TL;DR
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can feel complex. This guide simplifies the cost of policies using moratorium underwriting, helping you make a confident and informed choice for your health. Pricing differences explained simply Choosing a private medical insurance (PMI) policy in the UK involves a key decision: how will the insurer assess your medical history?
Key takeaways
- No Medical Questionnaire: You don't need to list your entire medical history when you apply. This makes the application process incredibly quick.
- The "Five-Year" Rule: The policy automatically excludes any condition for which you have sought advice, received treatment, or experienced symptoms in the five years leading up to your policy start date.
- The "Two-Year" Rolling Period: For these pre-existing conditions to become eligible for cover, you must remain on the policy for two continuous years without experiencing any symptoms, needing any treatment, medication, or medical advice for that specific condition.
- Claim Time Assessment: When you make a claim, the insurer will then look into your medical history to see if the condition is new (and therefore covered) or pre-existing and excluded under the moratorium.
- Lower Initial Premiums: Insurers save on administrative costs because they don't need to medically underwrite each application individually at the start. These savings are often passed on to you, making moratorium policies appear more affordable upfront.
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can feel complex. This guide simplifies the cost of policies using moratorium underwriting, helping you make a confident and informed choice for your health.
Pricing differences explained simply
Choosing a private medical insurance (PMI) policy in the UK involves a key decision: how will the insurer assess your medical history? This is called "underwriting," and one of the most common methods is moratorium underwriting.
Put simply, a moratorium policy is the "don't ask, don't tell" option at the start. You won't fill out a detailed medical questionnaire. Instead, the policy automatically excludes treatment for any medical conditions you've had symptoms, treatment, or advice for in the five years before your cover began.
This approach directly impacts the cost and can often make a policy cheaper and quicker to set up. However, the initial simplicity comes with nuances that can affect what you're covered for down the line. This guide will break down exactly how moratorium underwriting influences your premium, what factors drive the price, and how it compares to other options.
What is Moratorium Underwriting and How Does It Work?
Moratorium underwriting is a popular choice for UK private health cover because it's fast and straightforward. Think of it as a "wait and see" approach.
Here’s the process step-by-step:
- No Medical Questionnaire: You don't need to list your entire medical history when you apply. This makes the application process incredibly quick.
- The "Five-Year" Rule: The policy automatically excludes any condition for which you have sought advice, received treatment, or experienced symptoms in the five years leading up to your policy start date.
- The "Two-Year" Rolling Period: For these pre-existing conditions to become eligible for cover, you must remain on the policy for two continuous years without experiencing any symptoms, needing any treatment, medication, or medical advice for that specific condition.
- Claim Time Assessment: When you make a claim, the insurer will then look into your medical history to see if the condition is new (and therefore covered) or pre-existing and excluded under the moratorium.
This means there's less certainty on day one about what's covered compared to the alternative, Full Medical Underwriting (FMU).
Moratorium vs. Full Medical Underwriting (FMU) at a Glance
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Very fast, no health questionnaire | Slower, requires a full medical declaration |
| Initial Cost | Often slightly cheaper | Can be slightly more expensive |
| Cover Certainty | Less certainty at the start | Clear from day one what is excluded |
| Pre-existing Conditions | Automatically excluded for a period | Exclusions are listed specifically in your policy |
| Claims Process | Can be slower as insurer investigates history | Generally faster as cover is pre-agreed |
| Best For | People with few recent health issues seeking a quick start | People with a complex medical history who want clarity |
How Moratorium Underwriting Impacts Your Private Health Insurance Cost
The type of underwriting is a significant factor in your premium calculation. With moratorium, the pricing dynamics are unique.
- Lower Initial Premiums: Insurers save on administrative costs because they don't need to medically underwrite each application individually at the start. These savings are often passed on to you, making moratorium policies appear more affordable upfront.
- Speed and Simplicity: The quick and easy setup is attractive for both consumers and insurers, reducing the friction and cost associated with starting a policy.
- Potential for Future Premium Changes: The main trade-off is a degree of uncertainty. If a previously excluded condition meets the criteria for cover after the two-year period, your policy becomes more valuable. However, if you then claim for that condition, it may lead to a higher premium at your next renewal, just as any claim would.
Essentially, you pay for speed and convenience at the start, with the understanding that the full scope of your cover will become clearer over time.
Key Factors That Determine Your PMI Premium with Moratorium Underwriting
While moratorium underwriting sets the framework, several personal factors combine to determine your final monthly or annual premium.
