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Full Medical Underwriting or Moratorium Health Insurance?

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What is Health Insurance Underwriting?

One of the biggest factors to consider if you’re looking into buying Private Health Insurance is the type of underwriting you choose.

The two main types available are

  • Moratorium
  • Full Medical Underwriting.

These are two very different approaches to underwriting and will considerably impact what your Health Insurance covers you for.

The underwriting process could see the insurer put exclusions on health conditions you’re already suffering from and sometimes those you’ve suffered from in the past.

Unfortunately, neither type of underwriting will allow you coverage for a condition you’re currently suffering from or receiving treatment for. However, if that condition subsides for long enough to satisfy the insurer’s terms, you may be able to get coverage later on.

What is Moratorium Underwriting Health Insurance?

Moratorium underwriting excludes most pre-existing medical conditions you’ve suffered from over a set period, usually the past 5 years.

Moratorium underwriting is the most common type of medical underwriting for Health Insurance is divided into plans underwritten on a rolling moratorium or a fixed moratorium basis.

Rolling Moratorium Medical Underwriting

The vast majority of Health Insurance is written on a rolling moratorium basis.

Rolling moratorium underwriting means the insurer will consider any claims for medical conditions that you’ve suffered from in the 5 years before taking out the policy, providing you’ve served 2 years on the policy without any advice, medication or treatment for that condition.

This includes both self-funded private treatment or NHS treatment.

ski injury portrait

After a skiing injury, Mason was fully discharged from followups after shoulder surgery the year before taking out cover. For the next 3 years on the policy Mason was fine and required no further advice, treatment or medication, but then had a sudden relapse.

In this case under a rolling moratorium the insurer would most likely pay for treatment as Mason hadn’t needed to seek medical advice for 3 years after taking out her cover.

Fixed Moratorium Medical Underwriting

Fixed moratorium underwriting is a more lenient type of underwriting that rolling moratorium underwriting.

It still excludes any medical conditions you’ve suffered from in the 5 years leading up to the policy start date.

However, once you’ve served 2 years on the policy, the insurer will then consider covering you for that condition – regardless of whether you’ve received treatment for that condition or not over those 2 years.

It’s important to realise that often the most serious conditions – such as cardiac and cancer cases – are unlikely to be eligible for fixed moratorium underwriting.

Only one insurer still uses fixed moratorium underwriting for its Medical Insurance, however.

knee injury

After injuring her knee a year before taking out Health Insurance, Amy had an arthroscopy to repair damaged cartilage. In the first two years of having Medical Insurance, Amy visited an NHS physiotherapist and her GP for follow-up treatment and advice.

Under a fixed moratorium, despite having needed treatment in the first two years of the policy, the insurer would consider covering her knee condition.

Pros and Cons of Moratorium Medical Underwriting

Advantages of moratorium underwriting

  • Moratorium underwriting can speed up the implementation of your Medical Insurance because you don’t usually have to fill in a health declaration.
  • If you haven’t suffered from any major health conditions in the past 5 years, moratorium underwriting means there’ll typically be no automatic exclusions.
  • If you do have any pre-existing conditions, you may be able to get coverage for them after a 2 year period on the policy.
  • The 5 year window means that historic medical conditions before this 5 year period will usually be covered.

Disadvantages of moratorium underwriting

  • Even if you’ve only suffered from a minor health condition in the past 5 years, this will likely be automatically excluded with little chance for leeway from your insurer.
  • With moratorium underwriting, you may not be sure exactly what you’re covered for based on your past medical history until you try to claim.

Full Medical Underwriting Health Insurance

Buying fully medically underwritten Health Insurance means you disclose your entire medical history to the insurer from the start.

This lets your insurer take your health into consideration when deciding how to provide you with cover.

Do I Need to Disclose My Medical History to Take Out Health Insurance?

Yes, if you opt for full medical underwriting then you’ll need to fill out a health questionnaire to buy Medical Insurance.

You provide your medical history through a health declaration form, which will ask a set of questions about your health and previous medical conditions.

Depending on what comes up on the form, the insurer might write to your GP for further evidence of your medical history to back up the underwriting.

Any disclosures on the health declaration form or that later come up if the insurer decides to write out for your medical history will result in an exclusion for that condition.

It’s essential that you’re upfront and honest with your insurer when you’re filling in the health declaration form.

Any failure to disclose a pre-existing condition, even if you think it’s not worth putting down, could lead to your Health Insurance provider pulling coverage later down the line on the grounds of the non-disclosure.

