TL;DR
As FCA-authorised private medical insurance experts in the UK, WeCovr has helped arrange over 900,000 policies of various kinds, giving us a deep understanding of the market. This guide demystifies one of the most premium options available: Medical History Disregarded underwriting, and how it impacts your costs. How medical history disregarded affects pricing Medical History Disregarded (MHD) underwriting is the most comprehensive and, therefore, the most expensive type of health insurance underwriting available in the UK.
Key takeaways
- How it works: The insurer simply disregards your medical history. If you need treatment for an eligible acute condition—even one you've suffered from before—it will be covered, subject to your policy's terms.
- Application Process: Extremely simple. There are no medical questionnaires to fill out regarding your past health.
- Claims Process: Very straightforward. The claims team doesn't need to investigate your medical history to see if the condition is pre-existing.
- Who it's for: Almost exclusively for larger corporate health insurance schemes. Insurers offer it to groups because the risk is spread across many employees, some healthy and some not, making the overall risk profile manageable for them.
- How it works: When you join, the insurer applies a "moratorium" period. Any medical condition you have had symptoms, treatment, or advice for in the 5 years before your policy starts is considered "pre-existing" and is excluded from cover.
As FCA-authorised private medical insurance experts in the UK, WeCovr has helped arrange over 900,000 policies of various kinds, giving us a deep understanding of the market. This guide demystifies one of the most premium options available: Medical History Disregarded underwriting, and how it impacts your costs.
How medical history disregarded affects pricing
Medical History Disregarded (MHD) underwriting is the most comprehensive and, therefore, the most expensive type of health insurance underwriting available in the UK. Its primary feature is that the insurer agrees to ignore your past medical history when you make a claim. This means that, unlike other forms of underwriting, pre-existing conditions are covered from day one.
Because the insurer is taking on a much greater and largely unknown risk, the price reflects this. An MHD policy can be significantly more expensive—often 50% to 100% more—than a standard policy with moratorium or full medical underwriting. This premium cost is the price of certainty; you are paying for the peace of mind that your entire medical history will not be used to decline a future claim for an eligible acute condition.
However, it's crucial to understand that MHD is almost exclusively available for group private medical insurance schemes, typically for businesses with 20 or more employees. For individuals and small groups, it is extremely rare and often prohibitively expensive.
Understanding Underwriting: MHD vs. Moratorium and Full Medical Underwriting
When you buy private medical insurance, the insurer needs to understand the level of risk you present. This process is called "underwriting." It determines what they will and won't cover, and it's a major factor in calculating your premium. In the UK, there are three main types.
Medical History Disregarded (MHD): The Premium Option
As we've touched upon, MHD is the gold standard of underwriting.
- How it works: The insurer simply disregards your medical history. If you need treatment for an eligible acute condition—even one you've suffered from before—it will be covered, subject to your policy's terms.
- Application Process: Extremely simple. There are no medical questionnaires to fill out regarding your past health.
- Claims Process: Very straightforward. The claims team doesn't need to investigate your medical history to see if the condition is pre-existing.
- Who it's for: Almost exclusively for larger corporate health insurance schemes. Insurers offer it to groups because the risk is spread across many employees, some healthy and some not, making the overall risk profile manageable for them.
Crucial Note: MHD still does not cover the routine management of chronic conditions. For example, it would cover an acute flare-up of a pre-existing condition like Crohn's disease, but it would not pay for the day-to-day medication and check-ups required to manage it.
Moratorium Underwriting: The Common Standard
This is the most popular type of underwriting for individuals and families in the UK.
- How it works: When you join, the insurer applies a "moratorium" period. Any medical condition you have had symptoms, treatment, or advice for in the 5 years before your policy starts is considered "pre-existing" and is excluded from cover.
- The "Rolling" Rule: These exclusions can be lifted. If you go for a continuous 2-year period after your policy starts without experiencing symptoms, needing treatment, medication, or advice for that specific condition, it may become eligible for cover.
- Application Process: Quick and easy. You don't need to declare your medical history upfront.
- Claims Process: Can be slower. When you make a claim, the insurer will investigate your medical history to check if the condition is new or pre-existing from the 5 years before you joined. This can involve requesting records from your GP.
Full Medical Underwriting (FMU): The Detailed Approach
With FMU, you provide your complete medical history to the insurer at the start.
- How it works: You fill out a detailed health questionnaire. Based on your answers, the insurer decides what they will and will not cover.
- Permanent Exclusions: Unlike a moratorium, any conditions you declare are typically excluded permanently. There is no 2-year rule for them to become eligible for cover later.
- Application Process: Slower and more involved due to the detailed questionnaire.
- Claims Process: Generally faster and more certain than moratorium. Because the insurer already knows what's excluded, there's less investigation needed when you claim.
