Moratorium underwriting vs full medical underwriting for UK health insurance
When you buy health insurance the underwriting option you choose when you apply will determine what your insurer will cover, so getting it right is key. In this guide, we explain the difference between moratorium underwriting and full medical underwriting so that you can understand which approach may best fit you and your private medical insurance.
What you need to know about moratorium vs full medical underwriting
- The medical underwriting process describes how your insurance company determines what your policy covers and how much it costs.
- Moratorium underwriting does not require you to disclose your full health upfront; instead, your insurer will only ask for it if or when you submit a health insurance claim.
- Full medical underwriting (FMU) requires you to provide detailed medical information before your policy starts and you'll receive a list of personal medical exclusions.
- Pre-existing medical conditions may be treated differently depending on the type of underwriting. Moratorium means exclusions are time-limited and may be removed later. With FMU, exclusions are typically fixed unless your insurer agrees to review them.
- Modified versions of moratorium underwriting now include brief health screening questions, slightly blurring the lines between the two types.
- Choosing the right health insurance underwriting approach comes down to your own personal preference. Ask yourself whether you’d prefer a fast, simple set-up with future flexibility (moratorium) or complete transparency and peace of mind from day one (FMU).
What is medical underwriting?
Medical underwriting describes how private medical insurance providers assess risk and decide on the cover levels they are willing to provide. They evaluate your application, and depending on the underwriting type you choose, they may use your medical history to identify and exclude pre-existing medical conditions that you may have.
While underwriting applies to all kinds of insurance, what is unique to private health insurance is that new customers can choose the type they want to go for: moratorium or full medical underwriting (FMU).
When setting up your health insurance policy, underwriting is arguably the most important decision you will need to make, as it will dictate the cover you will receive.
What is a pre-existing medical condition?
A pre-existing medical condition is any medical issue or symptom you have ever had, regardless of whether anything was formally diagnosed or you even sought medical advice for it.
In relation to health insurance in the UK, it can refer to any disease, illness, injury or medical issue for which you've had symptoms, sought advice, received treatment, taken medication or undergone diagnostic tests before your policy starts.
Pre-existing medical conditions can be long-term, such as diabetes and arthritis, one-off injuries or issues such as broken bones or back pain, or mental health conditions like depression or anxiety.
Moratorium underwriting requires answering minimal questions about your medical past when you apply. Instead, your health insurance cover excludes all medical conditions from the last five years. Some health insurance providers now offer a three-year exclusion period, but in most cases, it's five.
However, there is a welcome twist in that these medical conditions may be covered by your health insurance in the future. Typically, this happens if you go two continuous years without symptoms, treatment, tests, medication or advice for a condition after the policy begins (see our graphic below). These two years are known as the moratorium period.
With moratorium, your health insurance company will need little to no information about your medical past upfront and, instead, will only ask about your history when you claim on your health insurance.
You can read more about how moratorium underwriting works in our deep dive section further on.
Full medical underwriting, as the name suggests, involves your insurer taking a detailed look at your medical history during the application process to establish your personal medical exclusions.
It operates in a reverse way to moratorium underwriting in that you will be required to provide your complete medical history at the outset so that the insurer can let you know exactly what is and isn't covered by your policy. If you choose full medical underwriting your insurer may also ask to contact your GP for more information.
If you opt for full medical underwriting and your insurer comes back with personal medical exclusions that you feel undermine the reasons for having health insurance, you aren't obliged to continue and can stop your application.
Our full medical underwriting in-depth section later in this guide explains how this type of underwriting works with private medical insurance.
There's no universal "better" option when it comes to your medical underwriting. Whether moratorium or full medical underwriting is best depends on your personal health history and whether you value the benefits of one type over the other.
When moratorium underwriting may be better
Moratorium is a quicker and more straightforward approach to underwriting and could be ideal if you want to be covered as soon as possible. There is also the attraction that pre-existing medical conditions initially excluded at the start of your policy could be automatically added back over time, so your cover could expand in the future.
Moratorium underwriting may also suit those who don't want to trawl through their medical records and dislike paperwork. However, the trade-off is that you won't be certain what is covered, so you could find a claim declined further down the line because of an exclusion you were unaware of.
When full medical underwriting may be better
Full medical underwriting requires you to share more medical information during the application process, enabling your health insurer to tell you exactly what is and isn't covered before your plan starts. This certainty about your level of cover can provide valuable peace of mind and avoid nasty surprises when you make a claim.
If you have a complicated medical history or crave absolute certainty over what is covered, then full medical underwriting may be a better choice.
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Moratorium underwriting vs full medical underwriting for private health insurance
The table below summarises how the main features of moratorium underwriting and full medical underwriting compare
Understanding how these two types of underwriting stack up will make it easier for you to decide which one could be right for you. You can read more about the pros and cons of moratorium and full medical underwriting further on.
If you are looking to buy your first health insurance policy, the concept of moratorium underwriting is likely to be new to you, so in this section, we will explain precisely how it works.
Some health insurance providers now offer "modified moratorium"
In recent years several insurers have introduced medical screening questions to their moratorium underwriting that can either give you a discount on your premiums or better policy terms depending on whether you meet the insurer's criteria. We have coined this approach "modified moratorium.
These screening questions have slightly blurred the lines between moratorium and full medical underwriting, and depending on the insurer will ask about:
- any cancer diagnosis within the last five years
- whether you have been diagnosed with diabetes
- if you have high blood pressure
- any history of heart disease
- your smoking status
- your Body Mass Index (BMI)
While it's not as detailed as the medical questionnaires required for full medical underwriting, it is a move away from the strictly "no medical information" at application approach of traditional moratorium underwriting.
