Understanding Continuing Personal Medical Exclusions (CPME)
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr specialises in making complex topics simple. This guide to Continuing Personal Medical Exclusions (CPME) will help you understand how to switch your UK private medical insurance provider without losing valuable cover.
WeCovr's guide to CPME when switching between private health insurers
Switching your car insurance or home insurance is often a simple annual task. You compare prices, find a better deal, and move. But when it comes to private medical insurance (PMI), the process can feel more daunting. What happens to the cover for that knee problem you had treated last year? Will a new insurer cover it?
This is where a vital but often misunderstood term comes into play: Continuing Personal Medical Exclusions (CPME).
Understanding CPME is the key to unlocking the freedom to move between insurers, potentially saving you money and accessing better benefits, all without the fear of losing cover for conditions you’ve previously claimed for. In this comprehensive guide, we'll break down everything you need to know.
A Quick Refresher: What is Private Medical Insurance?
Before we dive into the specifics of switching, let's quickly recap what private medical insurance is designed for.
PMI, also known as private health cover, is an insurance policy that covers the costs of private medical care for acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Think of things like joint replacements, cataract surgery, or treatment for a hernia.
The Golden Rule of UK PMI
It is absolutely crucial to understand this point: Standard private medical insurance in the UK does not cover pre-existing or chronic conditions.
- Pre-existing Conditions: Any illness or injury you had before you took out the policy.
- Chronic Conditions: An illness that cannot be cured, only managed. Examples include diabetes, asthma, arthritis, and high blood pressure. PMI may cover the initial diagnosis of a chronic condition, but it will not cover the long-term monitoring and management.
The NHS provides excellent care for chronic conditions, and PMI is designed to work alongside it, giving you faster access to treatment for new, curable health issues that arise after your policy begins.
The Foundation of Your Cover: Understanding Underwriting
"Underwriting" is the process an insurer uses to assess your health and medical history to decide what they will and won't cover. There are two main ways they do this when you first take out a policy.
1. Moratorium Underwriting
This is the most common type of underwriting for personal PMI policies in the UK.
- How it works: You don't need to fill out a detailed medical questionnaire. Instead, the insurer applies a blanket "moratorium" period, usually two years. During this time, they will not cover any medical conditions you have had symptoms of, or received treatment or advice for, in a set period before the policy started (typically the last five years).
- The "Two-Year Rule": If you go for two continuous years after your policy starts without experiencing any symptoms or needing any treatment, advice, or medication for that pre-existing condition, the insurer may then agree to cover it in the future.
- Best for: People who are generally healthy and want a quicker, simpler application process.
2. Full Medical Underwriting (FMU)
This method is more detailed from the outset.
- How it works: You complete a full health questionnaire, declaring your entire medical history. The insurer's underwriting team will review your answers and may ask your GP for more information. They will then offer you a policy with specific, named exclusions for any pre-existing conditions.
- Clarity from Day One: With FMU, you know exactly what is and isn't covered from the very beginning. The exclusions are permanent and will not be removed after a set period.
- Best for: People who want absolute certainty about their cover from the start, or those who have had a pre-existing condition in the distant past that they want to be sure is covered.
Here’s a simple table to compare the two:
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Medical Declaration | No initial health questionnaire required. | Detailed health questionnaire required. |
| Application Process | Fast and simple. | Slower, may require GP reports. |
| Exclusions | General exclusion for recent pre-existing conditions. | Specific, named exclusions for life. |
| Cover for Past Issues | Can be covered after a 2-year trouble-free period. | Never covered if listed as an exclusion. |
| Certainty of Cover | Less certainty at the point of claim. | Full certainty from day one. |
The Problem: Why Switching Insurers Can Be Risky
So, you've had your PMI policy for a few years. You've noticed your premium has increased, and you see a competitor offering what looks like a better deal. Why not just switch?
Here's the trap: If you switch to a new insurer using standard Moratorium or FMU underwriting, any condition you've been treated for under your old policy will now be classed as a "pre-existing condition" by your new insurer. This means it will be excluded from cover.
Let's look at a real-world example:
David's Story: David took out a PMI policy with Insurer A in 2022 on a moratorium basis. In 2024, he developed persistent shoulder pain. His PMI covered a private consultation, an MRI scan, and a course of physiotherapy. He's now pain-free.
In 2025, his renewal quote from Insurer A is higher than he'd like. He sees an advert for Insurer B offering a cheaper premium. If David cancels his policy with A and takes out a new moratorium policy with B, his recent shoulder problem will be considered pre-existing. Insurer B will not cover him if the shoulder pain returns in the next two years. He has effectively lost a key benefit he had already earned.