Your Age
Age is the single most significant factor influencing the cost of private medical insurance. As we get older, the statistical likelihood of needing medical treatment increases, and premiums reflect this risk. Insurers use age brackets, and costs can rise noticeably as you move into a new decade.
Illustrative Monthly Premiums by Age (Mid-Range Cover)
| Age Bracket | Estimated Monthly Premium |
|---|---|
| 30-39 | £45 - £65 |
| 40-49 | £60 - £90 |
| 50-59 | £85 - £130 |
| 60-69 | £120 - £200+ |
Disclaimer: These are illustrative estimates for a non-smoker with a £250 excess outside London. Your actual quote will vary.
Your Location (Postcode)
Where you live in the UK has a direct impact on your premium. Medical costs, particularly for private hospital facilities and specialists, are highest in Central London. This "London loading" means a policy for a London resident can be 30-50% more expensive than for someone in a rural part of Scotland or the North of England.
Regional Cost Variation Example
- Central London: Highest premiums due to expensive private hospitals (e.g., The London Clinic, HCA at The Shard).
- South East England: High premiums, but generally less than Central London.
- Major Cities (Manchester, Birmingham): Moderate premiums.
- North of England, Wales, Scotland: Lower premiums reflecting lower local hospital costs.
Level of Cover
Insurers offer tiered plans to suit different needs and budgets. The more comprehensive the cover, the higher the cost.
- Basic/Entry-Level: Covers the most expensive treatments. This typically includes in-patient (overnight hospital stays) and day-patient (a planned procedure without an overnight stay) care only. Out-patient costs like consultations and diagnostics are not included.
- Mid-Range: The most popular option. It includes everything in a basic plan plus a set limit for out-patient cover (e.g., £1,000 to £1,500 per year). This is often enough to cover the consultations and scans needed to diagnose a condition before in-patient treatment.
- Comprehensive: The premium tier. It offers full in-patient and day-patient cover, plus extensive or unlimited out-patient cover. These plans often include additional benefits like therapies (physiotherapy, osteopathy), mental health support, and sometimes dental or optical cover.
Your Chosen Excess
An excess is the amount you agree to pay towards a claim in any policy year. A higher excess signals to the insurer that you will cover the smaller costs yourself, which reduces their risk and, in turn, your premium.
Impact of Excess on a £80/month Premium (Example)
| Excess Level | Potential Premium Reduction | New Estimated Monthly Premium |
|---|---|---|
| £0 | 0% | £80 |
| £250 | ~15-20% | £64 - £68 |
| £500 | ~25-30% | £56 - £60 |
| £1,000 | ~35-40% | £48 - £52 |
Choosing a higher excess is an effective way to make your cover more affordable, but you must be comfortable paying that amount if you need to make a claim.
Hospital List
Insurers group UK private hospitals into lists or networks. The hospital list you choose affects your premium.
- Local/Trust Hospitals: The most affordable lists, often using private wings of NHS Trust hospitals.
- National Networks: A broad list of private hospitals across the country, excluding the most expensive Central London centres.
- Premium/London Upgrade: The most expensive option, providing access to all hospitals in the insurer's network, including the premier facilities in Central London.
Smoker Status and Lifestyle
Smokers will always pay more for health insurance—often 15-25% more—due to the proven health risks associated with smoking.
Increasingly, insurers are also interested in your broader wellness. Many now offer rewards and discounts for engaging in healthy activities, such as tracking your steps or gym visits. As part of our commitment to our clients' wellbeing, WeCovr provides complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, helping you build and maintain a healthy lifestyle.
The Important Distinction: Acute vs. Chronic Conditions
It is a fundamental principle of the UK private medical insurance market that policies are designed to cover acute conditions, not chronic conditions.
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An Acute Condition is a disease, illness, or injury that is likely to respond quickly to treatment and aims to return you to your previous state of health. Examples include cataracts, joint replacements, hernia repairs, and diagnosing and treating most cancers. PMI is designed for this.
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A Chronic Condition is an illness that cannot be cured but can be managed. It typically requires long-term monitoring and care. Examples include diabetes, asthma, high blood pressure, and arthritis. Standard UK PMI does not cover the long-term management of chronic conditions.
A policy might cover the initial diagnosis of a chronic condition. For instance, if you develop symptoms, your PMI could pay for the out-patient consultations and tests that lead to a diagnosis of, say, Crohn's disease. However, the ongoing treatment and management of the disease would then be passed back to the NHS.
