treatment, or advice for gastritis, then after those two years, it could become eligible for cover should it reoccur. If it flared up before those two years were complete, it would remain excluded.
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Scenario D: Chronic Condition (Not Covered)
- You were diagnosed with Type 2 diabetes four years ago and manage it with medication. You take out a moratorium policy.
- Outcome: Diabetes is a chronic condition. Even if you complete two years without a 'flare-up' requiring acute treatment, the underlying chronic condition and its ongoing management will never be covered under a standard private health insurance policy, regardless of underwriting method. This is a crucial distinction.
The key takeaway with moratorium is that the insurer conducts their medical underwriting at the point of claim. When you make a claim, they will request your full medical history from your GP to ascertain if the condition is pre-existing and, if so, whether it has cleared the two-year claim-free period.
Advantages of Moratorium Underwriting
- Speed and Simplicity: The application process is much quicker and requires minimal paperwork upfront. You can often get cover in minutes.
- Privacy (Initially): You don't have to disclose sensitive medical details to the insurer immediately.
- Good for Healthy Individuals: If you're generally healthy with little to no recent medical history, it can be a straightforward path to cover.
- Potential for Future Coverage: If a minor, acute pre-existing condition genuinely resolves and stays resolved for two years, it can then become covered.
Disadvantages of Moratorium Underwriting
- Uncertainty at Claim Stage: This is the biggest drawback. You won't know for sure if a pre-existing condition is covered until you make a claim. This can lead to unexpected denials and frustration.
- Less Clarity: The policy wording regarding pre-existing conditions can be broad, making it difficult for you to interpret what might or might not be covered.
- No Appeal Process: If a claim is denied because the condition is deemed pre-existing and hasn't cleared the moratorium, there's generally no room for negotiation or appeal based on medical reports.
- Problematic for Fluctuating Conditions: If you have conditions that tend to recur intermittently (e.g., specific pains, skin conditions), they may never clear the two-year period, meaning they remain perpetually excluded.
- Can be more expensive: While often perceived as cheaper, for individuals with complex or frequent health issues that might struggle to clear the 2-year period, it can effectively mean you pay for cover that doesn't include significant aspects of your health history.
Who it's Best For
Moratorium underwriting is often a good fit for:
- Individuals who are generally healthy and have very little to no medical history within the last five years.
- Those who value a quick, easy application process and are comfortable with the uncertainty at the point of claim regarding potential pre-existing conditions.
- People who have had minor, acute conditions in the past that they are confident will not recur, or which they are prepared to pay for themselves if they do.
Table: Moratorium Underwriting Pros & Cons
| Feature | Pros | Cons |
|---|
| Application | Quick, minimal medical questions, easy to set up. | No upfront clarity on pre-existing condition coverage. |
| Clarity | Simple at application. | Uncertainty about what is covered at claim stage. |
| Privacy | No need to disclose detailed history upfront. | Full medical history required at claim stage. |
| Pre-existing Conditions | May become covered after 2 years claim-free. | Automatically excluded for 5 years initially; uncertainty on what exactly counts as "pre-existing". |
| Claim Process | Straightforward for new conditions. | Insurer investigates medical history thoroughly, potential for denied claims if not understood. |
| Cost | Often appears competitive initially. | Value depends on whether pre-existing conditions become covered. |
Deep Dive: Full Medical Underwriting (FMU)
Full Medical Underwriting (FMU) takes a different approach, prioritising clarity and certainty from day one. It's a more rigorous process upfront, but it aims to remove surprises later on.
What it is
With FMU, you provide a comprehensive medical history to the insurer at the time of application. This typically involves completing a detailed medical questionnaire, outlining any past or present conditions, symptoms, treatments, and medications. The insurer's medical underwriters then review this information to assess your risk profile.
The Process
- Detailed Application Form: You'll complete a thorough questionnaire covering your health history, symptoms, diagnoses, treatments, and family medical history. This might include questions about specific systems (e.g., cardiovascular, musculoskeletal) and general health.
- GP Report Requests (if needed): For certain conditions or if your answers require clarification, the insurer may request a medical report from your General Practitioner (GP). They will always seek your explicit consent before contacting your GP, and you usually cover the cost of the report, though some insurers may reimburse this.
- Underwriter Review: A specialist underwriter will review all the information provided.
- The Offer: Based on their assessment, the insurer will typically issue one of the following:
- "Clean" Acceptance: Your policy is issued with no specific exclusions or premium loadings. This usually happens if you have a very clean medical history.
- Specific Exclusions: The most common outcome. The insurer will permanently exclude certain pre-existing conditions from your cover. For example, if you've had a knee injury, the policy might state "Knee conditions (right) permanently excluded."
