Applying for certain types of health insurance, such as a short term health insurance, often requires a step called medical underwriting. During medical underwriting, insurance companies review your health before deciding whether to offer you coverage. Knowing what information you’ll need — and gathering it before you apply — can save time, help you answer questions more accurately and make the application process go more smoothly.
When does medical underwriting apply?
Affordable Care Act (ACA) Marketplace plans do not use medical underwriting or deny coverage because of a person’s health status.1
That’s because ACA-compliant health plans generally must accept anyone who applies even if they have preexisting conditions.2 These plans also can’t charge higher monthly payments (premiums) based on a person’s medical history.
Some types of coverage do not have to follow ACA rules. These plans may use medical underwriting. Examples include:
What information should you gather before you apply?
Having a few pieces of info handy is helpful. It can make the application easier to complete and help you avoid searching for records halfway through.
Depending on the plan, you may be asked about:
- Current and past health conditions
- Prescription medications
- Recent doctor visits
- Hospital stays or surgeries
- Lab tests or other healthcare
- Tobacco or nicotine use
You’ll also need basic information, such as:
If you use an online patient portal, review it before you start your application. It can help you find medication lists, visit dates and other health information you may need.
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How can you reduce the risk of delays when filling out the application?
It’s easy to rush through an application. But even small mistakes can slow things down if the plan needs to ask follow-up questions or verify your information.
Before you submit your application:
- Answer every required question.
- Confirm dates for diagnoses or treatment if you can.
- Check prescription medication names and doses.
- Review your application before submitting it.
If you aren’t sure about an answer, call your provider to get further details. Spending a little extra time now may help prevent delays later.
What information do underwriters review?
Medical underwriting helps insurers learn more about your health before deciding whether to offer coverage. Every plan has its own process, but many review similar types of information.
Preexisting conditions
Some plans review health conditions you had before applying. Depending on the type of coverage, these conditions may affect your:
- Eligibility
- Premium
- Other coverage terms
Recent diagnoses and treatment
Plans may also review recent healthcare, such as:
- A new diagnosis
- Surgery
- Ongoing treatment
This doesn’t always mean your application will be denied. The insurer may simply need more information before making a decision.
Prescription medications
Your prescription history can help confirm current or past health conditions. Keeping an up-to-date list of your medications can make your application easier to complete.
Tobacco and nicotine use
Many plans also ask about tobacco or nicotine use. Depending on the plan, it may affect your premium or other coverage terms. Answering these questions honestly can help avoid delays later in the review process.
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What happens after you submit your application?
Submitting your application isn’t always the last step. Depending on the plan and the information you provide, the insurer may contact you with additional questions or ask for supporting documents.
If that happens, try to respond promptly. Keeping copies of prescriptions, medical records and your providers’ contact information nearby can make it easier to answer questions and keep your application moving.
After reviewing your application, the insurer may:
- Approve your application as submitted.
- Approve coverage with a different premium.
- Approve coverage with certain limits.
- Ask for more information.
- Decline coverage.
If coverage isn’t offered, you may still have options. Depending on your situation, you may qualify for an ACA Marketplace plan, employer-sponsored insurance, a government health program or another type of health coverage.
Frequently asked questions
What’s the difference between full medical underwriting and moratorium underwriting?
Full medical underwriting includes a detailed review of your health history, medical records and current medications before a decision is made. Moratorium underwriting asks fewer health questions and usually doesn’t require medical records, but it may offer more limited coverage. The best choice for you depends on your health, budget and how quickly you need coverage.
Is a physical exam required for medical underwriting?
Most short term and supplemental health plans don’t require a physical exam. However, some insurers may ask for a phone interview or request access to your medical records. Requirements vary by insurer and plan.
Does my age affect how underwriting works?
Age is one factor insurers consider, along with your health history. It may affect which plans are available to you and how much they cost. Some plans may have an age requirement. You may need to be under age 65 to apply, for example. Age alone usually isn’t the only reason a plan may deny coverage.
Need help finding a health insurance plan that fits your needs? Call 1-844-211-7730 to speak with a licensed insurance agent, or browse available plans online.
For informational purposes only. This information is compiled by UnitedHealthcare, and/or one of its affiliates, and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.
Sources:
- Healthinsurance.org. “Medical underwriting.” Accessed August 6, 2026. Retrieved from https://www.healthinsurance.org/glossary/medical-underwriting/
- Healthcare.gov. “Health benefits and coverage.” Accessed August 6, 2026. Retrieved from https://www.healthcare.gov/coverage/pre-existing-conditions/
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