Real-World Cost Examples of Moratorium Policies (2025)
To bring these factors to life, here are some illustrative personas. Your own quote from an expert broker like WeCovr will provide an accurate price for your specific circumstances.
| Persona | Location | Age | Cover Level | Excess | Estimated Monthly Premium |
|---|---|---|---|---|---|
| Anya, a Graphic Designer | Manchester | 32 | Basic (In-patient only) | £500 | £35 - £50 |
| David & Sarah, a Couple | Surrey | 48 | Mid-Range (with £1k Out-patient) | £250 | £140 - £180 (for both) |
| Robert, a Director | Central London | 57 | Comprehensive (Full Out-patient) | £250 | £190 - £250 |
Note: These are illustrative examples for non-smokers in good health applying for a new moratorium policy. Premiums are subject to change and depend on the insurer chosen.
The key takeaway is that your policy is highly personal. Anya wants a simple, affordable safety net for major issues. David and Sarah want balanced cover for peace of mind. Robert needs comprehensive access to the best London facilities. Each of these needs can be met, but the price will differ accordingly.
How to Get the Best Value from Your Moratorium PMI Policy
Getting the right cover isn't just about finding the lowest price; it's about securing the best possible value for your needs.
- Use a Specialist Broker: This is the single most effective tip. An independent, FCA-authorised broker like WeCovr works for you, not the insurers. We compare policies from across the market, explain the subtle but crucial differences in each provider's moratorium wording, and handle the application for you. Our service comes at no cost to you.
- Select the Right Excess: Choose an excess that gives you a meaningful premium discount but is an amount you could comfortably afford to pay if you needed treatment. Don't set it so high that you'd hesitate to make a claim.
- Review Your Hospital List: If you don't live or work near Central London, you can achieve significant savings by choosing a policy that excludes the most expensive London hospitals.
- Take Advantage of Wellness Benefits: Engage with the wellness programmes offered by insurers. Not only can they earn you discounts or rewards, but they genuinely support your long-term health, which is the best way to keep future premiums down. Using tools like the complimentary CalorieHero app from WeCovr is a great start.
- Consider Multi-Policy Discounts: When you purchase a PMI or life insurance policy through WeCovr, you may be eligible for discounts on other types of cover you need, adding even more value.
The Role of a Specialist PMI Broker like WeCovr
With moratorium underwriting, the policy wording is everything. The definition of a "pre-existing condition" or the rules for the two-year period can vary slightly between insurers. An expert broker is invaluable in navigating this.
Why use WeCovr?
- Whole-of-Market Advice: We aren't tied to any single insurer. We provide impartial advice based on the best fit for your needs and budget.
- Expert Guidance: Our team are specialists in the UK PMI market. We understand the complexities of moratorium underwriting and can explain it to you in simple terms.
- No Cost to You: Our service is completely free for you to use. We are paid a commission by the insurer you choose, which is built into the standard policy price, so you don't pay a penny more.
- High Customer Satisfaction: Our clients consistently rate our service highly for its clarity, efficiency, and friendly, professional approach.
- Added Value: We go beyond the policy, offering complimentary tools like the CalorieHero app and discounts on other insurance products to support your overall financial and physical wellbeing.
Navigating private health insurance doesn't have to be a solo journey. We're here to provide the expert guidance you need to secure the right protection.
Is moratorium underwriting always cheaper than full medical underwriting?
Initially, a moratorium policy is often cheaper and faster to set up because the insurer does less administrative work upfront. However, it may not be cheaper in the long run. A Full Medical Underwriting (FMU) policy provides certainty from day one, which some people prefer. The best option depends on your medical history and preference for speed versus certainty. A broker can help you compare quotes for both types.
What happens if I need treatment for a pre-existing condition during the two-year moratorium period?
If you require advice, medication, or treatment for a condition that was excluded under the moratorium, you would not be able to claim for it on your private medical insurance. You would need to use the NHS for that care. Furthermore, seeking advice or treatment for that condition will "reset the clock," meaning you would need to go another two full years from that point without any symptoms or care for it to become eligible for cover.
Do I have to declare my medical history at all with a moratorium policy?
You do not need to declare your medical history on the initial application form. However, your history is not ignored. When you make your first claim, the insurer will request access to your medical records to determine if the condition is new (and therefore covered) or pre-existing (and therefore excluded under the five-year rule). So, while the process is simpler at the start, full disclosure is effectively made at the point of claim.
Ready to find out how much your personalised private health cover could cost?
Get a free, no-obligation quote from our friendly experts at WeCovr today. We'll compare the UK's leading insurers to find the perfect policy for your needs and budget.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.