- Premium Loading: For a higher perceived risk, the insurer might apply an additional percentage to your premium (e.g., +10% premium) instead of or in addition to exclusions.
- Postponement: If you have an active or very recent condition, the insurer might postpone offering cover until the condition has stabilised or a certain period has passed.
- Refusal: In rare cases of extremely high risk, the insurer might decline to offer cover.
Types of Exclusions in FMU
Exclusions under FMU are usually specific and permanent. This means that if a condition is excluded, it will not be covered for the lifetime of that policy. Unlike moratorium, these exclusions won't magically disappear after a certain period.
Advantages of Full Medical Underwriting
- Clarity from Day One: You know exactly what is and isn't covered before you need to make a claim. This provides immense peace of mind.
- Fewer Surprises at Claim Stage: Since all the medical history has been assessed upfront, the claims process for covered conditions is generally smoother and less likely to lead to unexpected denials.
- Potential for Pre-existing Condition Coverage: While many pre-existing conditions are excluded, some minor or well-managed conditions might be covered if the insurer assesses the risk as acceptable, possibly with a premium loading. This is not typically possible with moratorium.
- Tailored Policy: The policy is specifically tailored to your health profile, ensuring it's as comprehensive as possible given your medical history.
Disadvantages of Full Medical Underwriting
- Longer Application Process: The application takes more time and effort due to the detailed questionnaire and potential for GP reports.
- Less Privacy (Initially): You must disclose your full medical history to the insurer.
- Potential for Higher Premiums or More Exclusions: If you have a significant medical history, your premium might be higher, or you may face more permanent exclusions than with moratorium.
- GP Report Fees: You might incur a fee for your GP to provide a medical report, though some insurers may cover this.
- Can be Daunting: For some, the thought of detailing their entire medical history can feel overwhelming.
Who it's Best For
Full Medical Underwriting is often the preferred choice for:
- Individuals with a known medical history who want absolute certainty about what their policy covers.
- Those who prefer to deal with any potential exclusions or premium loadings upfront rather than at the point of claim.
- People with stable, well-managed pre-existing conditions that they might hope to get covered (even with a loading) or who want clear, permanent exclusions.
- Anyone who prioritises clarity and peace of mind above a quick application process.
Table: Full Medical Underwriting Pros & Cons
| Feature | Pros | Cons |
|---|
| Application | Detailed, takes more time, may require GP reports. | Can be lengthy and feel intrusive. |
| Clarity | Full clarity on specific exclusions from day one. | Upfront exclusions mean certain conditions are never covered. |
| Privacy | Detailed medical history disclosed upfront. | Less initial privacy. |
| Pre-existing Conditions | Clearly excluded or covered (with possible loading) from policy start. | Once excluded, generally permanently excluded for the policy's lifetime. |
| Claim Process | Smoother for covered conditions, as assessment is done. | No surprises, but clarity may mean no cover for certain pre-existing conditions. |
| Cost | Premiums reflect known risk; may be higher if medical history is complex. | Higher initial premiums for higher risk profiles. |
Key Differences and Commonalities: Moratorium vs. FMU
To truly grasp the distinction, let's put the two methods side-by-side.
Table: Moratorium vs. Full Medical Underwriting - A Direct Comparison
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|
| Initial Process | Minimal medical questions upfront. Quick setup. | Detailed medical questionnaire. Can involve GP reports. Slower setup. |
| Pre-existing Conditions | Automatically excluded for 5 years initially; may be covered after 2 years claim-free. | Declared upfront and either permanently excluded, covered (possibly with loading), or policy refused. |
| Clarity of Cover | Less clear upfront; clarity only at claim stage. | Absolute clarity on what is covered and excluded from day one. |
| Privacy | More private initially; full medical history reviewed at claim. | Less private initially; full medical history reviewed upfront. |
| Claim Process | Insurer investigates medical history at claim to check for pre-existing conditions. Potential for unexpected denials. | Smoother claims for covered conditions as assessment is done. Few surprises. |
| Suitability | Best for generally healthy individuals with minimal/no recent medical history. | Best for those with known medical history who want certainty, or those hoping specific conditions might be covered. |
| Exclusions | Broad, applies to any condition in the 5-year qualifying period. Can 'lift' after 2 clear years. | Specific, permanent exclusions for declared pre-existing conditions. |
Common Ground
Despite their differences in approach, both Moratorium and FMU underwriting share fundamental principles within UK private health insurance:
- Focus on Acute Conditions: Both methods are designed to cover acute, curable conditions, not chronic illnesses that require ongoing management.
