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.
Chris Steele founded myTribe and is a CII-qualified insurance expert (IF1, IF7, I10) with over ten years of experience in private health insurance. His research is regularly cited by The Times, The Guardian, The Telegraph and other national media.
Full BioWhat you need to know about moratorium vs full medical underwriting
- Moratorium underwriting does not require you to disclose your full medical history 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.
- 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.
What is moratorium underwriting?
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, such as the AXA Health Plan and Saga, 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.
What is full medical underwriting?
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.
What is better, moratorium or full medical underwriting?
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.
Moratorium underwriting in-depth
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.
Automatic exclusions for recent pre-existing medical conditions
With moratorium underwriting any medical conditions that you've experienced symptoms of, sought advice or received treatment for in the past five years (three years in some cases) are automatically excluded from your cover.
Once your policy starts, if you go symptom-free for two continuous years and don't need treatment or advice, have tests or take medication for a pre-existing condition during that moratorium period, you will be covered for it in the future.
In essence, it's a "wait-and-see" approach, enabling you to gain cover as your policy continues. It means pre-existing conditions aren't permanently excluded and your cover can evolve over time.
Simpler and usually faster application process
By putting a blanket exclusion on all pre-existing conditions for a set period, the insurer doesn't need to evaluate your full medical history when you apply. This enables a policy to be set up quickly and avoids the hassle of submitting a detailed medical history at the outset.
In most cases, you provide basic personal information and answer a few simple medical questions when you apply instead. Moratorium underwriting is the method that insurers tend to use for their online health insurance quotations.
How does it affect the claims process?
It is important to understand that while some underwriting takes place upfront, the medical assessment under moratorium underwriting is deferred until a claim is made. At that point the insurer will ask you for your medical history to assess whether the condition is new, pre-existing, or linked to a pre-existing condition to check whether you are covered.
There's not as much clarity with moratorium health insurance underwriting
The main disadvantage of moratorium underwriting is the lack of clarity about what is covered, so you may find you have less cover than you expected only when you make a claim. This is especially the case for health issues related to pre-existing conditions, which insurers will also often exclude regardless of the type of underwriting you choose but which may not be obvious to you when your policy starts.
An example of moratorium underwriting in action
Let's say you had pain in your left hip three years before you took out a policy. You saw your GP, and it's been ok since. With moratorium underwriting, you can expect that conditions that might have caused that pain will be excluded for at least the first two years of your health insurance plan. But, if two years pass after your policy starts without further symptoms, treatment or medical advice, then the exclusions for conditions that might have caused that pain will usually be lifted.
However, if your hip pain comes back, or you need treatment after getting your health insurance, the moratorium period will reset, and you'll have to go trouble-free for two years before cover is provided.
Some health insurance providers now offer "modified moratorium"
In recent years some insurers, including Vitality and Saga, 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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Full medical underwriting in-depth
In this section, we outline precisely how full medical underwriting works when you take out health insurance.
Detailed application process
If you opt for full medical underwriting you'll complete a comprehensive health questionnaire when applying for your policy. You will need to list past and present medical conditions, describe your symptoms, provide details and dates of treatment you have received, and answer questions about your lifestyle.
Depending on your health declaration, your insurer may ask you to contact your doctor for clarification or additional records. Using this information, they can build a full picture of your health to decide what conditions will be covered and those that won't.
Exclusions are individually assessed
Whether any of your pre-existing conditions are covered depends on whether your insurer's underwriting team believes there is a risk that they may come back and require further treatment. They'll tell you before the policy starts if you have any exclusions and what they are, so you'll know what you're covered for. You can stop your application if you're unhappy with what the insurer will exclude.
Be honest with your insurer about pre-existing conditions
It is crucial that you answer every question fully and accurately, even about symptoms that seem minor or weren't diagnosed. The Consumer Insurance (Disclosure and Representations) Act 2012 requires you to take reasonable care not to give your insurer a misleading picture of your health. If you don't, it can add the exclusions it would have applied, reduce what it pays on a claim or, in serious cases, cancel the policy and refuse claims.
Unlike moratorium underwriting, with FMU, pre-existing medical conditions that are initially excluded won't be automatically covered in the future, regardless of how long you've gone symptom-free. However, some insurers set a date when a particular exclusion will be reviewed or removed, which your policy documents will show, and you can ask your insurer to review the others to see whether it is possible to lift them.
You can learn more about why health insurance typically doesn't cover pre-existing conditions or pending treatments in our guide.
An example of full medical underwriting in action
Let's use the same example as earlier. As a reminder, you had hip pain three years ago, saw your GP, and it's been fine since. When you submit your health insurance application and provide medical history details, your prospective insurer will decide what exclusions your policy may have.
As the hip pain was short-lived, occurred several years ago and required no treatment, they don't add exclusions to your policy. Equally, they may decide the symptoms warrant a general exclusion of hip pain, as you didn't get a formal diagnosis at the time.
If exclusions are added, the good news is you'll know what they are before you pay a penny, so you can decide with that information in hand whether you want to continue.
Assuming you go ahead with the policy and accept the exclusions, in most cases, the only way to remove them is by asking your insurer to review them, usually at renewal.
Quicker claims process
While the amount of health information that is required for full medical underwriting means it can take longer for a new health insurance policy to be set up, at the other end of the spectrum, the claims process should be quicker as the insurer should already have a sound knowledge of your medical history.
Advantages of full medical underwriting
Some of the key benefits of full medical 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 directly or buy a policy through an insurance broker, which may not suit everyone.
Alternatives to moratorium and FMU
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 fulfil 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, and the new insurer usually carries them across as they are, although some insurers can add extra exclusions of their own.
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 usually offered only to companies with around 15 or more employees (Bupa, for example, from around 15 people covered). 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 usually 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?
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What’s excluded, and which insurer is fairest.
- 9 tips when buying health insurance - 2026 Guide
Nine checks to make before you choose a policy.
- What are common health insurance exclusions in the UK?
What most policies won’t pay for, and why.
Research your options before you buy
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 before you buy.
If you need help finding the right private health insurance for your circumstances, request a quote and we’ll connect you with one of our FCA-regulated partner brokers, who we vet and monitor.
Frequently Asked Questions
What does a 2-year moratorium mean?
In a 2-year moratorium, insurers exclude conditions you had in the last five years (three with some insurers) for at least the first two years of the policy. If you have no symptoms, treatment, tests, medication or advice for a condition during that time, it may be covered afterwards, and any problem restarts the two-year clock. This simplifies underwriting because you don't need to give a full medical history when you apply.
More questions? Search our site to find the answers
Disclaimer: This is general information, not personal advice. Speak to a qualified broker before making a decision. Our broker partners compare policies from a panel of leading UK health insurers, but not all insurers may be available.