Most personal policies exclude pre-existing conditions — anything you've had symptoms, advice or treatment for, typically in the last 5 years. Under moratorium underwriting, cover for a condition can return after 2 trouble-free years. Large group schemes with medical history disregarded (MHD) underwriting cover pre-existing conditions from day one.
- ✓Pre-existing means symptoms or advice, not just a formal diagnosis.
- ✓Moratorium cover typically returns after 2 years without symptoms, treatment or medication.
- ✓Group schemes with MHD underwriting cover pre-existing conditions from day one.
What counts as a pre-existing condition
A pre-existing condition is broader than most people expect. It isn't just something a doctor has formally diagnosed — insurers generally define it as any condition you've had symptoms of, sought advice about, or received treatment or medication for before your policy started, whether or not it was ever given a name.
That distinction matters. If you saw your GP about knee pain last year and were told to rest it, that knee is typically pre-existing — even with no scan, no diagnosis and no treatment. The trigger is usually the symptom or the consultation, not the label.
It's worth saying what this doesn't mean. Having pre-existing conditions doesn't stop you buying health insurance, and it doesn't inflate the premium on most personal policies — the conditions are simply carved out of cover, temporarily or permanently, while everything new remains fully insured. Plenty of people with medical history hold private cover and claim happily for the conditions that came later.
Exactly what's excluded depends on how your policy is underwritten. The two main routes for personal cover are moratorium and full medical underwriting, and they handle your history very differently.
How moratorium underwriting works
Moratorium is the most common route for personal policies, partly because there's no medical questionnaire at application. Instead, the insurer applies a rolling rule: conditions you've had in a look-back period — typically the last 5 years, though this varies by insurer — start out excluded.
The important part is that moratorium exclusions aren't necessarily permanent. If you then go a set period — typically 2 continuous years after joining — without symptoms, treatment, medication, tests or medical advice for that condition, it can generally become eligible for cover again.
The catch is that the 2-year clock restarts each time the condition resurfaces. Anything that needs ongoing medication — say, blood pressure tablets — generally never becomes symptom- and treatment-free, so it stays excluded for as long as the treatment continues.
Note the timing too: the moratorium applies from the day your policy starts, so a condition from four years ago still needs 2 clear years after joining before it can be covered — the clock doesn't get backdated for time you were already well.
Full medical underwriting and permanent exclusions
Full medical underwriting (FMU) takes the opposite approach: you complete a health questionnaire when you apply, and the insurer tells you up front exactly what's excluded. There's no automatic 2-year mechanism — exclusions are typically permanent unless the insurer agrees to review them.
That sounds worse, but it has real advantages. You get certainty from day one, conditions the insurer decides not to exclude are covered immediately, and some insurers will reconsider an exclusion after a few clear years if you ask — often with supporting evidence from your GP.
| Moratorium | Full medical underwriting | |
|---|---|---|
| Medical questions at application | None | Full health questionnaire |
| Look-back period | Typically 5 years | Whole medical history |
| Exclusions decided | At claim, against the rules | Up front, in writing |
| Can exclusions lift? | Yes — typically after 2 clear years | Only if the insurer agrees a review |
Neither route is universally better. Moratorium suits people whose past issues are behind them and likely to stay that way; FMU suits people who want certainty, or whose history is minor enough that little gets excluded. We compare both when we quote.
Not sure what your history means for cover?
The group scheme exception: medical history disregarded
Medical history disregarded (MHD) underwriting, available on larger company schemes, is the one route where pre-existing conditions genuinely are covered. As the name suggests, the insurer ignores medical history entirely — everyone on the scheme is covered for eligible treatment from day one, existing conditions included.
MHD is typically offered on group schemes above a certain size — often around 15 to 20 employees, though thresholds vary by insurer — because the risk is spread across the whole workforce. It's one of the strongest arguments for joining a workplace scheme, or for setting one up if you run a business.
If your employer offers health cover, check the underwriting basis before assuming your history is a problem — it may not be one at all.
Frequently asked questions
What counts as a pre-existing condition for health insurance?
Generally, any condition you've had symptoms of, sought advice about, or received treatment or medication for before the policy started — a formal diagnosis isn't required. A GP visit about a niggling shoulder can make that shoulder pre-existing. Insurers typically look back 5 years under moratorium terms, or at your whole history under full medical underwriting.
What does two symptom-free years actually mean on a moratorium?
It means two continuous years after joining with no symptoms, treatment, medication, tests or medical advice for the excluded condition. Taking a repeat prescription or mentioning the condition to your GP typically restarts the clock. Once you've genuinely had two clear years, the condition can generally become eligible for cover again.
Can a pre-existing condition exclusion be reviewed or removed later?
Sometimes. Moratorium exclusions generally lift once you've completed the trouble-free period, typically 2 years. Full medical underwriting exclusions are permanent by default, but many insurers will review one on request after a few clear years, usually with supporting GP evidence. It's always worth asking at renewal rather than assuming an exclusion is forever.
How do group schemes cover pre-existing conditions?
Larger company schemes can use medical history disregarded (MHD) underwriting, where the insurer ignores medical history entirely and covers everyone for eligible treatment from day one, existing conditions included. MHD is typically available above roughly 15–20 employees, varying by insurer. If your employer offers cover, check the underwriting basis before assuming your history is excluded.
Do I have to declare my medical history on a moratorium policy?
There's no medical questionnaire at application — that's the point of moratorium. But you're not hiding anything: the insurer applies its look-back rules at claim time, usually by checking your GP records. You must still answer honestly any questions the insurer does ask, and claims for conditions within the look-back period will be declined until exclusions lapse.
Will the insurer check my GP records when I claim?
Very often, yes — particularly on moratorium policies, where claim time is when underwriting actually happens. The insurer typically asks your consent to request relevant GP records to confirm when symptoms first appeared. This is routine, not suspicion, but it's why hiding history never works: the records show what they show.
Does a condition I recovered from years ago still count as pre-existing?
If it falls outside the look-back period — typically 5 years on moratorium — and you've had no symptoms, treatment or advice for it since, it's generally not treated as pre-existing at all. A broken arm from a decade ago is a non-issue. Conditions that flare periodically are different: each recurrence effectively refreshes them.
Can I switch insurers without losing cover for a condition?
Often, yes. Many insurers offer switch terms — sometimes called continued or no-worse-terms underwriting — that carry over your existing underwriting position rather than starting a fresh moratorium. Conditions that arose while insured can stay covered. This needs arranging correctly at switch time, which is exactly the kind of detail we check when comparing renewal against the market.
What happens if I don't disclose a condition?
On full medical underwriting, non-disclosure can lead to declined claims or the policy being voided, depending on severity. On moratorium there's less to disclose up front, but your GP records reveal the true history at claim time, and claims within the look-back rules are declined regardless. Honesty costs nothing at application and protects every future claim.
Does taking regular medication stop the moratorium clock?
Generally, yes — ongoing medication for a condition counts as treatment, so the trouble-free clock never completes while you're taking it. This is why conditions managed with long-term prescriptions, such as high blood pressure or asthma, tend to stay excluded on moratorium terms indefinitely. A group MHD scheme is the main route to cover in that situation.