Celtic Insurance Company

Humana

In Oklahoma, medical underwriting is allowed except for HMO plans. There is a no limit for look back and exclusionary periods for preexisting conditions for all carriers except for HMO’s, in which preexisting conditions may not be considered.

 

Oklahoma has a high risk pool called the Oklahoma Health Insurance High Risk Pool. You may be eligible for this pool due to your HIPAA rights or if you are a resident of Ohio, have been denied coverage by two carriers, and are not insured by any other program.

 

In Oklahoma, medical underwriting is allowed with plus or minus 25% of the indexed rate based on the health status of the group.  There is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior healthcare.

Oklahoma offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce. 

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children

Children (ages 1-5)-185% of the Federal Poverty Level
Children (Ages 6-19)-185% of the Federal Poverty Level

 

Pregnant Women and Infants

Pregnant Women-185% of the Federal Poverty Level
Infants (ages 0-1)-185% of the Federal Poverty Level

 

Parents

Non-Working Parents-36% of the Federal Poverty Level
Working Parents-45% of the Federal Poverty Level

 

Other populations

Medically Needy Individual- 36% of the Federal Poverty Level

Medically Needy Couple- 34% of the Federal Poverty Level

Supplemental Security Income Recipients- 74% of the Federal Poverty Level

Aged, blind, and disabled- 100% of the Federal Poverty Level

Ambulance, ambulatory Surgery Center services, behavioral health and substance abuse services (outpatient), case management services, chemotherapy and radiation therapy, clinic services including renal dialysis services, dental services, dentures for adults residing in nursing facilities, durable medical equipment and supplies, family planning services and supplies, Federally Qualified Health Center services, home health services, inpatient hospital services, inpatient hospital services in an institution for mental disease for people who are 65 years of age or older, intermediate Care Facilities for the mentally retarded, laboratory and X-ray services, medical supplies and equipment, including diabetic supplies, nurse midwife services, nursing facility services, outpatient hospital services, personal care services, physician services, podiatry services, prescription drugs and insulin, prenatal, delivery and postpartum services, rural health clinic services, transplants that are prior authorized, transportation to obtain covered medical care, and tuberculosis services.

Co-Payments

Co-payments vary.  There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

 

You may learn more about Oklahoma Medicaid at http://www.ohca.state.ok.us/. 

Oklahoma offers the SoonerCare program to children under the age of 19 whose family incomes are up to 185% of the Federal Poverty Level, and who are not eligible for Medicaid, are not institutionalized, are not in state or tribal custody, and are not enrolled in a private HMO. Please visit the SoonerCare website for more detailed information at http://www.okdhs.org/medapp/soonercare.htm.