TL;DR
Choosing a private medical insurance (PMI) policy in the UK can feel like navigating a maze of unfamiliar terms. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows the biggest point of confusion for new clients is often "underwriting." This single choice determines how an insurer views your past health and, crucially, what they will and won't cover. A jargon-free comparison of the two main underwriting methods, explaining the pros, cons, and which one gets you covered faster This guide will demystify the two main types of medical underwriting in the UK: Moratorium and Full Medical Underwriting (FMU).
Key takeaways
- Application: The application is quick. You provide basic personal details but no medical history.
- The "Moratorium Period": Your policy will exclude any medical condition for which you have had symptoms, treatment, medication, or advice in the 5 years before your policy start date.
- The "Two-Year Rule": This exclusion is not necessarily permanent. If you remain on the policy for a continuous two-year period without experiencing any symptoms, needing treatment, or seeking advice for that specific pre-existing condition, it will likely become eligible for cover in the future.
- For the first 2 years of your new policy, any issues with that knee will be excluded.
- If, during those 2 years, your knee is perfectly fine and you don't see a doctor, physio, or specialist for it, your policy may then start covering new issues with that knee from year 3 onwards.
Choosing a private medical insurance (PMI) policy in the UK can feel like navigating a maze of unfamiliar terms. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows the biggest point of confusion for new clients is often "underwriting." This single choice determines how an insurer views your past health and, crucially, what they will and won't cover.
A jargon-free comparison of the two main underwriting methods, explaining the pros, cons, and which one gets you covered faster
This guide will demystify the two main types of medical underwriting in the UK: Moratorium and Full Medical Underwriting (FMU). By the end, you'll understand exactly how they work, the key differences, and be able to confidently choose the right path for your health and financial peace of mind in 2026.
First, What is Medical Underwriting Anyway?
In simple terms, medical underwriting is the process a health insurance provider uses to assess your health and medical history before they offer you a policy. Their goal is to understand the level of risk they are taking on.
This is the most important fact to understand about UK private health cover:
Private medical insurance is designed to cover new, acute conditions that arise after your policy begins.
An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. It is not designed to cover long-term, incurable conditions, known as chronic conditions (like diabetes or asthma), or medical issues you already have, known as pre-existing conditions.
The type of underwriting you choose dictates how the insurer will handle any pre-existing conditions.
Moratorium Underwriting: The "Get Covered Fast" Option
Moratorium underwriting is the most common and straightforward way to get private health cover. Think of it as a "buy now, assess later" approach.
You don't need to complete a detailed medical questionnaire when you apply. Instead, the insurer applies a blanket waiting period for any medical conditions you've experienced in the recent past (typically the last five years).
How does it work?
- Application: The application is quick. You provide basic personal details but no medical history.
- The "Moratorium Period": Your policy will exclude any medical condition for which you have had symptoms, treatment, medication, or advice in the 5 years before your policy start date.
- The "Two-Year Rule": This exclusion is not necessarily permanent. If you remain on the policy for a continuous two-year period without experiencing any symptoms, needing treatment, or seeking advice for that specific pre-existing condition, it will likely become eligible for cover in the future.
A Real-Life Example: Imagine you had physiotherapy for knee pain 3 years before taking out a moratorium policy.
- For the first 2 years of your new policy, any issues with that knee will be excluded.
- If, during those 2 years, your knee is perfectly fine and you don't see a doctor, physio, or specialist for it, your policy may then start covering new issues with that knee from year 3 onwards.
- However, if you have a flare-up in year 1 and see your GP, the two-year clock resets from that point.
| Pros of Moratorium Underwriting | Cons of Moratorium Underwriting |
|---|---|
| Fast & Simple: Get covered in minutes with no paperwork. | Uncertainty: You don't know for sure what's covered until you claim. |
| Less Intrusive: No need to disclose your entire medical history. | Slower Claims: The insurer investigates your history at the point of a claim. |
| Potential Future Cover: Pre-existing conditions can become eligible for cover over time. | Can Be More Expensive: The insurer prices in the unknown risk. |
Expert Tip: A moratorium is great for speed, but that speed comes at the cost of certainty. The real underwriting happens when you make a claim, which can sometimes lead to delays or unexpected exclusions.
Full Medical Underwriting (FMU): The "Certainty from Day One" Option
Full Medical Underwriting (FMU) is the opposite of a moratorium. It's an "assess now, have certainty later" approach.
With FMU, you complete a comprehensive medical questionnaire as part of your application. You must declare your medical history, including any past conditions, treatments, and consultations. The insurer's underwriting team then reviews this information and makes a decision.
How does it work?
- Application: You fill out a detailed form about your health history. It's vital to be completely honest and thorough.
- Assessment: The insurer's medical underwriters review your application. They may need to contact your GP for more information (with your permission).
- The Offer: The insurer provides a policy with specific, named exclusions based on your history. For example, it might state, "Treatment for back pain and related conditions is excluded."
These exclusions are typically permanent and will not be reviewed.
A Real-Life Example: Suppose you declared on your FMU form that you had several consultations for recurring migraines five years ago.
- The insurer will likely add a specific exclusion to your policy documents, stating that "migraines, headaches, and related neurological investigations" are not covered.
