Moratorium underwriting skips the medical questions: conditions from (typically) the last 5 years are excluded, but can regain cover after around 2 symptom- and treatment-free years. Full medical underwriting means declaring everything up front for fixed, written exclusions. Prices are usually the same — the choice is about certainty versus convenience.
- ✓Moratorium: no forms now, typically a 5-year look-back, cover can return after ~2 clear years.
- ✓Full medical underwriting: declare everything, get exclusions in writing, certainty from day one.
- ✓Both routes usually cost the same — you're choosing how your history is handled, not a price.
The two ways insurers handle your medical history
Private health insurance covers new conditions, not pre-existing ones. Underwriting is simply the mechanism for drawing that line — and UK insurers offer two versions of the pencil. Moratorium draws the line automatically, by date. Full medical underwriting (FMU) draws it explicitly, condition by condition, based on what you declare.
The same insurers — Bupa, AXA Health, Aviva, Vitality, WPA, The Exeter — offer both routes on broadly the same products. Which you pick shapes the application experience now and, more importantly, how claims involving your history get decided later.
It's worth saying early: neither route lets you insure a condition you already have. Pre-existing conditions are excluded under both — the choice is about how the exclusion is defined, whether it can expire, and how much you know in advance. Get that framing right and the rest of the decision is straightforward.
How moratorium underwriting works
You answer few or no medical questions. Instead, a standard rule applies: any condition you had symptoms of, or received treatment, medication or advice for, in a look-back period — typically the last 5 years — is excluded as pre-existing.
The clever part is that moratorium exclusions can expire. On most 'rolling' moratorium terms, an excluded condition becomes covered once you've gone a set period — typically around 2 consecutive years after joining — without symptoms, treatment, medication or advice for it. Exact wording varies by insurer, and it's the wording that decides claims, so read yours.
A worked example: you pulled your back in 2023 and had physio. Join on a moratorium in 2026 and back trouble is excluded — it's inside the five-year window. Stay symptom-, treatment- and advice-free about your back until 2028, and it typically comes back into cover. Twinge in 2027 and see a GP about it? The clock restarts from there.
How full medical underwriting works
You complete a health questionnaire covering your medical history — conditions, symptoms, medications, referrals. The insurer assesses it up front and issues your policy with any exclusions stated in writing. Occasionally they'll ask your GP for a report; usually the questionnaire is enough.
From day one you know exactly where you stand: this policy covers everything except, say, 'disorders of the left knee'. There's no look-back logic to argue about at claim time, because the assessment already happened. Some FMU exclusions are permanent; others can be reviewed after a few clear years if you ask. The price of that certainty is effort and honesty — the questionnaire takes time, and an answer you get wrong (even innocently forgetting a referral) can undermine a claim later.
Not sure which route fits your history?
Side by side
| Moratorium | Full medical underwriting | |
|---|---|---|
| Application | Minutes — few or no medical questions | Health questionnaire; occasionally a GP report |
| Pre-existing conditions | Auto-excluded via look-back (typically 5 years) | Individually excluded, listed in your documents |
| Route back to cover | Typically after ~2 years symptom- and treatment-free | Only if the insurer agrees to review the exclusion |
| Certainty at claim time | Assessed against records when you claim | Known from day one |
| Price | Usually identical | Usually identical |
On price: both routes typically cost the same with the same insurer for the same cover. Underwriting isn't a discount lever — it's a risk-definition lever. Anyone selling one route as 'cheaper' is usually comparing different products, not different underwriting. Where money does enter it is at claim time: the route you chose decides how smoothly a claim near your history gets paid.
Who suits which? If your last five years are genuinely uneventful, moratorium is the pragmatic choice: nothing meaningful to exclude, no forms to fill. If you have a documented condition — especially a chronic one like diabetes, covered in our diabetes guide — FMU's written clarity usually beats the moratorium's ambiguity, since ongoing treatment blocks the two-year route back anyway.
Switching insurers: CPME and keeping your terms
Underwriting choices follow you when you switch. Move to a new insurer on standard terms and the clock resets — a new moratorium look-back or a fresh FMU assessment, with conditions that arose during your old policy now counting as pre-existing.