Comparison of Underwriting Types
| Feature | Medical History Disregarded (MHD) | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|---|
| Pre-Existing Conditions | Covered from day one (for acute episodes). | Excluded for at least the first 2 years. | Declared conditions are usually excluded permanently. |
| Application Process | Very fast. No health questions. | Fast. No health questions upfront. | Slower. Requires a full health questionnaire. |
| Claim Process | Fast and certain. No history checks. | Can be slower. Insurer investigates history. | Fast and certain. Exclusions are pre-agreed. |
| Cost | Highest | Lowest | Generally low, but can vary. |
| Best For | Large company group schemes. | Individuals and families seeking a balance of cost and cover. | Individuals who want certainty on what is covered from the outset. |
What Factors Determine Private Health Insurance Cost in the UK?
The type of underwriting is just one piece of the puzzle. Your final premium is calculated based on a wide range of factors. Understanding these can help you tailor a policy that fits your budget.
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Age: This is the single biggest factor. As we get older, the statistical likelihood of needing medical treatment increases. Premiums therefore rise in line with age, often with noticeable jumps at milestone birthdays (e.g., 40, 50, 60). According to the Office for National Statistics (ONS), life expectancy continues to rise, meaning insurers plan for longer periods of potential claims.
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Location: Where you live in the UK significantly impacts your premium. Private hospital costs vary dramatically by region. Central London has some of the most expensive private medical facilities in the world, so policies that include access to them are the most costly. A policy for someone in Scotland or the North of England will typically be much cheaper than an identical policy for someone in London or the South East.
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Level of Cover: You can customise your policy to control costs. Key choices include:
- Core Cover: All policies cover inpatient and day-patient treatment (when you need a hospital bed).
- Outpatient Cover (illustrative): This is a crucial optional extra. It covers consultations, diagnostic tests, and scans that don't require a hospital bed. You can choose a full cover limit, a set monetary limit (e.g., £1,000 per year), or no outpatient cover at all to reduce your premium.
- Additional Options: You can add extras like mental health cover, dental and optical care, and therapies (physiotherapy, osteopathy, etc.). The more you add, the higher the cost.
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Excess: An excess is the amount you agree to pay towards a claim. For example, if you have a £250 excess and your eligible treatment costs £3,000, you pay the first £250 and the insurer pays the remaining £2,750. Choosing a higher excess (e.g., £500 or £1,000) will directly reduce your monthly or annual premium.
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Hospital List: Insurers group hospitals into tiers. A policy with a "local" or "regional" list will be cheaper than one giving you access to a full "national" list, which is in turn cheaper than a list that includes the premium Central London hospitals.
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No Claims Discount (NCD): Similar to car insurance, most individual private medical insurance policies include an NCD. For every year you don't make a claim, you get a discount on your renewal premium, up to a maximum level (often 60-75%). Making a claim will typically reduce your NCD level.
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Lifestyle: Some insurers ask about your smoking status. Smokers are considered higher risk and will pay a higher premium. Conversely, some providers, like Vitality, actively reward healthy living with premium discounts and other perks.
How Different Factors Impact Your Premium
| Factor | To Lower Your Premium | To Increase Your Premium |
|---|---|---|
| Excess | Choose a higher excess (£500, £1000). | Choose a low or nil excess (£0, £100). |
| Outpatient Cover | Limit it (e.g., to £500) or remove it. | Choose full, unlimited outpatient cover. |
| Hospital List | Select a local or regional hospital list. | Choose a national list including London hospitals. |
| Underwriting | Choose Moratorium underwriting. | Choose Medical History Disregarded (if available). |
| Add-ons | Avoid optional extras like dental or therapy. | Include comprehensive mental health, dental, etc. |
An expert broker, such as WeCovr, can help you navigate these options to build the most cost-effective policy for your specific needs, at no extra cost to you.
A Deep Dive into Medical History Disregarded (MHD) Costs
So, just how much more does an MHD policy cost? While individual quotes vary, it's helpful to look at illustrative examples.
Let's imagine a medium-sized tech company in Manchester wants to provide private health insurance for its 50 employees. They are deciding between a standard group policy on a moratorium basis and a premium group policy with MHD underwriting.
| Profile | Underwriting Type | Key Benefit | Estimated Monthly Premium Per Employee |
|---|---|---|---|
| Group Scheme (50 employees) | Moratorium | Cost-effective, covers new conditions. | £45 - £65 |
| Group Scheme (50 employees) | Medical History Disregarded | Covers pre-existing conditions, hassle-free claims. | £80 - £120 |
These are illustrative estimates for a comprehensive mid-range policy for an employee base with an average age of 40. Actual costs will vary based on the provider, final policy options, and employee demographics.
As the table shows, the MHD option is significantly more expensive per person. Why would a company pay this?
- Attracting & Retaining Talent: Offering a health plan that covers pre-existing conditions is a powerful employee benefit, particularly for senior staff who may have prior health issues.
- Simplicity & Fairness: It creates a level playing field. Everyone is covered for everything (subject to policy terms), regardless of their personal medical history. This avoids difficult conversations about what is and isn't covered.
