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Medical Underwriting

Medical Underwriting Explained

Updated August 2026
In A Nutshell

Medical underwriting decides how your health history is treated. There are five real types: Moratorium, Full Medical Underwriting, CPME, Continued Moratorium and MHD, each applying in different situations, explained clearly below.

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The Basics

What Is Medical Underwriting?

Every health insurer needs a way to assess the risk they're taking on before they cover you, this is underwriting. In practice, it means deciding how your existing medical history is treated by the policy, specifically, which conditions are covered from day one, and which are excluded, either temporarily or permanently.

The method used genuinely changes what you're covered for, so it's worth understanding before you compare, not after. There are five real types worth knowing: two that apply when you first take out a policy (Moratorium and Full Medical Underwriting), and three mechanisms that come into play when you switch insurer or join a company policy (CPME, Continued Moratorium and MHD). We've explained each one properly below, with visuals for the two that trip people up most.

New To Health Insurance

Moratorium And Full Medical Underwriting

If you're taking out health insurance for the first time, these are the two options you'll actually be choosing between.

Most Common For New Policies

Moratorium

No medical questionnaire upfront. Instead, a rolling medical-history check applies automatically.

5 Years
Before
Policy
Starts
2 Years
Later
Must be symptom, treatment and advice free
Your medical history is checked hereNow covered

Anything you've had symptoms, treatment (including medication) or advice for, such as a GP appointment or consultation, in the 5 years before your policy starts is excluded from day one. From the date your policy actually starts, if you then go 2 years completely symptom, treatment and advice free for it, it becomes covered again automatically. Worth knowing too, most insurers also exclude any associated conditions, not just the exact condition itself, so it's worth checking exactly what that covers with your broker.

Look-back periods vary by insurer

5 years is the market standard, but it isn't universal. Saga offers a shorter 3-year look-back option for many conditions, and AXA offers both a 3-year and the standard 5-year product too. Always confirm the exact current terms with your broker.

Full Medical Underwriting (FMU)

You declare everything upfront, the insurer decides what's excluded before you join.

1
Complete a full medical questionnaire
2
Insurer reviews your history
3
Specific exclusions confirmed, in writing

More upfront effort, but you know exactly where you stand from day one, no automatic rolling clock to track. Some insurers may also contact your GP for further detail before confirming terms.

Worth Checking

How Moratorium Actually Varies By Insurer

The basic principle is the same everywhere, but the detail genuinely differs, and it's rarely obvious upfront.

InsurerWorth Knowing
SagaShorter 3-year look-back option for many conditions, rather than the standard 5 years
AXA HealthOffers both a 3-year through their direct sales channels and the standard 5-year look-back product via intermediary partners
VitalityMoratorium+ offers an extra 15% discount if you can answer "no" to a shorter 3-year medical declaration, rather than the standard 5-year one
BupaStandard moratorium option, the 5-year look-back applies with exclusions cleared after a 2-year symptom-free period
AvivaStandard 5-year look-back and 2-year clear period, confirmed via Aviva's own published terms
The ExeterStandard 5-year look-back and 2-year clear period.
WPAStandard terms, but moratorium isn't available at all from age 66.
FreedomStandard terms, but online instant quotes are moratorium-only, Full Medical Underwriting needs contacting them or a broker directly
The clock can reset, this catches people out

On a standard "rolling" moratorium, if you see a GP or get any treatment, tests or advice for that condition during your 2-year symptom-free wait, even briefly, the clock resets and you start the 2 years again from that point. This is genuinely worth asking your broker about directly, since it can catch people out.

Switching Or Joining A Company Policy

CPME, Continued Moratorium And MHD

These three aren't underwriting methods in their own right, they're mechanisms that apply in specific situations, switching insurer or joining a larger employer scheme.

Comparing health insurance options when switching provider

Continued Personal Medical Exclusions (CPME)

Not a type of underwriting itself, a bridge that carries your specific accepted terms when you switch, whichever underwriting method you were originally on.

Current
Insurer Terms
New Insurer
Matches Them

If a new insurer agrees to match your current terms, conditions already accepted under your existing policy keep being covered, no restarting underwriting from scratch.

Genuinely Different From CPME

Continued Moratorium (CMORI)

Only available if you're switching from a policy that was already on moratorium terms. Rather than carrying over specific exclusions, it carries over the actual clock itself.

If you'd already served 1 year of a 2-year symptom-free wait with your old insurer, CMORI lets that year count, so you'd only need to serve 1 more year with the new insurer, not a fresh 2 years. It typically requires no break in cover between the old policy ending and the new one starting. Bupa markets this specifically as its "moratorium switch facility," worth asking for by that name if you're a Bupa customer switching elsewhere.

CPME vs CMORI

CPME carries over a specific list of accepted exclusions. CMORI instead carries over your original moratorium start date, so the 5-year look-back and 2-year clearance continue counting from when your policy first began, not from scratch with the new insurer. If your original policy was on moratorium terms, CMORI is usually what you actually want, not CPME. It's also possible with some insurers for written medical exclusions to be added on top, worth confirming exactly what applies with your broker before switching.