- Exclusion of Chronic Conditions: Neither method will typically cover the long-term management of chronic conditions like diabetes, asthma, or hypertension.
- NHS for Emergencies: Both assume the NHS will handle emergency care (A&E) and routine GP visits (unless specific add-ons are purchased).
- Risk Assessment: At their core, both are tools for the insurer to assess risk and price policies appropriately.
- Importance of Honesty: Regardless of the method, it is crucial to be entirely honest and transparent. Misrepresentation, even unintentional, can lead to policy voidance or denied claims.
The Crucial Aspect of Pre-existing and Chronic Conditions
This is perhaps the most misunderstood area of private health insurance, and it's vital to grasp the distinctions regardless of your chosen underwriting method.
What is a "Pre-existing Condition"?
In the context of private health insurance, a "pre-existing condition" is generally defined as any illness, injury, or disease (or symptoms of them) for which you've experienced symptoms, sought advice, or received treatment, medication, or diagnosis before the start date of your private health insurance policy. The look-back period for this varies by insurer and underwriting method (e.g., 5 years for moratorium).
Examples:
- You had recurring knee pain last year that you saw a physiotherapist for.
- You've been on medication for high cholesterol for the past three years.
- You had a suspicious mole removed two months ago.
What is a "Chronic Condition"?
A "chronic condition" is a disease or illness that:
- Has no known cure.
- Requires ongoing or long-term management.
- Is likely to recur or persist.
Examples:
- Diabetes: Requires lifelong management of blood sugar levels.
- Asthma: Requires ongoing medication and management of airways.
- Hypertension (High Blood Pressure): Requires long-term medication and monitoring.
- Multiple Sclerosis (MS): A progressive neurological condition.
- Rheumatoid Arthritis: An autoimmune disease causing chronic joint inflammation.
Why Insurers Do Not Cover Chronic Conditions
Private medical insurance is built on the principle of covering acute healthcare needs – conditions that are expected to resolve through treatment, restoring you to health. Chronic conditions, by their very definition, are incurable and require continuous care. Covering such conditions would make the premiums prohibitively expensive for most, as the cost of ongoing medication, monitoring, and management is substantial and indefinite.
This is a fundamental pillar of how UK private health insurance operates. Neither Moratorium nor Full Medical Underwriting will lead to the coverage of the chronic management of a long-term condition.
The Nuance: Acute Flare-ups of Chronic Conditions
This is where it gets slightly more complex. While the chronic condition itself is excluded, an acute flare-up of a chronic condition that requires specific, short-term treatment to get it back under control might be covered if:
- The underlying chronic condition was disclosed and accepted (under FMU, perhaps with a loading).
- Or, under moratorium, if the acute flare-up is treated as a new, acute episode and the specific criteria are met (e.g., if the condition that caused the flare-up wasn't pre-existing). This is very rare.
Example:
- You have asthma (a chronic condition, generally excluded). If you develop a severe, acute chest infection that is a direct result of your asthma and requires hospitalisation and intensive, acute treatment to clear the infection and get your breathing stable again, the acute treatment for the infection might be covered. However, the ongoing management, medication, or regular check-ups for your asthma itself would not be.
- For a pre-existing chronic condition that has been permanently excluded under FMU, even an acute flare-up related to it would typically be excluded.
It is crucial to understand that even if a pre-existing acute condition becomes covered under moratorium (i.e., you've gone two years clear), if that condition then becomes chronic, the policy will cease to cover the chronic aspect of it.
Navigating the Claim Process with Each Underwriting Method
The moment of truth for any insurance policy is when you need to make a claim. Your underwriting method will significantly influence this experience.
Claiming with Moratorium Underwriting
When you make a claim under a moratorium policy, especially for a condition that could potentially be pre-existing, this is when the insurer will delve into your medical history.
- Notification: You inform your insurer of your symptoms or diagnosis.
- GP Records Request: The insurer will ask you for consent to obtain your full medical records from your GP (typically for the last five years, matching their qualifying period).
- Review: Their medical team will meticulously review your notes to determine:
- If you had any symptoms, advice, or treatment for the current condition (or a related one) within the 5 years before your policy started.
- If so, whether you have subsequently had two consecutive years without symptoms, treatment, or advice for that specific condition since your policy began.
- Decision:
- If the condition is deemed new and acute (i.e., no prior history in the qualifying period), the claim proceeds as normal.
- If it is deemed pre-existing and has not cleared the two-year claim-free period, the claim will be denied, and the condition will remain excluded until the two-year period is met.
- If it is deemed pre-existing and has cleared the two-year claim-free period, the claim will typically be covered.