- Reduced Absenteeism: By providing fast access to treatment for all acute conditions, MHD can help key employees get back to work faster, boosting productivity.
For an individual, obtaining an MHD policy is almost impossible. The risk for an insurer is too high. If it were offered, the premium could easily be three or four times that of a standard moratorium policy, making it unaffordable for most.
The Crucial Point: What UK Private Medical Insurance Does NOT Cover
It is vital to understand that private medical insurance is designed for a specific purpose: to diagnose and treat acute conditions that arise after you take out your policy.
Chronic Conditions
A chronic condition is one that is long-term and cannot be cured, only managed. Examples include:
- Diabetes
- Asthma
- Hypertension (high blood pressure)
- Crohn's disease
- Arthritis
- Eczema
Standard UK private medical insurance does not cover the ongoing, routine management of chronic conditions. This care remains the responsibility of the NHS. A policy may cover the initial diagnosis of a chronic condition, and it may cover an "acute flare-up" of a chronic condition, but it will not pay for the day-to-day medication, check-ups, and management.
Pre-existing Conditions
A pre-existing condition is any illness, injury, or disease for which you have had symptoms, medication, advice, or treatment before your policy began.
- On a Moratorium policy, these are excluded for at least 2 years.
- On an FMU policy, they are typically excluded forever.
- On an MHD policy, acute flare-ups of pre-existing conditions are covered. This is the key difference and the reason for its high cost.
Other Standard Exclusions
Nearly all UK policies exclude:
- A&E / Emergency services
- Normal pregnancy and childbirth
- Cosmetic surgery (unless for reconstruction after an accident/eligible surgery)
- Treatment for addiction (drugs, alcohol)
- Self-inflicted injuries
- Organ transplants
- Experimental or unproven treatments
Always read your policy documents carefully to understand what is and is not included.
How to Get the Best Value from Your Private Health Cover
Getting the right private medical insurance UK policy isn't just about finding the cheapest price; it's about finding the best value. Here are some tips from our experts.
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Use an Expert Broker A specialist PMI broker like WeCovr provides invaluable, impartial advice at no cost to you. We are paid by the insurer we place you with. Our role is to:
- Understand your needs: We listen to what you want and what your budget is.
- Scan the market: We have access to policies from a wide range of top UK insurers.
- Explain the jargon: We cut through the complexity of underwriting, hospital lists, and benefit limits.
- Find the best fit: We recommend the policy that offers the best value for your specific circumstances.
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Tailor Your Policy Don't pay for cover you don't need. If you have a good corporate dental plan, you probably don't need to add it to your PMI. If you are happy to pay a bit more towards a claim, increasing your excess from £100 to £500 can create significant premium savings. (illustrative estimate)
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Review Your Policy Annually Your renewal price will likely increase each year due to your age and medical inflation (the rising cost of private healthcare). Don't just auto-renew. An annual review with your broker can ensure you're still on the best possible plan, and we can re-broke the policy if a competitor is offering better value.
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Embrace Wellness Programmes Many leading insurers now offer wellness programmes. These reward you for staying active, eating well, and having regular health checks. You can earn discounts on your premium, gift cards, cinema tickets, and more. It's a fantastic way to get more value from your policy while also improving your health. As a WeCovr client, you also get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to support your health goals.
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Look for Bundled Discounts At WeCovr, we believe in rewarding loyalty. When you purchase a private medical or life insurance policy through us, we can often offer you discounts on other types of cover you may need, such as home or travel insurance, providing even greater value.
The UK Healthcare Landscape in 2025: Why Consider PMI?
The NHS is a national treasure, but it is under immense pressure. As of mid-2024, the referral-to-treatment (RTT) waiting list in England remains stubbornly high, with NHS England data showing millions of treatment pathways waiting to be started. For many non-urgent but life-impacting procedures, patients can wait well over a year.
This is where private medical insurance finds its purpose. The key benefits are:
- Speed: Bypass long NHS waiting lists for eligible treatments.
- Choice: Choose your specialist, consultant, and hospital from an approved list.
- Comfort: Access to a private room, en-suite facilities, and more flexible visiting hours.
- Access to New Treatments: Some policies provide access to drugs or treatments not yet available on the NHS due to cost.
- Peace of Mind: Knowing that if you develop an acute condition, you can be diagnosed and treated quickly, minimising worry and disruption to your life and work.
For many, PMI is a valuable complement to the essential services provided by the NHS, offering control and convenience when it's needed most.
Is Medical History Disregarded (MHD) underwriting available for individuals?
Will my private health insurance premium go up every year?
Do I still need the NHS if I have private medical insurance?
What's the main difference between an acute and a chronic condition?
Ready to explore your options and find the right private health cover for your needs and budget? Our expert, friendly advisors at WeCovr are here to help. Get your free, no-obligation quote today and discover how affordable peace of mind can be.
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.
