TL;DR
As an FCA-authorised expert with experience in over 900,000 policies, WeCovr helps you navigate the UK private medical insurance market. While you can buy a policy almost instantly, "immediate cover" has important nuances. This guide reveals the truth about when your private health cover really begins.
Key takeaways
- You had a condition in the 5 years before the policy started.
- You serve a continuous 2-year period on the policy after your start date.
- During those 2 years, you remain completely free of any symptoms, treatment, medication, or medical advice for that specific condition.
- Cover the condition: This is rare but possible for very minor, historic issues.
- Exclude the condition: They may place a specific exclusion on the condition (e.g., "no cover for treatment related to gallstones").
As an FCA-authorised expert with experience in over 900,000 policies, WeCovr helps you navigate the UK private medical insurance market. While you can buy a policy almost instantly, "immediate cover" has important nuances. This guide reveals the truth about when your private health cover really begins.
Is instant cover possible, and what restrictions typically apply?
In the digital age, we expect everything on demand. You can order a taxi, a takeaway, or a new television and have it within the hour. So, it’s natural to ask: can you get immediate private medical insurance cover?
The short answer is yes and no.
You can certainly purchase a private medical insurance (PMI) policy very quickly, sometimes in under an hour, especially online. Your policy document might state a start date of today. However, this does not mean you are instantly covered for every possible medical condition.
The reality is that all new private health cover in the UK comes with conditions, waiting periods, and exclusions. These are not designed to catch you out; they are fundamental to how insurance works, ensuring the system remains fair and affordable for everyone. The most significant restriction is that standard UK PMI is designed to cover new, acute conditions that arise after your policy begins. It does not cover long-term chronic illnesses or pre-existing conditions you already have.
Think of it like car insurance: you can’t buy a policy after you’ve had an accident and expect the insurer to pay for the repairs. Similarly, you cannot take out health insurance to cover a condition you are already aware of or receiving treatment for.
Understanding Underwriting: The Key to Your Cover Start Date
The process that determines what you are and aren't covered for from day one is called underwriting. This is the insurer's way of assessing risk. In the UK, there are two main types of underwriting for personal PMI policies. The one you choose has a massive impact on how "immediate" your cover truly is.
An expert PMI broker, such as WeCovr, can help you decide which option is best for your personal circumstances at no extra cost to you.
1. Moratorium (MORI) Underwriting
This is the most common and fastest way to get a policy started. With a moratorium, you don't need to provide your full medical history upfront. Instead, the insurer applies a blanket clause to your policy.
How it works: A moratorium typically excludes any medical condition for which you have experienced symptoms, sought advice, or received treatment in the five years leading up to your policy start date.
However, these conditions can become eligible for cover later on, provided you meet specific criteria. This is often called the "2-5-2" rule:
- You had a condition in the 5 years before the policy started.
- You serve a continuous 2-year period on the policy after your start date.
- During those 2 years, you remain completely free of any symptoms, treatment, medication, or medical advice for that specific condition.
Example: Imagine you had physiotherapy for knee pain 3 years before buying your policy. Under a moratorium, your knees would be excluded from cover for the first 2 years of your policy. If, during those 2 years, your knee pain returns and you see a GP, the 2-year clock resets. If, however, you go 2 full years with no knee issues whatsoever, it could become eligible for cover in the future.
2. Full Medical Underwriting (FMU)
This is a more detailed, upfront process. With FMU, you are required to complete a comprehensive health questionnaire, declaring your full medical history. The insurance company's underwriting team will then review your application.
Based on your disclosures, they will decide one of three things for any pre-existing conditions:
- Cover the condition: This is rare but possible for very minor, historic issues.
- Exclude the condition: They may place a specific exclusion on the condition (e.g., "no cover for treatment related to gallstones").
- Exclude the condition with a review: They might exclude it but offer to review the exclusion after a certain period of symptom-free time has passed.
