TL;DR
Choosing private medical insurance in the UK can feel complex, but at WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we believe in making it simple. This guide demystifies one of the most crucial choices you'll make: the type of underwriting for your policy. A plain-English guide to moratorium versus full medical underwriting in current UK policies When you apply for private health cover, the insurer needs to understand your health history to calculate the risk and decide what they can cover.
Key takeaways
- The Look-Back Period (5 Years): The insurer will not cover any condition you’ve experienced in the 5 years before your policy began.
- The Qualifying Period (2 Years): If you then go for a continuous 2-year period after your policy starts without having any symptoms, treatment, medication, or advice for that specific pre-existing condition, it may become eligible for cover.
- The 'Rolling' Nature: This 2-year clock resets every time you seek advice or treatment for that condition.
- Application: The process is fast. He answers a few simple questions but doesn't need to list his old shoulder injury. His policy is active within days.
- The Catch: For the first two years of his policy, any recurrence of that shoulder pain will not be covered.
Choosing private medical insurance in the UK can feel complex, but at WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we believe in making it simple. This guide demystifies one of the most crucial choices you'll make: the type of underwriting for your policy.
A plain-English guide to moratorium versus full medical underwriting in current UK policies
When you apply for private health cover, the insurer needs to understand your health history to calculate the risk and decide what they can cover. This process is called underwriting.
The two main ways they do this in the UK are Moratorium Underwriting and Full Medical Underwriting (FMU). Your choice between them affects what’s covered, how quickly you get your policy, and what happens when you need to make a claim. Understanding this difference is the key to finding the best private medical insurance policy for you and your family.
What is Underwriting in Private Medical Insurance?
Think of underwriting as the insurer's health check on you before they offer you a policy. Its main purpose is to identify any pre-existing medical conditions you've had in the past.
Why is this so important? Because standard private medical insurance in the UK is designed to cover new, acute conditions that arise after you join. It does not cover long-term, ongoing (chronic) conditions or medical issues you already had before taking out the policy.
Underwriting allows the insurer to set the terms of your contract, making it clear from the outset what will and won't be covered. This prevents surprises later and helps keep premiums fair and affordable for everyone in the insurance pool.
Moratorium Underwriting Explained
Moratorium underwriting is the most common type offered in the UK. It’s popular because it’s quick, simple, and doesn’t require you to fill out a long medical questionnaire.
Instead of asking about your entire medical history upfront, a moratorium policy applies a simple rule: it automatically excludes treatment for any medical condition you've had symptoms, treatment, or advice for in a set period before your policy starts (usually the last five years).
How Does a Moratorium Work? The '2-Year Rolling' Rule
The "moratorium" is a waiting period. Here’s the typical rule, broken down:
- The Look-Back Period (5 Years): The insurer will not cover any condition you’ve experienced in the 5 years before your policy began.
- The Qualifying Period (2 Years): If you then go for a continuous 2-year period after your policy starts without having any symptoms, treatment, medication, or advice for that specific pre-existing condition, it may become eligible for cover.
- The 'Rolling' Nature: This 2-year clock resets every time you seek advice or treatment for that condition.
Let's look at a simple table to illustrate.
| Timeline | Event | Is Treatment for Old Knee Pain Covered? |
|---|---|---|
| 2023 | You saw a GP for knee pain. | N/A (Before policy starts) |
| Jan 2025 | You take out a PMI policy with moratorium underwriting. | No. Your knee pain is a pre-existing condition from the last 5 years. |
| Jan 2027 | You have remained symptom-free and had no advice for your knee for 2 full years. | Yes. The condition may now be eligible for cover as you've passed the 2-year moratorium. |
| June 2026 | Alternative Scenario: You see a physio for a knee twinge. | No. The 2-year clock resets. You'd need to go another 2 years from June 2026 without issues for it to become eligible. |
A Real-Life Moratorium Example
Meet David. David is 45 and generally healthy. He wants private health cover quickly to bypass potential NHS queues for any future problems. He had some shoulder pain after a sports injury three years ago, which was resolved with a few physiotherapy sessions.
David chooses a policy with moratorium underwriting.
- Application: The process is fast. He answers a few simple questions but doesn't need to list his old shoulder injury. His policy is active within days.
- The Catch: For the first two years of his policy, any recurrence of that shoulder pain will not be covered.
- The Future: If David remains free of any shoulder trouble for two continuous years, his policy may then cover new issues with that shoulder from that point onwards. If, a year into his policy, he develops a new problem like back pain, it will be covered (subject to his policy terms) because it's not a pre-existing condition.
