Plan Finder

The Health Insurance Plan Finder provides you with cost, and coverage information based on your specific needs for individual and family health insurance. This is not an application for insurance. Please complete the following information, and click on the submit form at the bottom of the page. All requests are processed the day they are received. 

General Information:

Date of Birth: -- mm/dd/yy
Sex: Male Female
Smoker? No Yes
Married or Single: Married Single
Spouse to be covered ... ? Yes No
Spouse; Date of Birth: -- mm/dd/yy
Smoker? No Yes
Children to be covered? Yes No
Number of children: 0 1 2 3 4 5
Self-employed? Yes No
Occupation?
Your current health provider?
Your current health plan? Employer Sponsored Individual
Under COBRA None
Where do you Live: Missouri
Outstate
Specify County:

Plan Preferences: Please provide the following information so that we may provide you information on a plan that most closely fits your needs. Choose one answer for each. 5 = "very important" and 1 = "not important".

 High Deductible Plans (lower premium)? 1 2 3 4 5
Doctor Co-Pays? 1 2 3 4 5
Choice of Doctor? 1 2 3 4 5
Preventive Care Coverage? 1 2 3 4 5
Prescription Drug Coverage? 1 2 3 4 5
Vision/Dental Coverage? 1 2 3 4 5
Emergency Services? 1 2 3 4 5
Pregnancy Coverage? 1 2 3 4 5
Information on HSA Plans? Yes No

How long will you need coverage?

 0-3 Months 3-12 Months 1+ Years

Contact Information:

First name

Last name

Organization
(if applicable)
Street address
Address (cont.)
City
State/Province
Zip/Postal code

Work Phone

E-mail

    Do any applicants have any pre-existing health conditions? (If yes, comment below)

    Click on "Submit Form".  Please be sure to include e-mail address or daytime phone number should any information be incomplete.

 

Copyright © 2005  Missouri Health Insurance Network