Moratorium vs. Full Medical Underwriting: A Comparison
Choosing the right underwriting is a critical decision. Here’s a simple table to help you compare:
| Feature | Moratorium (MORI) Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Speed | Fast. No initial medical questionnaire. | Slower. Requires a detailed health declaration. |
| Initial Certainty | Less certain. You may not know if a condition is covered until you claim. | Total certainty. You know exactly what is and isn't covered from day one. |
| Admin at Claim | More complex. Insurers will investigate your medical history when you make a claim. | Simpler. The insurer already has your history, so claims are often faster to process. |
| Cover for Pre-existing | Possible, but only after a 2-year clear period on the policy. | Unlikely. Conditions are typically excluded permanently from the outset. |
| Best For... | People with a clean bill of health seeking a quick start. | People with a complex medical history who want clarity on their cover. |
The Critical Distinction: Acute vs. Chronic Conditions
A fundamental principle of private medical insurance in the UK is that it is designed to treat acute conditions. It is not designed for the ongoing management of chronic conditions.
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An Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a hernia, appendicitis, cataracts, or a joint injury. The goal of the treatment is to return you to your previous state of health.
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A Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics:
- It needs ongoing or long-term monitoring.
- It has no known "cure."
- It is likely to recur.
- It requires palliative care or management.
Examples of chronic conditions include diabetes, asthma, high blood pressure, arthritis, and multiple sclerosis. While the NHS provides excellent ongoing care for these conditions, they are excluded from cover by standard PMI policies. A policy may cover the initial diagnosis of a chronic condition, but it will not cover the long-term management.
What About Pre-existing Conditions? The Uninsurable Truth
This is the single biggest source of confusion for new PMI customers. A pre-existing condition is any illness, injury, or symptom you had before your policy start date. This applies whether you were formally diagnosed or not. If you had symptoms or sought advice, it is considered pre-existing.
Standard UK private medical insurance does not cover pre-existing conditions.
This is a core rule across the entire market. The business model is based on insuring against unforeseen future risks, not paying for existing problems. How an insurer deals with your pre-existing conditions is determined by the underwriting method you choose (Moratorium or FMU).
- With Moratorium, any condition from the last 5 years is automatically excluded for at least 2 years.
- With Full Medical Underwriting, you declare the condition, and the insurer will almost certainly apply a permanent exclusion for it in your policy terms.
It is vital to be completely honest during your application. Failing to disclose a condition, especially on an FMU application, could be considered non-disclosure and may lead to your policy being cancelled and claims being rejected.
Common Waiting Periods and Exclusions on New PMI Policies
Even with "instant" cover for new, acute conditions, most policies have specific waiting periods and general exclusions.
Initial Waiting or "Cooling-Off" Period
All insurance policies in the UK come with a statutory 14-day cooling-off period. During this time, you can cancel the policy for a full refund. While cover is technically active, it's wise not to plan any treatment during these first two weeks. Some insurers also impose their own initial waiting period of around 30 days where no claims can be made.
Benefit-Specific Waiting Periods
Beyond the initial period, some high-value benefits may have their own waiting periods before you can use them. This prevents people from buying a policy to immediately claim for a major, expensive treatment.
| Benefit Type | Typical Waiting Period | Notes |
|---|---|---|
| Outpatient Consultations | 0 - 30 days | For new conditions, this is often available immediately. |
| Musculoskeletal (MSK) | 0 - 30 days | Cover for joints, muscles, and bones. |
| Mental Health Treatment | 0 - 2 years | Some policies cover it from day one; others impose a significant wait. |
| Cancer Cover | 0 - 90 days | While diagnosis may be covered sooner, access to advanced drugs/therapies can have a wait. |
| Maternity Complications | 10 - 24 months | Standard pregnancy is not covered, but complications may be after this period. |
Standard Policy Exclusions
Every PMI policy has a list of standard exclusions. These are treatments and conditions that are never covered, regardless of when they occur. Common examples include:
- Emergency Services: PMI is for planned, non-emergency treatment. A&E care is provided by the NHS.
- Normal Pregnancy & Childbirth: Only unforeseen complications might be covered.
- Cosmetic Surgery: Unless it is reconstructive following an accident or eligible surgery.
- Self-inflicted Injuries: Including those from substance abuse or dangerous sports.
- Infertility Treatment: IVF and other fertility procedures are typically excluded.
- HIV/AIDS: Although some policies may offer limited monitoring or wellbeing support.
- Experimental or Unproven Treatments: Insurers only cover established medical procedures.
Real-Life Scenarios: How "Immediate" Cover Works in Practice
Let's look at two examples to see how this plays out.
Scenario 1: Sarah Chooses Moratorium (MORI) Underwriting
Sarah, 35, is healthy and active. She wants cover quickly and chooses a policy with moratorium underwriting. Her policy starts on 1st November.