This process highlights the uncertainty of moratorium. You might believe a condition is new, but your medical records could reveal a fleeting symptom or a single GP visit years ago that the insurer deems relevant, leading to a denial.
Claiming with Full Medical Underwriting (FMU)
The claim process with FMU is generally more straightforward for conditions that are not explicitly excluded:
- Notification: You inform your insurer of your symptoms or diagnosis.
- Referral: Your insurer will guide you on getting a GP referral to a private specialist.
- No Surprise Medical History Dive: Because your medical history has already been assessed and accepted (or excluded) upfront, the insurer typically won't conduct another deep dive into your past records for conditions already known to them.
- Decision:
- If the condition is covered by your policy (i.e., not one of your specific exclusions), the claim proceeds smoothly.
- If the condition is one of your pre-agreed exclusions, the claim will be denied, but this denial comes with no surprise, as you were aware of the exclusion from the outset.
The peace of mind that comes with knowing precisely what is covered before you even need treatment is a significant advantage of FMU.
Choosing the Right Underwriting Method for You
The "best" underwriting method isn't universal; it depends entirely on your personal circumstances, medical history, and appetite for risk.
Consider Your Health History
- Generally Healthy with No Recent Issues? Moratorium might seem appealing due to its ease and speed. However, ensure you genuinely have a minimal medical footprint over the last five years. Even seemingly minor past ailments can cause issues at claim time with moratorium.
- Known Medical Conditions (even if resolved) within the last 5 years? FMU is often recommended. While you might face initial exclusions, you'll have absolute clarity. With moratorium, you'd be hoping these conditions don't recur for two years, which is a gamble.
- Multiple, Minor Past Issues? Moratorium could mean a long list of potential future exclusions that you only discover at claim. FMU would likely give you upfront, permanent exclusions, but at least you'd know.
Your Preference for Certainty vs. Simplicity
- Value Certainty and Clarity Above All Else? FMU is your best bet. You want to know exactly where you stand, even if it means a bit more effort upfront.
- Prioritise a Quick, No-Fuss Application? Moratorium offers this, but be prepared for the potential for less certainty later on.
Your Risk Tolerance
- Comfortable with Uncertainty? If you're willing to take a chance that a past, minor condition won't recur (and therefore become covered after two years) or are prepared to self-fund if it does, moratorium could work.
- Prefer to Minimise Risk and Surprises? FMU removes the guesswork.
Long-Term Perspective
- Are you likely to switch insurers frequently? This is a critical point. If you start with moratorium and later switch to a new insurer, you typically start the moratorium clock again, meaning your pre-existing conditions won't have cleared. If you have FMU, you might be able to transfer your specific exclusions via a process called Continued Personal Medical Exclusions (CPME) to a new insurer, maintaining continuity.
Understanding these factors is key, and it's precisely where impartial, expert advice can make all the difference.
The Role of a Broker Like WeCovr
Choosing between moratorium and full medical underwriting, and then selecting the right policy from the multitude of insurers available, can be a daunting task. This is where a specialist health insurance broker like WeCovr becomes invaluable.
At WeCovr, we act as your independent guide through the complex landscape of UK private health insurance. We don't work for a single insurer; instead, we work for you. This allows us to provide truly impartial advice, comparing options from all the major UK insurers, including Bupa, AXA PPP Healthcare, Vitality, Aviva, WPA, and others.
How we help:
- Understanding Your Needs: We take the time to understand your unique health history, preferences, and budget to recommend the most suitable underwriting method and policy structure for you.
- Explaining the Nuances: We translate the complex jargon of insurance policies into clear, understandable language, ensuring you grasp the implications of each underwriting choice. We'll walk you through real-life scenarios for both moratorium and FMU.
- Comparing the Market: Instead of you spending hours researching individual insurer offerings, we do the heavy lifting, providing you with a side-by-side comparison of policies that meet your specific requirements.
- Navigating Complex Medical Histories: If you have a tricky medical history, we can guide you through the FMU application process, knowing what information insurers need and how best to present it to secure the most favourable terms.
- No Cost to You: Critically, our service comes at absolutely no cost to you. We are remunerated by the insurer if you take out a policy through us, meaning our advice is free, unbiased, and focused on finding you the best coverage.
Leveraging our expertise means you benefit from a clear, informed decision without the stress and time commitment of going it alone. We ensure you understand the fine print, so there are no surprises down the line.
Switching Private Health Insurance Providers
The underwriting method you initially choose also plays a significant role if you decide to switch private health insurance providers in the future.
