
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.
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.
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 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?
A Real-Life Example: Imagine you had physiotherapy for knee pain 3 years before taking out a moratorium policy.
| 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) 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?
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.
| 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.
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. |
The best choice is entirely personal. Here are some common scenarios to help guide your decision.
You should consider Moratorium underwriting if:
You should consider Full Medical Underwriting if:
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.
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.
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.
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.