Larger Company Policies Only

Medical History Disregarded (MHD)

Used almost exclusively for larger employer company or business policies, not typically available for individual personal cover. The insurer disregards your medical history entirely, no underwriting exclusions are applied for pre-existing conditions at all, though policy terms and benefit limits still apply.

Some insurers, including WPA, also offer an MHD variant that includes heart and cancer qualifying questions as an alternative version, worth checking if this applies to your specific scheme.

At A Glance

All Five, Side By Side

Which one actually applies to you, in one table.

TypeWhen It AppliesWhat Carries Over
MoratoriumNew policyNothing, rolling 5-year check applies
Full Medical (FMU)New policyNothing, exclusions confirmed upfront
CPMESwitching insurerSpecific accepted exclusions
Continued Moratorium (CMORI)Switching from a moratorium policyThe moratorium clock itself
MHDLarger company or business policiesN/A, medical history disregarded entirely
Why Use A Broker

The Benefits Of Working With A Broker

If reading all of the above has made one thing clear, it's that underwriting is genuinely complex. Five different types, insurer-specific variations, a clock that can silently reset, this isn't something most people can confidently navigate alone, and getting it wrong can mean losing cover for a condition you assumed was protected.

  • They know exactly which insurer suits your specific medical history
  • They can confirm CPME or CMORI eligibility before you switch, not after
  • Whole-of-market, not tied to one insurer's own terms
  • They handle the application and underwriting questions for you
  • Ongoing support if you ever need to query a decision
Speaking to a broker about medical underwriting options
FAQs

Medical Underwriting FAQs

What does moratorium underwriting mean?

Moratorium underwriting means your insurer doesn't ask about your medical history when you apply, instead automatically excluding anything you've had symptoms, treatment or advice for in the 5 years before your policy starts. If you then go 2 continuous years without any symptoms, treatment or advice for that condition, it becomes covered again automatically, this is the most common underwriting type for new UK health insurance policies.

What's the difference between moratorium and full medical underwriting?

Moratorium needs no medical questionnaire upfront, instead automatically excluding anything you've had symptoms, treatment or advice for in the past 5 years, until you go 2 years symptom-free. Full medical underwriting asks for your complete history upfront, and the insurer confirms specific exclusions in writing before you join, giving more certainty from day one but requiring more effort at the start.

What's the difference between CPME and Continued Moratorium?

CPME carries over a specific list of accepted exclusions when you switch insurer, regardless of your original underwriting type. Continued Moratorium (CMORI) only applies if your original policy was on moratorium terms, and instead of carrying a list of exclusions, it carries over the actual time already served on your moratorium clock, so you're not starting the wait over from scratch.

What is Medical History Disregarded (MHD) underwriting?

MHD means the insurer disregards your medical history entirely, no exclusions are applied for pre-existing conditions at all. It's used almost exclusively for larger company or business health insurance policies rather than individual personal cover, and policy terms and benefit limits still apply even though individual underwriting doesn't happen. Some insurers, including WPA, also offer a variant with heart and cancer qualifying questions built in.

Is the 5-year moratorium look-back the same for every insurer?

No, 5 years is the market standard but not universal. Saga offers a shorter 3-year look-back option for many conditions, and AXA offers both a 3-year and the standard 5-year product too. Always check the exact current terms with your broker rather than assuming the standard figure applies.

Can I switch underwriting type without switching insurer?

Generally, underwriting type is set when you first take out a policy and doesn't change while you stay with the same insurer. Changing underwriting type typically means switching insurer entirely, at which point CPME or Continued Moratorium can help protect the cover you've already built up, depending on which type your original policy used.

Is moratorium underwriting available at any age?

Not always. Most insurers offer moratorium regardless of age, but WPA is a genuine exception, moratorium isn't available at all from age 66, and new joiners at that age must use Full Medical Underwriting with a minimum £500 excess instead. Worth checking this specifically if you're comparing cover in your late 60s or beyond, since it can affect which insurers are genuinely available to you.

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Related Guides

Explore More Health Insurance Guides

Underwriting connects to a lot of other decisions, here's where to go next.

Pre-Existing Conditions

See our full pre-existing conditions guide.

How To Switch

See our full step-by-step switching guide.

The Complete Guide

See our full guide to private health insurance.

Sources & Disclaimer

Written by: Darren Lewis, health insurance specialist and founder of Compare My Health Insurance. Last reviewed: August 2026. Next scheduled review: February 2027.

Sources: Published insurer underwriting documentation including WPA's own underwriting guidance, and broker experience from Compare My Health Insurance's specialist partners.

Compare My Health Insurance works with FCA-regulated broker partners and may earn a fee when you take out a policy through our service. This does not affect our editorial content above. Any information on this page is for general information only and should not be considered financial advice, regulated advice or a personal recommendation. Suitability depends on your individual circumstances, needs and budget.

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