- You know this from the moment your policy starts. Any other new, eligible condition (like a hernia or appendicitis) will be covered as normal. There are no grey areas.
| Pros of Full Medical Underwriting | Cons of Full Medical Underwriting |
|---|---|
| Total Certainty: You have a clear list of what is and isn't covered. | Slow Application: The process can take several weeks. |
| Faster Claims: As underwriting is done, claims are usually processed quickly. | Intrusive Process: You must provide a full medical history. |
| Potentially Cheaper: If you are in good health, your premium may be lower. | Permanent Exclusions: The exclusions applied are unlikely to ever be removed. |
Expert Tip: FMU is for people who value clarity above all else. If you have a known medical history, it provides peace of mind by removing any doubt about what would happen if you needed to claim.
Comparison Table: Moratorium vs. Full Medical Underwriting at a Glance
This table breaks down the key differences to help you decide which is the best fit for you in 2026.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Speed | Very Fast - Often instant online | Slow - Can take days or weeks |
| Initial Paperwork | Minimal - Just personal details | Extensive - Full medical questionnaire |
| Certainty of Cover | Low - You only find out what's excluded when you claim | High - You get a written list of exclusions from the start |
| Claims Process Speed | Slower - Insurer investigates your medical history at claim time | Faster - Underwriting is already complete |
| Cover for Pre-existing Conditions | Excluded for 2 years. Can become eligible if you go 2 years trouble-free. | Excluded permanently from the start, based on your declarations. |
| Potential Cost | Can be more expensive to reflect the insurer's unknown risk. | Can be cheaper if you have a clean bill of health. |
| Best For... | Those wanting fast cover with a simple application and a relatively clean, minor medical history. | Those who value certainty, have a known medical history, or want to potentially achieve a lower premium. |
Which Underwriting Method is Right for You? Practical Scenarios
The best choice is entirely personal. Here are some common scenarios to help guide your decision.
You should consider Moratorium underwriting if:
- You want cover to start immediately. The application is quick and hassle-free.
- You are in good health and haven't seen a doctor for anything significant in the last five years.
- You are uncomfortable sharing your full medical history on an application form.
- A pre-existing condition you have is very old or minor, and you are confident you can go two years without it troubling you, giving it a chance to become covered.
You should consider Full Medical Underwriting if:
- You value absolute certainty. You cannot stand the thought of a "maybe" when it comes to your health cover.
- You have a specific medical history (e.g., joint problems, past surgeries) and want to know upfront exactly how it will be treated by the insurer.
- You are in excellent health and want that to be reflected in a potentially lower premium.
- You are switching from an existing fully underwritten policy and want to maintain your current cover terms (see 'Switching' section below).
Switching Health Insurance: A Critical Factor in Your Decision
Your choice of underwriting becomes very important if you ever decide to switch your PMI provider to get a better deal.
If you are on a Full Medical Underwriting policy, you can often switch to a new insurer on a "Continued Personal Medical Exclusions" (CPME) basis. This means the new insurer agrees to accept the same medical exclusions you had with your old provider. This is a huge benefit, as it prevents new exclusions from being added for conditions that developed while you were covered by your previous policy.
If you are on a Moratorium policy, you can switch to a new provider on a "Continued Moratorium" basis. This allows you to carry over the time you've already served on your moratorium "clock" to the new insurer, so you don't have to start the two-year waiting period all over again for your pre-existing conditions.
Navigating a switch can be complex. An expert broker like WeCovr can manage this process for you, ensuring a seamless transition and that you don't lose valuable cover.
Common Mistakes to Avoid
- Assuming a Moratorium Covers Everything After Two Years: It doesn't. Only specific pre-existing conditions for which you have had zero symptoms, treatment, or advice for two continuous years become eligible. A chronic condition like asthma will never be covered.
- Forgetting Minor Details: With a moratorium, a single forgotten visit to a physio for a sore back four years ago is enough for an insurer to exclude your back when you try to claim.
- Being Dishonest on an FMU Application: Never omit information on a Full Medical Underwriting form. Insurers can access your medical records (with your consent) and will check. Non-disclosure can lead to your policy being cancelled and claims being refused, which can affect your ability to get insurance in the future.
- Choosing Based on Price Alone: The cheapest policy isn't always the best. A slightly more expensive FMU policy that gives you certainty might be far more valuable than a cheaper moratorium policy that leaves you with doubt.
How WeCovr Makes the Choice Simple
Deciding between moratorium and full medical underwriting is one of the most important decisions you'll make when buying private health insurance in the UK. You don't have to do it alone.
As independent, FCA-authorised brokers, our job is to provide impartial, expert advice tailored to you.
- We Assess Your Needs: We'll listen to your health background and priorities to recommend the underwriting type that best suits you.
- We Compare The Market: We have access to policies from all the UK's leading insurers and can find the most suitable cover at the best price.
- Our Service is Free: We are paid by the insurer, so you get our expert guidance and market comparison at no cost to you.
Furthermore, WeCovr clients get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, and can benefit from discounts on other insurance products, like life or income protection cover.
Ready to Find Your Perfect Policy?
The choice between Moratorium and Full Medical Underwriting hinges on a simple trade-off: speed versus certainty. By understanding your own health history and what you value most in a policy, you can make an informed decision.
If you're ready to explore your options and get clear, jargon-free advice, our friendly team is here to help.
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Can I still get private health insurance if I have pre-existing conditions?
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What happens if I don't declare something on a full medical underwriting application?
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