Impact of Underwriting on Switching
- Switching from Moratorium to a New Moratorium Policy: If you move from one moratorium policy to another, the 2-year claim-free period for any pre-existing condition generally resets with the new insurer. This means you'd have to go another two years without symptoms for that condition to potentially be covered by your new policy. This is a common pitfall for those who jump between insurers.
- Switching from Full Medical Underwriting (FMU) - Continued Personal Medical Exclusions (CPME): This is where FMU offers a distinct advantage for continuity. Many insurers offer a feature called Continued Personal Medical Exclusions (CPME) or similar. If you switch from an FMU policy to a new FMU policy with a new insurer, and your previous policy was underwritten and in force for a certain period (e.g., 12 months), the new insurer may honour the exclusions you already have. This means you won't have to go through the full medical underwriting process again from scratch with the new insurer. Your previously declared conditions remain excluded, and newly developed conditions (since your old policy started) can be covered by the new policy. This provides excellent continuity of cover.
- Switching from Moratorium to FMU: If you've been on a moratorium policy and decide you want the certainty of FMU with a new insurer, you will go through the full medical underwriting process. Any conditions that were 'dormant' under your moratorium policy but now appear in your medical history will be assessed and likely excluded or have a loading applied.
The implication here is significant: staying with the same insurer under FMU, or leveraging CPME when switching FMU policies, helps you maintain continuity of cover. Frequently switching moratorium policies can mean you might never clear the exclusion period for conditions that sporadically recur.
Common Misconceptions and Important Considerations
The world of health insurance is rife with misunderstandings. Let's address some common ones.
Misconception 1: "Private health insurance covers everything."
Reality: Absolutely not. As discussed, private health insurance in the UK is primarily designed for acute conditions. It does not replace the NHS for emergencies (A&E), nor does it cover chronic conditions, general practice care, or purely cosmetic procedures. It's a supplementary service, not an all-encompassing solution.
Misconception 2: "Moratorium is always cheaper than FMU."
Reality: While moratorium might appear cheaper initially due to the lack of upfront risk assessment, this isn't always the case long-term. If you have a complex history that under FMU would lead to specific exclusions, but under moratorium constantly triggers new 2-year periods for different flare-ups, you might end up paying for cover that doesn't include the issues you actually experience. An FMU policy, while potentially having a higher premium or more exclusions, provides clear, defined cover for the price.
Misconception 3: "Once I have private insurance, I don't need the NHS."
Reality: This is dangerous thinking. The NHS remains your primary point of contact for emergencies (e.g., heart attack, severe accident), and for the ongoing management of chronic conditions. Private health insurance complements, rather than replaces, the NHS. You'll still rely on your GP for referrals, and the NHS for immediate, life-threatening situations.
Important Considerations:
- Full Disclosure is Paramount (Even with Moratorium): Even with moratorium, you must be honest about your health history if asked, and always when making a claim. Deliberate non-disclosure or misrepresentation can lead to your policy being voided from inception, meaning any claims paid could be reclaimed by the insurer.
- Read the Policy Wording: Always, always read the full policy document. Understand the definitions of "pre-existing," "chronic," and any specific exclusions. If in doubt, ask your broker or the insurer directly.
- Review Your Needs Annually: Your health and financial circumstances can change. It's wise to review your policy and underwriting method annually, especially if your health history evolves.
- Definition of "Symptom": Insurers often have broad definitions of a "symptom," which can mean you might unknowingly have a pre-existing condition. Even vague aches, pains, or feelings that didn't lead to a diagnosis can be considered symptoms.
Final Thoughts and Your Next Steps
Choosing the right private health insurance policy, and specifically the correct underwriting method, is one of the most significant decisions you can make for your health and financial peace of mind. Both Moratorium and Full Medical Underwriting offer distinct advantages and disadvantages, and the "right" choice is highly personal.
- If you prioritise simplicity and have a remarkably clean recent medical history, moratorium might appeal. But be prepared for the insurer's scrutiny at claim time.
- If certainty, clarity, and comprehensive upfront knowledge are your priorities, especially if you have any pre-existing conditions, Full Medical Underwriting is generally the superior option.
The key is to avoid making this decision in isolation. The complexities of medical terminology, insurer definitions, and the long-term implications of your choice demand expert guidance.
We strongly encourage you to speak with a specialist health insurance broker. At WeCovr, we are dedicated to helping individuals and families across the UK navigate these choices with confidence. We'll listen to your needs, explain your options clearly, compare policies from all major insurers, and guide you through the application process – all at no cost to you. Our aim is to ensure you have the best possible coverage tailored to your unique circumstances, giving you peace of mind that your health is in capable hands.
Don't leave your health protection to chance. Understand your options, choose wisely, and embrace the peace of mind that comes with a well-suited private health insurance policy.