- December: Sarah is playing netball and badly sprains her ankle. It's a new injury. She calls her insurer, gets a GP referral, and is approved to see a private orthopaedic consultant and have an MRI scan within a week. Her policy covers this.
- June (the following year): She starts getting pain in her left knee, which she remembers seeing a physiotherapist for about four years ago. She tries to make a claim. The insurer reviews her GP records and sees the history of knee trouble. As this was a pre-existing condition within the last 5 years, the claim is rejected. Her knee will remain excluded until she has gone two full, continuous years on the policy with no knee pain, advice, or treatment.
Scenario 2: David Chooses Full Medical Underwriting (FMU)
David, 52, has a few minor health issues he wants to be clear about. He opts for FMU and uses WeCovr to help him complete the application. He declares a history of migraines and a bout of acid reflux five years ago.
The insurer reviews his application and offers him a policy with a specific, written exclusion for "investigation and treatment of headaches and migraines." They agree to cover the acid reflux as it was a one-off, historic event. David accepts. His policy starts on 1st November.
- January: David develops severe abdominal pain. His GP suspects gallstones. He calls his insurer. Because this is a brand new, unrelated condition, his policy immediately covers the consultation, ultrasound, and subsequent keyhole surgery to remove his gallbladder.
- August: His migraines return. He knows this is excluded from his policy, so he continues to manage this through his NHS GP.
David had to wait a little longer for his policy to be approved, but he had complete peace of mind knowing exactly where he stood.
How to Get Covered as Quickly as Possible: A Step-by-Step Guide
While truly "instant" cover for everything isn't realistic, you can take steps to get your policy in place efficiently and understand its limits from the get-go.
- Gather Your Information: Before you start, have your personal details ready. If you are considering Full Medical Underwriting, spend some time thinking about your medical history over the last 5-10 years.
- Decide on Underwriting: Think about your priorities. Do you want speed and are happy with the ambiguity of a moratorium? Or do you prefer the absolute clarity of FMU, even if it takes longer?
- Use an Expert Broker: This is the single best shortcut. An independent, FCA-authorised broker like WeCovr can save you hours of research. We work for you, not the insurers. We will:
- Explain the pros and cons of MORI vs. FMU for your specific situation.
- Compare policies from across the UK market to find the best private health cover for your needs and budget.
- Help you complete application forms accurately.
- Do all of this at no cost to you. Our commission is paid by the insurer you choose.
- Complete the Application Honestly: Whether you choose MORI or FMU, honesty is paramount. Hiding a condition will only cause problems later.
- Review Your Policy Documents: Once your policy is live, read the documents carefully. Pay close attention to the start date, the schedule of benefits, and the list of exclusions. This is your contract – make sure you understand it.
Beyond Insurance: Proactive Health and Wellness
The best way to manage your health is to be proactive. While private medical insurance is an incredible tool for when things go wrong, focusing on wellness can reduce your need to claim. With NHS waiting lists in England reaching 7.54 million cases in April 2024, taking control of your health has never been more important.
- Diet: A balanced diet rich in fruit, vegetables, and whole grains can prevent a host of issues, from heart disease to type 2 diabetes. As a WeCovr policyholder, you get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to help you stay on track.
- Exercise: The NHS recommends at least 150 minutes of moderate-intensity activity a week. This could be a brisk walk, cycling, or swimming. Regular activity boosts both physical and mental health.
- Sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep is linked to a weakened immune system, poor concentration, and an increased risk of chronic illness.
- Mental Wellbeing: Many PMI policies now include access to mental health support, such as digital CBT or counselling sessions. Don't be afraid to use them.
Furthermore, at WeCovr, we believe in rewarding our clients. When you take out a PMI or Life Insurance policy with us, you can also benefit from discounts on other types of cover, helping you protect your family's future more affordably.
Frequently Asked Questions (FAQs)
Do I need to declare a minor condition I had years ago?
What happens if I need emergency treatment? Do I go to a private hospital?
Is it cheaper to buy health insurance direct from an insurer or use a broker like WeCovr?
Ready to find out how quickly you can get covered and what your best options are? The world of PMI can be complex, but you don't have to navigate it alone.
Contact WeCovr today for a free, no-obligation quote. Our expert advisors will compare the UK's leading insurers and provide personalised advice to help you secure the right private health cover for you and your family.
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.