The Pros and Cons of Moratorium Underwriting
| Advantages (Pros) 👍 | Disadvantages (Cons) 👎 |
|---|---|
| Speed & Simplicity: No lengthy medical forms to complete. You can often get cover in place very quickly. | Lack of Certainty: You don't know for sure what's excluded until you make a claim. |
| Privacy: You don't need to disclose your full medical history at the start. | Claims Can Be Slower: When you claim, the insurer will investigate your medical history to see if the condition is pre-existing. This can add delays. |
| Potential for Future Cover: Pre-existing conditions can become eligible for cover over time if you remain symptom-free. | The 'Reset' Rule: The 2-year symptom-free period can be difficult to achieve for recurring issues, meaning they may never be covered. |
| Most Common Option: It's the standard offering from most major UK PMI providers. | "Grey Areas": It can be hard to define if a new symptom relates to an old condition, leading to potential disputes. |
Full Medical Underwriting (FMU) Explained
Full Medical Underwriting (FMU) is the opposite of a moratorium. It’s a more detailed process where you provide your complete medical history to the insurer upfront by filling out a comprehensive health questionnaire.
The insurer’s medical underwriters then review your application and decide precisely what they will and will not cover. Any specific conditions they decide to exclude are written explicitly into your policy documents. These are called exclusions.
How Does Full Medical Underwriting Work?
- The Application: You complete a detailed form asking about past illnesses, treatments, surgeries, and consultations. It's crucial to be completely honest and thorough.
- The Assessment: The insurer may also request access to your medical records from your GP (with your permission) to verify the information.
- The Decision: The insurer comes back with a decision. They might:
- Offer cover with no special exclusions.
- Offer cover but with specific, named exclusions for certain conditions (e.g., "no cover for treatment related to the spine").
- Offer cover for a condition but with a higher premium.
- In rare cases, decline to offer cover altogether.
A Real-Life FMU Example
Meet Chloe. Chloe is 52 and had a minor back issue five years ago that required an MRI scan. She also has a history of occasional migraines. She wants absolute clarity on what her private health insurance will cover from day one.
Chloe chooses a policy with Full Medical Underwriting.
- Application: She spends an hour filling out the health questionnaire, carefully detailing her back history and migraines. She gives the insurer permission to contact her GP.
- The Offer: The insurer reviews her file. They come back with a policy that explicitly states: "Cover is provided for all new, acute conditions, with the exception of any investigation or treatment related to degenerative spinal conditions." They decide her migraines are low-risk and agree to cover them.
- The Result: Chloe's premium might be slightly higher or lower than a moratorium policy, but she has complete certainty. She knows her back is excluded, but if she develops a new condition like gallstones, she is 100% confident it will be covered.
The Pros and Cons of Full Medical Underwriting
| Advantages (Pros) 👍 | Disadvantages (Cons) 👎 |
|---|---|
| Total Certainty: You know exactly what is and isn't covered from the very beginning. No surprises at the point of claim. | Slower Application: The process takes longer due to the detailed questionnaire and potential need for medical reports. |
| Faster Claims: Because underwriting is done upfront, claims are often processed more quickly as there's no need to investigate your past history. | Requires Full Disclosure: You must be prepared to share your entire medical history. Forgetting something can invalidate your policy. |
| Potential for Lower Premiums: If you're in good health with a clean medical history, an FMU policy can sometimes be cheaper than a moratorium equivalent. | Permanent Exclusions: Exclusions applied at the start are usually permanent and won't become eligible for cover later on. |
| Negotiable Terms: In some cases, you or your broker may be able to discuss the terms of an exclusion with the insurer. | More Intrusive: Some people find the process of sharing detailed personal health information uncomfortable. |
Moratorium vs. Full Medical Underwriting: A Head-to-Head Comparison
Choosing between these two underwriting methods is a personal decision based on your priorities. Here’s a direct comparison to help you decide.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Speed | Fast. Often minutes or hours. | Slow. Can take days or weeks. |
| Convenience | High. No long forms. | Low. Requires detailed health questionnaire. |
| Upfront Certainty | Low. You only find out what's excluded when you claim. | High. All exclusions are clearly stated in your policy documents. |
| Claim Speed | Slower. Insurer investigates your history at the time of claim. | Faster. Underwriting is already complete. |
| Privacy | High. No need to disclose medical history at the start. | Low. You must provide a full medical history. |
| Cover for Pre-existing Conditions | Possible after a 2-year symptom-free period. | Unlikely. Conditions are typically excluded permanently. |
| Best For... | People who want cover quickly, have a clean or simple medical history, and value privacy. | People who want absolute clarity, have a complex medical history, or want to ensure faster claims. |
The Critical Point: Pre-existing and Chronic Conditions
This is the single most important concept to grasp about private medical insurance in the UK.