Nadeem Farid
Head of Employee Benefits at Drewberry

With full medical underwriting, any serious condition you’ve suffered from in the past will likely be excluded, even if it occurred more than 5 years ago.

This exclusion will usually be permanent, although it may be possible to get it lifted at a later date with medical evidence from your GP.

For more minor conditions, however, you may be able to negotiate coverage with your insurer, particularly if that condition occurred a number of years ago.

The Pros and Cons of Full Medical Underwriting

Advantages of full medical underwriting

  • Transparency – you know exactly what you will and won’t be covered for from the outset
  • You may be able to get coverage for conditions that have occurred during the past 5 years, especially if that condition is minor, subject to your insurer’s discretion

Disadvantages of full medical underwriting

  • It can take extra time to arrange a policy when it’s fully medically underwritten because of the health questionnaire and the possible need to write to your GP
  • If further down the line you want to examine having a medical exclusion removed from your policy with evidence from your GP, you may need to pay for these reports. However, there’s no guarantee that the insurer will accept your attempt to get the exclusion removed even after you’ve paid for the reports.
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What is the Best Health Insurance Underwriting?

Now you understand the difference between full medical underwriting and moratorium underwriting, you’ll have to consider which is the best health insurance underwriting for you.

The Best Medical Underwriting for Serious Conditions

If you’ve recovered from a serious medical condition in the past 5 years, it may be better to opt for moratorium underwriting.

That’s because after 2 years on the policy, the insurer will reassess your health and, providing you haven’t sought any advice, medication or treatment for that condition in those 2 years, potentially look in to covering you.

With full medical underwriting, on the other hand, this serious condition is likely to face an ongoing exclusion, even if you suffered from it more than 5 years ago.

It can be very tricky to get an exclusion removed from a policy that’s used full medical underwriting at a later date.

The Best Medical Underwriting for Minor Conditions

If you’ve suffered from a minor condition in the past 5 years, then full medical underwriting may be better than moratorium underwriting.

This is because moratorium underwriting will put an exclusion on most medical conditions you’ve suffered in the past 5 years regardless of severity.

However, when an insurer examines your medical history during the full medical underwriting process they may deem the condition to be minor enough for them to offer you cover for it regardless.

The Best Medical Underwriting for Historic Conditions

If you’ve suffered from a medical condition more than 5 years ago, then moratorium underwriting is likely better than full medical underwriting.

This is because moratorium underwriting only looks at conditions you’ve suffered in the past 5 years.

Full medical underwriting, on the other hand, will go back through your entire medical history and may put exclusions on policies you’ve suffered historically, even if you’ve not had any symptoms for some time.

Private Medical Insurance Underwriting Advice

If you’re still not sure which option to pick when taking out Private Medical Insurance, then talking it over with one of our experts could help.

They will listen to your concerns and take a basic medical history from you before using their experience and expertise to help you decide which medical underwriting is most suitable for you.

Why Speak to Us?

We started Drewberry because we were tired of being treated like a number and not getting the service we all deserve when it comes to things as important as protecting our health and our finances. Below are just a few reasons why it makes sense to talk to us.

  • There is no fee for our service
  • We are independent and impartial
    Drewberry isn’t tied to any insurance company, so we can provide completely impartial advice to make sure you get the most appropriate policy based solely on your needs.
  • We’ve got bargaining power on our side
    This allows us to negotiate better premiums for you than you going direct yourself.
  • You’ll speak to a dedicated expert from start to finish
    You will speak to a named expert with a direct telephone and email. No more automated machines and no more being sent from pillar to post – you’ll have someone to speak to who knows you.
  • Benefit from our 5-star service
    We pride ourselves on providing a 5-star service, as can be seen from our 2049 and growing independent client reviews rating us at 4.92 / 5.
  • Gain the protection of regulated advice
    You are protected. Where we provide a regulated advice service we are responsible for the policy we set-up for you. Doing it yourself or going direct to an insurer won’t provide this protection, so you won’t benefit from these securities.
  • Claims support when you need it the most
    You have support should you need to make a claim. The most important thing when it comes to insurance is that claims are paid and quickly. We are here to support you during the claims process and make sure it’s as smooth and stress free as possible.
Nadeem Farid Health & Wellbeing Expert at Drewberry

We are here to offer impartial and, most importantly, fee-free Health Insurance advice.

If you want to talk through your options to make sure you are looking at the most suitable cover then don’t hesitate to  pop us a call on 02084327333.

Nadeem Farid
Health & Wellbeing Expert at Drewberry

Sam was very helpful and kept me informed at all times. Brilliant service.

Paul Williams
05/06/2019
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