The fix is switch terms: continued personal medical exclusions (CPME), sometimes called continued moratorium. The new insurer agrees to carry over your existing underwriting position — same exclusions, no new look-back — usually on evidence of your current certificate and continuous cover, and subject to their acceptance criteria. If you've held cover for years, protecting that accumulated position is often worth more than any premium saving, so always ask for CPME terms when comparing a switch.
Two practical notes. First, CPME is generally only offered when you're switching like-for-like personal cover without a break — let a policy lapse and the option usually goes with it. Second, a broker can request CPME terms from several insurers at once, which is the realistic way to compare a switch properly; doing it insurer by insurer yourself is slow, and one mis-timed cancellation can cost you years of accumulated underwriting position.
Frequently asked questions
What does 'two years symptom-free' actually mean in practice?
It means two consecutive years — after your policy starts — with no symptoms, no treatment, no medication and no medical advice for the excluded condition. All four count: an innocent GP chat about an old back problem, or a repeat prescription, typically restarts the clock. It's assessed from your medical records when you claim, so the bar is what's documented, not what you remember.
Do I need my medical records for full medical underwriting?
Usually not — you complete a questionnaire from memory, and the insurer only occasionally requests a GP report. But your answers are checked against records if you claim, so accuracy matters more than paperwork. If you're hazy on dates or referrals, it's worth requesting your GP summary record before applying; getting a declaration wrong is the main way FMU goes bad.
Is moratorium cheaper than full medical underwriting?
Usually no — the same insurer typically charges the same premium for the same cover on either route. Underwriting determines how your history is treated, not the price. What you're choosing between is convenience now (moratorium) versus written certainty (FMU). If you see a price gap, you're almost certainly comparing different products or cover levels, not underwriting types.
Can insurers check my medical records when I claim?
Yes — with your consent, which claims processes require. Under a moratorium this is standard practice for any claim that could touch your history: the insurer requests relevant GP or specialist records and assesses the claim against the look-back wording. Under FMU it happens too, mainly to verify your original declarations. Records, not recollections, decide disputed claims.
What is CPME, or continued personal medical exclusions?
CPME is switching to a new insurer while carrying your existing underwriting position with you — your current exclusions transfer, and no new look-back or questionnaire is applied to the years in between. It's how long-standing policyholders change insurer without conditions that developed mid-policy becoming pre-existing. It's subject to the new insurer's acceptance, so confirm CPME terms in writing before cancelling anything.
Does the moratorium clock reset if a condition comes back?
Effectively, yes. On rolling moratorium terms, a recurrence — symptoms, treatment, medication or advice — means the condition is excluded again, and you need another clear period (typically around two years) before it can regain cover. That's the design: intermittent, recurring conditions may drift in and out of cover, which is exactly the uncertainty FMU avoids.
Which underwriting should I choose if I'm completely healthy?
Moratorium, for most people. With a genuinely clear five-year history there's nothing meaningful for the look-back to exclude, so you get the same practical cover as FMU without the questionnaire — and no risk of an innocent declaration error. The main counterargument is temperament: if you'd sleep better with your position confirmed in writing, FMU costs nothing extra.
Can an exclusion under full medical underwriting be removed later?
Sometimes. Some FMU exclusions are permanent, but many insurers will review one on request after a sustained clear period — often two to five years without symptoms or treatment — and may lift or narrow it. It doesn't happen automatically: you have to ask, usually at renewal, and possibly support it with GP evidence. Worth diarising if you were excluded for something long resolved.
Does asking my GP about an old condition restart the moratorium clock?
It can. The standard wording counts 'advice' as well as symptoms, treatment and medication — so a consultation about the excluded condition, even one ending in 'it's fine', is typically recorded and can restart the clear period. Don't avoid necessary care to protect a moratorium; do be aware that check-ins about the excluded condition have this effect.
Can I switch from moratorium to full medical underwriting later?
Often, yes — at renewal with your own insurer, or when switching insurers, you can ask to be re-underwritten on FMU terms. Whether it helps depends on your record: conditions now outside the look-back or long resolved may be accepted cleanly, while a recent history simply becomes a written exclusion. Ask for the FMU decision before committing, so you can compare it against your current moratorium position.