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Oklahoma Health Insurance

When researching your health insurance options in the state of Oklahoma, there are several things to keep in mind. If your employer does not offer benefits, are you healthy enough to obtain health insurance on the individual market? If so, Health Plan One can be of service to you in quoting plans appropriate for your needs and price range. Are you self-employed, owning your own business and employing between 2-50 employees? Health Plan One can also assist small business owners in obtaining small group coverage. Do you have any pre-existing conditions, disabilities, or are you below an income level which could qualify you for free or low-cost health care programs offered by the government? You may be eligible in Oklahoma for SoonerCare (Medicaid), SoonerPlan, Oklahoma Cares, Insure Oklahoma, or the high risk pool. Eligibility requirements for each of these options are available on this page.

What Every Oklahoma Resident Should Know About Health Insurance

The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not subject to medical underwriting, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.

Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.

What If I'm Between Jobs?

As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job, look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs, to invest in an individual/family insurance policy through Health Plan One.

With individual coverage, you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Oklahoma so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Oklahoma each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months. 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.

If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.

If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.

Small Group Plans

If you are self-employed, you could apply for a small group plan for your company. You must have 2 or more eligible employees who each work full-time, at least 24 hours per week. Small group plans are medically underwritten by all carriers in Missouri. There are no requirements for the length of time you've been in business, but you must show proof of earning taxable income. All carriers do medical underwriting on their small groups. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling.

Health Plan One can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.

SoonerCare - Oklahoma Medicaid

SoonerCare is a federal-state cooperative program which provides basic health coverage to low-income residents and other groups in need. To be eligible for SoonerCare, one must:

  • Reside in Oklahoma
  • Be a US citizen or qualified alien
  • Meet financial income and resources standards in certain categories

There is no cost of the program for those who meet income guidelines, but co-pays may apply to certain services. In practice, the program works for enrollees much like a traditional insurance plan. Benefits include ambulance services, home health services, dental services, lab and x-ray, prescription drugs, physician visits, and much more. To learn more about the program, visit their website at http://www.ohca.state.ok.us/individuals.aspx?id=52 Even if your family does not meet the Medicaid income guidelines, children may still be eligible under the federally-mandated SCHIP aspect of the program. SCHIP requires SoonerCare to extend Medicaid benefits to children whose families earn too much to qualify for traditional SoonerCare, but not enough to afford private health insurance for their children. Call SoonerCare's toll-free number for more information and to see if your children might still qualify for SoonerCare under the SCHIP income guidelines.

Children enrolled in SoonerCare should take advantage of the Child Health EPSDT check-ups available. For more information on the EPSDT program, click here http://www.ohca.state.ok.us/individuals.aspx?id=174&menu=42&parts=7517_7487_7515

For more information about Oklahoma Medicare plans, visit MedicareSolutions.com

SoonerPlan

SoonerPlan is Oklahoma's family planning initiative for uninsured women and men not enrolled in SoonerCare. Covered services include office visits and physical exams related to family planning, lab tests, tubal ligation, vasectomy, pregnancy tests and birth control supplies. To be eligible, one must be:

  • Age 19 or older
  • US citizens or qualified aliens
  • OK residents
  • Not enrolled in SoonerCare (Medicaid)
  • Uninsured
  • Within 185% of the federal poverty level

Visit the SoonerPlan website for more information at http://www.ohca.state.ok.us/individuals.aspx?id=176

Oklahoma Cares

Oklahoma Cares provides treatment of breast and cervical cancer and pre-cancerous conditions to eligible women. Women who qualify will have their breast and cervical cancer and pre-cancer diagnosis and treatment covered and will furthermore qualify for SoonerCare coverage that includes the full range of services. They will be able to continue their SoonerCare eligibility until they are either financially ineligible or no longer require treatment. To qualify a woman must:

  • Be screened under the Breast and Cervical Cancer Early Detection Program (NBCCEDP) and have an abnormal screen which requires further diagnosis or treatment
  • Be under age 65
  • Provide her social security number
  • Assign her rights to Third Party Liability
  • Have no other insurance covering breast and cervical cancer diagnosis or treatment
  • Have qualifying low income and not otherwise be eligible for SoonerCare

For more information, visit their website at http://www.ohca.state.ok.us/individuals.aspx?id=130&menu=42&parts=7477_7479_7481

Insure Oklahoma

Administered by the Oklahoma Health Care Authority, the Insure Oklahoma initiative was developed to assist adults age 19 to 64 under 185% of the federal poverty level obtain basic health coverage. The program will either pay a portion of a qualified individual's health care premiums or assist in the purchase of a state sponsored health plan operated under the SoonerCare program. There are 2 options for Insure Oklahoma assistance:

  1. Insure Oklahoma/O-EPIC ESI – Employer Sponsored Insurance, designed to assist small business owners in purchasing health insurance for employees and their families
  2. Insure Oklahoma/O-EPIC IP – Individual Plan, designed to assist sole proprietors, certain unemployed individuals, and working individuals without access to small group health coverage.

For more information on whether you or your small business qualify for Insure Oklahoma assistance, click herehttp://www.insureoklahoma.org/

Oklahoma High Risk Pool

The Oklahoma High Risk Pool makes basic health coverage accessible to residents who are unable to afford or obtain health insurance on the individual market due to a preexisting medical condition. For medically uninsurable individuals, the pool is the insurer of last resort. The eligibility requirements for OHRP are very extensive, and can be found here: http://okhrp.org/qualify.asp Benefits of the program are largely similar to those found with a private plan. To see if your preexisting condition is one that would qualify you for the pool, and to see a summary of benefits, visit the program's website at http://okhrp.org/