Medical Insurance - The Best Insurance

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Help us answer a few questions so we can get you the most accurate Medical Insurance quote

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Quick reminder: almost all the questions you’ll be asked through the process need to be answered. Those marked "optional" can be skipped if you like.

Information and Privacy Disclosure

To provide you with a quote, we work with third-party consumer reporting agencies to obtain information about your claim history and, where allowable by law, credit-based insurance score.

What are credit-based insurance scores?

We respect your privacy – the information you provide is secure and will only be used for the purpose of this quote. We take numerous steps to ensure your information remains secure and only use this information for insurance quotes and services.

We do not sell your information to third parties or share your information to nonaffiliated third parties other than necessary to provide you with a quote. Any information transmitted to us is protected by 256-bit encryption.

For the purpose of this quote, we'll rely on the information you provide about your home and claim history. If you decide to purchase this policy, we'll work with consumer reporting agencies to confirm the information you provided. If there's a discrepancy, your rate may vary from this quote. If you have any questions, please feel free to email us.

You agree that you've read this information disclosure, agree to our Privacy Policy and wish to continue with your quote.

About Yourself

Effective Date

The date your insurance with The Best Insurance should start.

How did you hear about The Best Insurance?

Prefix

First Name

Middle Name

Last Name

Date of Birth

Gender

Contact Information

Provide us with your contact information and we'll reach out about your quote and email you a copy

Email Address

Phone

Consent and Disclosure

By clicking the Continue button below, I provide my electronic signature, consent, and permission to receive marketing calls, text messages, and emails from The Best Insurance and its affiliates at the phone number and email address I’ve provided. These communications may be sent using an automatic dialing system, prerecorded or artificial voice messages, or AI technology. I understand that my consent is not required as a condition for purchasing any property, goods, or services, and I may revoke my consent at any time.

Information and Privacy Disclosure

To provide you with an accurate quote, we partner with third-party consumer reporting agencies to obtain details about your driving record, claims history, and, where permitted by law, your credit-based insurance score.

What are credit-based insurance scores?
They are tools used to help predict the likelihood of future insurance claims, and their use is regulated by state laws.

We respect your privacy. The information you provide is secure and will only be used by The Best Insurance. We do not sell your information to other companies or share it for marketing purposes. All transmitted data is protected by 256-bit encryption.

For the purpose of this quote, we rely on the driving record information you provide. If you choose to purchase a policy, we will confirm your record through consumer reporting agencies. Any differences may affect your final premium.

If you have any questions, please email us.

By proceeding, you acknowledge that you have read and agree to this disclosure and our Privacy Policy, and wish to continue with your quote.

Coverage Info

What type of medical coverage are you seeking?

Are you currently insured?YesNoCoverage ending soon

Do you receive health insurance through an employer or government program?

Do you want to include dental and/or vision coverage?

Primary Physician Info

Physician Name

Clinic/Hospital Name

City/State

Your Health Status

In general, how would you rate your health?

Do you use tobacco or nicotine products?YesNo

Are you currently taking any prescribed medications?YesNoPrefer not to say

Medical History

Have you or your family members had any hospitalizations in the past 5 years?YesNo

Hospitalizations

Number of hospitalizations

Estimated Date

Reason(s) for hospitalization

Do you require ongoing medical treatment or therapy?YesNo

Discounts

Would you like to receive quotes for:HSA-eligible PlansCatastrophic CoverageHigh-Deductible PlansPlans with $0 virtual care

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