Standard UK PMI is designed to cover acute conditions that begin after your policy starts. It is not designed to cover pre-existing conditions or chronic conditions.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery (e.g., appendicitis, a broken bone, cataracts, a hernia).
- Chronic Condition: An illness that is long-lasting or recurring and cannot be fully cured (e.g., diabetes, asthma, high blood pressure, eczema, arthritis).
Insurers exclude chronic conditions because managing them is long-term and costly. Covering them would make premiums unaffordable for the majority of people. PMI acts as a complement to the NHS, which provides excellent care for chronic conditions, allowing you to get fast access to treatment for new, curable health problems.
Regardless of whether you choose moratorium or FMU underwriting, long-term chronic conditions will not be covered.
Which Type of Underwriting is Right for Me?
Your personal circumstances and preferences will guide your choice. As expert PMI brokers, the team at WeCovr can provide personalised advice, but here are some general guidelines.
You might favour Moratorium Underwriting if:
- You are in good health and haven't seen a doctor for anything significant in the last five years.
- Your priority is getting covered as quickly and easily as possible.
- You prefer not to disclose your entire medical history.
- You have minor pre-existing conditions that you expect to remain symptom-free, hoping they will become covered in the future.
You might favour Full Medical Underwriting if:
- You want absolute certainty about what your policy covers from day one.
- You have a more complex medical history and want to know precisely where you stand.
- You believe you are in excellent health and want to see if you can get a cheaper premium by proving it.
- The idea of a claim being delayed or rejected due to a pre-existing condition worries you more than the upfront paperwork.
How WeCovr Can Help You Choose the Best PMI Policy
With NHS waiting lists in England remaining a significant concern for millions, according to official NHS data, taking control of your health with PMI is a sensible step. But navigating the market alone can be daunting.
That’s where an independent broker like WeCovr comes in.
- Expert, No-Cost Advice: Our specialists understand the nuances of every major UK insurer's underwriting rules. We can explain your options in plain English and help you decide between moratorium and FMU based on your specific needs. Our advice is free to you.
- Market Comparison: We compare policies from leading providers like Bupa, Aviva, AXA Health, and Vitality to find the right cover at the right price.
- Hassle-Free Process: We handle the paperwork and liaise with the insurer on your behalf, making the application process smooth and simple.
- High Customer Satisfaction: We pride ourselves on our service, which is reflected in the positive feedback we receive on independent customer rating websites.
As a WeCovr client, you also get complimentary access to our AI-powered nutrition app, CalorieHero, to help you stay on top of your health goals. Plus, clients who take out a private medical or life insurance policy with us are eligible for discounts on other types of cover, like home or car insurance.
A Note on Your Health and Wellbeing
While private medical insurance is an excellent tool for when things go wrong, the best strategy is always proactive health management. Insurers increasingly recognise this, often including wellness benefits and rewards in their policies.
- Diet: A balanced diet rich in fruits, vegetables, and whole grains is fundamental to good health. Using an app like CalorieHero can help you understand your nutritional intake and make healthier choices.
- Exercise: The NHS recommends at least 150 minutes of moderate-intensity activity a week. This could be brisk walking, cycling, or swimming. Regular activity reduces the risk of many conditions that PMI is designed to treat.
- Sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep is linked to a range of health issues, including a weakened immune system and high blood pressure.
By combining a healthy lifestyle with the security of a well-chosen PMI policy, you put yourself in the strongest possible position to manage your health.
Frequently Asked Questions (FAQ) about PMI Underwriting
Can I get private health cover for my asthma?
What happens if I forget to declare a condition on a Full Medical Underwriting (FMU) form?
Can I switch from a moratorium policy to a fully medically underwritten one?
Is moratorium underwriting always cheaper than full medical underwriting?
Ready to take the next step?
Choosing the right underwriting method is the foundation of a good private medical insurance policy. Let our friendly, expert team at WeCovr help you build a plan that gives you peace of mind and fast access to the best care.
Get your free, no-obligation PMI quote from WeCovr today.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
