Most health insurance companies will not review your application for insurance unless the application is accompanied by a check for the first month's premium payment. This is required for a few reasons and some insurance companies even have an application processing fee that must also be included. The premium payment is refundable, but the application fee usually is not. One reason that the insurance companies want advanced payment is that is shows as a sign of good faith that you intend on accepting the coverage if you are approved. There can be much time invested by the insurance company to process your medical insurance application. They do not want to invest this time unless they are confident that they will earn your enrollment. This good-faith payment epresses to them that your intentions are sincere. Another reason for collecting payment in advance is so they do not need to worry about billing you for the first month premium payment if your application is approved. This allows them to issue your coverage and ID cards more quickly, since they will not usually send out your policy and ID cards until they receive the payment for the first month. Health insurance premiums are always paid in advance of the month for which that premium provides coverage. If upon review of your policy during the free look period, you choose to cancel your policy, you may do so and receive a full return of your initial premium payment that was submitted with your application. Most insurance companies will not cash your check until they approve your policy. This makes it easier for them to return your money if they decline your application.