Advantages of moratorium underwriting
Some of the key benefits of moratorium underwriting include:
Speed and simplicity: There is less paperwork and no need to fill out extensive health forms upfront, so setting up a policy is swift. A new application can often be completed online and set up immediately.- You don't have to disclose everything: You don't need to remember your full medical history or chase up medical records, which avoids the risk of invalidating your policy if you fail to disclose relevant information.
- The ability to gain future cover: Pre-existing conditions aren't permanently excluded, so you could gain cover for them after the two-year moratorium period if you have been symptom-free.
- Shorter period for pre-existing conditions: Only conditions which occurred in the past five years (or, in some cases, three years) are automatically excluded. Fully medically underwritten policies can exclude conditions from any time in your past.
Disadvantages of moratorium underwriting
There are some disadvantages of moratorium underwriting that you should understand, such as:
- Lack of clarity: You won't know upfront what is and isn't covered by your policy. You will only find out when you make a claim, creating uncertainty about your cover.
- Automatic exclusions: Any medical condition that occurred in the last five years (or three years in some cases) will be automatically excluded for at least two years after the start date of your plan.
- Minor symptoms can mean bigger exclusions: Minor symptoms can result in broader exclusions under a moratorium policy, whereas fully underwritten policies may not treat early symptoms of a disease as significant.
- Longer claims: The retrospective medical assessment that insurers need to make when you claim can result in claims delays.
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In this section, we outline precisely how full medical underwriting works when you take out health insurance.
Advantages of full medical underwriting
Some of the key benefits of moratorium underwriting include:
- Clarity over cover: You know exactly what is and isn't covered from the outset, reducing the likelihood of claims being rejected and giving you greater peace of mind.
- Potentially fewer exclusions: By disclosing your full medical history, you could get cover for conditions you had during the five years before your policy which may be excluded through a moratorium, especially if it was relatively minor.
- Quicker claims: Any claims should be settled quickly as your insurer will know your medical history and be aware of any pre-existing conditions.
Disadvantages of full medical underwriting
There are some disadvantages of full medical underwriting to be aware of, including:
- Time-consuming set-up: Policies can take longer to arrange, especially if your medical history is complicated, due to the need to complete a health questionnaire. Insurers may also want to contact your GP.
- It can feel more intrusive: Some people may find full medical disclosure intrusive or be put off by the amount of paperwork needed for a policy to be set up.
- It's more difficult to remove exclusions: Unlike moratorium underwriting where you can gain cover in the future if you are trouble-free of pre-existing medical conditions for two continuous years, removing exclusions is trickier under FMU. It's not automatic, so policyholders must request a review, and there is no guarantee of success.
- Less online availability: Full medical underwriting is not always offered online, so you may need to call the insurer or buy a policy through an insurance broker, which may not suit everyone.
There are other types of underwriting that you may come across depending on whether you are looking to switch your private health insurance or are considering business health insurance.
Continued Moratorium Underwriting (when moving from previous insurer)
If you have an existing moratorium policy and want to move to a different insurer, you can use switch moratorium underwriting (also called continued moratorium underwriting). This allows you to move your health insurance cover with the moratorium you have previously earned to a new insurer rather than starting from scratch. You must fulfill some criteria, including that the new moratorium start date continues from your previous policy with no break in cover.
Continued Personal Medical Exclusions Underwriting (when moving from previous insurer)
Those with a fully medically underwritten health insurance policy looking to switch to a new insurer without losing cover can opt for Continued Personal Medical Exclusions Underwriting (CPME). Under this arrangement, you can move your existing personal medical exclusions to a different provider without the risk of adding new exclusions.
This is useful if you have received treatment for a condition and want to maintain cover for it in the future. A newly underwritten policy would classify it as a pre-existing medical condition and, depending on when it was resolved, might exclude it. But with Continued Personal Medical Exclusions, your new insurer may cover it, so long as you meet their criteria.
Medical History Disregarded
Medical history disregarded applies to business health insurance and is offered to companies with at least 15 employees. It means that your medical history will not be assessed when you apply for your employer's health insurance so you don't have to worry about underwriting exclusions. It's not available for individuals looking to take out their own private health insurance or smaller businesses.
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How to choose your health insurance underwriting type
When weighing up the pros and cons of moratorium vs full medical underwriting, think about your priorities. Ask yourself:
- Do I want a quicker and simpler application process without filling out long medical forms?
- How important is it for me to understand all exclusions clearly before my policy begins?
- Would I prefer to have pre-existing medical conditions automatically covered in the future if I don't need treatment for them over time?
- Will I find it more reassuring to have my medical history reviewed now to avoid any surprises when I claim?
Research and speak with a health insurance broker
As with all financial decisions, try to conduct as much research as possible to fully understand how moratorium and full medical underwriting work. This will give you plenty of talking points if you want to discuss your options with an insurance broker.
If you need help finding the right private health insurance for your circumstances, please click this link and request a free quotation.
Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.
Frequently Asked Questions
Does the type of underwriting affect my premium?
Choosing between moratorium underwriting and full medical underwriting usually does not impact the cost of health insurance. Both underwriting types typically result in the same pricing. Other factors, such as your age, where you live, and your lifestyle, will affect your health insurance premium.
What does a 2-year moratorium mean?
A 2-year moratorium in health insurance underwriting means insurers exclude cover for pre-existing medical conditions for two years. If the condition doesn't recur, need treatment, or show symptoms during this period, it may be covered thereafter. This approach simplifies underwriting without requiring a full medical disclosure.