This is the fear that stops many people from shopping around for their health insurance, leaving them stuck with uncompetitive providers and rising premiums.
The Solution: Continuing Personal Medical Exclusions (CPME)
This is where CPME comes to the rescue.
CPME is a special type of underwriting designed specifically for people who already have private medical insurance and want to switch to a new provider.
It allows you to move to a new insurer while "carrying over" your existing level of cover. In simple terms, the new insurer agrees to continue covering you on the same terms as your old policy. This means:
- No new medical exclusions are added for conditions that were already covered by your previous policy.
- Any personal exclusions you already had on your old policy will be carried over to the new one.
CPME is sometimes called "switch underwriting," "protected underwriting," or "no further medical underwriting." It ensures a seamless transition, allowing you to benefit from a more competitive market without being penalised for having used your insurance.
Revisiting David's Story with CPME:
David speaks to an expert PMI broker like WeCovr. We explain the CPME option. We find a policy with Insurer C that offers similar benefits to his old policy but for a lower monthly premium.
We help David apply to Insurer C on a CPME basis. He provides a copy of his current policy certificate from Insurer A. Insurer C's underwriters review it and agree to take him on.
Now, if David's shoulder pain returns, Insurer C will cover his treatment because it would have been covered by his old policy. He has successfully switched, saved money, and kept his continuity of cover.
How Does a CPME Switch Work in Practice?
The process is straightforward, especially when guided by an experienced broker.
- Gather Your Documents: You'll need your most recent policy certificate from your current insurer. This document confirms your underwriting type, any personal exclusions, and your cover start date.
- Contact an Expert Broker: Get in touch with the team at WeCovr. Our service is free, and we do the hard work for you. We'll discuss your current cover, what you're looking for in a new policy, and your budget.
- Market Comparison: We will approach the leading UK private health cover providers on your behalf to find the best CPME options available. We compare not just the price, but the subtle differences in policy terms.
- Application: We'll help you complete the application form for your chosen new insurer. It’s usually much simpler than a full medical underwriting form.
- Underwriting Review: The new insurer will review your application and your old policy certificate. They confirm they are happy to offer cover on a CPME basis.
- Seamless Switch: Your new policy is set up to start the day after your old one expires. There is no gap in your protection. You receive your new policy documents confirming that your cover continues on the same terms.
Who is Eligible for a CPME Switch?
While most people with an existing PMI policy can switch using CPME, there are a few general conditions:
- You must have an active, comparable UK PMI policy.
- Your current policy must have been underwritten on a Moratorium or Full Medical Underwriting basis.
- You cannot have a significant break in cover (usually no more than 14-28 days is allowed between policies).
- The switch must typically be from one individual or family policy to another. It may not be available if you are leaving a large corporate scheme.
CPME vs. Moratorium vs. FMU: A Detailed Comparison
This table breaks down the key differences to help you decide what's right for you.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) | Continuing Personal Medical Exclusions (CPME) |
|---|---|---|---|
| Who is it for? | People new to PMI, generally in good health. | People new to PMI who want absolute clarity on cover. | People with an existing PMI policy who want to switch. |
| Medical Declaration | None. | Full health history questionnaire. | Provide current policy certificate. |
| Cover for Old Conditions | Excluded for 2 years, then potentially covered. | Permanently excluded if declared. | Conditions covered by the old policy remain covered. |
| Cover for New Conditions | Covered after the policy starts. | Covered after the policy starts. | Covered after the policy starts. |
| Switching Process | You lose cover for conditions treated under the old policy. | You lose cover for conditions treated under the old policy. | You keep your cover for conditions treated under the old policy. |
| Main Advantage | Simple to set up. | Certainty from day one. | Allows you to shop the market without losing cover. |
| Main Disadvantage | Uncertainty over what's covered at claim time. | More complex application; exclusions are for life. | Cover is "like-for-like"; won't add cover for existing exclusions. |
The Benefits of Switching Insurers with CPME
The UK's private health insurance market is dynamic and competitive. Sticking with the same provider year after year without reviewing your options could mean you're missing out.
1. Maintain Your Hard-Earned Cover
This is the single biggest benefit. You don't have to start from scratch with a new moratorium period. The peace of mind you have, knowing your existing conditions remain covered, is invaluable.
2. Find a Better Price
Premiums can increase at renewal for many reasons, including age and medical inflation. According to recent market analysis, renewal premiums can often be higher than the price a new customer would pay. Switching on a CPME basis allows you to take advantage of more competitive pricing from other insurers.
3. Access Improved Benefits
The PMI market is constantly evolving. Newer policies might include benefits that your older policy lacks, such as:
- Enhanced Mental Health Cover: More comprehensive support for therapy and psychiatric care.
- Advanced Cancer Care: Access to the latest drugs and treatments not yet available on the NHS.
- Virtual GP Services: 24/7 access to a GP by phone or video call.
- Wellness and Rewards Programmes: Discounts on gym memberships, fitness trackers, and healthy food.
4. Experience Better Customer Service
If you've been frustrated by your current insurer's claims process or customer service, switching gives you a fresh start with a provider known for higher satisfaction ratings.
Potential Pitfalls: What to Watch Out For
While CPME is a fantastic tool, it's important to be aware of a few nuances. This is where using a specialist broker is vital.
- "Like-for-Like" Doesn't Mean "Identical": Your new insurer will aim to match the level of your old cover. For example, if you had a £1,000 outpatient limit, your new policy will likely be quoted with the same limit. However, the overall policy wording, definitions, and hospital lists may differ. A good broker will highlight these differences.
- Exclusions are Still Exclusions: Remember, CPME carries over your existing cover terms. If your original policy had a personal medical exclusion for a bad back you had 10 years ago, that exclusion will move with you to the new insurer. CPME does not add new cover; it protects the cover you already have.
- Benefit "Downgrades": If your old policy had a very high or unlimited benefit that a new insurer doesn't offer as standard (e.g., unlimited outpatient diagnostics), they may have to place a cap on it. This will be made clear in the quote.
Your Health is Your Wealth: A Holistic Approach
While private medical insurance provides a safety net for when things go wrong, the best approach to health is always prevention. The NHS continues to face significant pressure, with waiting lists for routine treatments reaching record levels in recent years. Taking proactive steps to manage your wellbeing can reduce your risk of needing medical intervention in the first place.
- Balanced Diet: Focus on whole foods, fruits, vegetables, and lean proteins. A Mediterranean-style diet has been shown to have numerous health benefits. As a WeCovr client, you get complimentary access to our AI-powered nutrition app, CalorieHero, to help you track your intake and make healthier choices.
- Regular Activity: Aim for at least 150 minutes of moderate-intensity activity, like brisk walking or cycling, per week. Find something you enjoy to make it a sustainable habit.
- Prioritise Sleep: Good quality sleep is fundamental to physical and mental health. Aim for 7-9 hours per night and practice good sleep hygiene, like avoiding screens before bed.
- Manage Stress: Chronic stress can contribute to a range of health problems. Incorporate mindfulness, yoga, or simple breathing exercises into your daily routine. Many modern PMI policies include access to mental health support apps and services.
By combining a healthy lifestyle with a robust private medical insurance policy, you create a powerful strategy for protecting your long-term health and wellbeing.
Why Use WeCovr for Your CPME Switch?
Navigating the PMI market and the specifics of a CPME switch can be complex. Working with an independent, FCA-authorised broker like WeCovr removes the stress and ensures you get the best possible outcome.
- Unbiased Expert Advice: We are not tied to any single insurer. Our goal is to find the right policy for you. We understand the fine print and can explain the pros and cons of each option in plain English.
- Whole-of-Market Access: We have relationships with all the leading UK private medical insurance providers, giving you the widest possible choice.
- It Costs You Nothing: Our expert advice and support are completely free. We receive a commission from the insurer you choose, which is already built into the premium. You pay the same price as going direct, but with the added value of our guidance.
- We Handle the Paperwork: We manage the application process from start to finish, ensuring everything is submitted correctly for a smooth and successful switch.
- Added Value: When you arrange your PMI or Life Insurance through WeCovr, you not only get expert service but also complimentary access to our CalorieHero app and potential discounts on other types of cover you might need.
Don't let inertia or fear of losing cover keep you tied to an expensive or outdated policy. A CPME switch could be the smartest financial and health decision you make this year.
Can I switch to a policy with better benefits using CPME?
Will my premium go down if I switch on a CPME basis?
What happens if I have an ongoing claim when I want to switch?
Do I need to have another medical check-up to switch with CPME?
Take the Next Step
Ready to see if you could get better cover or a better price for your private medical insurance? Let our friendly, expert team do the hard work for you.
[Get your free, no-obligation PMI quote from WeCovr today and discover the benefits of a seamless CPME switch.]
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
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