It is not always easy to find proper health insurance in Oklahoma. In fact, the state is known to have one of the highest uninsured rates in the country. Prior to the implementation of the ACA, Oklahoma’s uninsured rate was 21.4%, which made the state one of the just five states with uninsured rates above 20%.
The implementation of the ACA reduced the uninsured rate in the state to 16.5% by late 2015. This however, is well above the national average uninsured rate of 11.7%.
Private Health Insurance in Oklahoma
It doesn’t help that only Blue Cross Blue Shield of Oklahoma is the sole carrier offering plans in the state’s federally facilitated exchange. BCBSOK has long maintained dominance in the health insurance market in Oklahoma, which can explain why for 2017 they increased the average rate of their health plans by an astounding 76%. This increase was, by far, the largest rate increase for health plans in the whole country for 2017. However, the rate increase for 2018 was only in single digits.
There may be some health insurance plans that you can find off-marketplace for Oklahoma residents. To find these plans, you can enter your zip code into our search bar, and you will get the plans that are available for the county you live in.
Employer-Sponsored & Small Business Health Insurance Oklahoma
Many companies offer their workers access to health benefits to attract and keep them in their workforce. Employees also reap the advantage of these health plans because the employer pays for a significant portion of the premium. This reduces the cost of health insurance for the employed.
If you do lose your job, it doesn’t necessarily mean that you also immediately lose the benefits of your previous employer’s health plan. You can extend the coverage for up to 18 months through the COBRA program, so that you can have enough time to find a suitable private health insurance plan or another job that provides employer-sponsored insurance (ESI).
To encourage participation in employer-sponsored insurance, the state also has an initiative called Insure Oklahoma which also offers an ESI program. If you’re a participant in this program, you only need to pay a maximum of 15% of the ESI premium. Your employer chips in for 25% of the premium and Insure Oklahoma pays for the remaining 60% of the monthly premium costs.
The 2018 ESI income guidelines provide income ceilings for households of various sizes. An individual applicant must have an annual income of no more than $27,564 (or a monthly income of $2,297). The annual income ceiling is $37,368 for a family of two, $47,184 for a family of three, and $56,988 for a family of four.
If you’re qualified to join as an employee and your spouse is also eligible and enrolled in the program, Insure Oklahoma covers 85% of the premium costs.
SoonerCare & Low Income Health Insurance Oklahoma
This is Oklahoma’s version of the Medicaid program. The state has voted to refuse the federal funding for ACA expansion, which means that the program’s stringent eligibility standards remain unchanged. This explains why enrollment in SoonerCare has grown only 1.5% since the implementation of ACA, compared to the national average of 27%.
As of 2016, a little over 800,000 Oklahoma residents are enrolled in SoonerCare and 2/3 of them are children. Children under the age of 19 are qualified with income ceilings for their families reaching up to 205% of the federal poverty level. For a family of four, that’s an annual income ceiling of $51,455.
Pregnant women are also eligible, and the unborn child counts as part of the household. To qualify, the pregnant woman’s household income cannot exceed 138% FPL. That’s $34,638 for a family of four. Benefits include prenatal, delivery, and postpartum care, and the infant can also be included into SoonerCare as well.
The program also has somewhat more generous income ceilings for the aged, the blind, and the disabled. However, non-disabled adults ages 19 to 64 have to meet stringent income ceilings. For the adults with dependent children, the income ceiling is a paltry 42% of the FPL. For a family of two with a parent and a child, the income has to be less than $6,913 per year. A family of four has an annual income ceiling of only $10,542. Very few can meet these requirements as their incomes aren’t low enough.
As for able-bodied adults with no dependent children, they are ineligible for Medicaid regardless of how little they earn. Expansion of the Medicaid program would have qualified them for assistance, however.
Aside from the ESI plan, the Insure Oklahoma program also has an individual plan with a limited health coverage package. It is available for those who are self-employed and uninsured, an employee who works with a business that doesn’t offer an Insure Oklahoma ESI plan or who is ineligible for the plan, or is unemployed.
You will have to pay a monthly premium that is based on the household income and the size of the household. However, this premium cannot exceed 4% of your annual household income. You also have to pay for the copayments to receive the medical services. Coverage of the program is also not immediate, as you need to first pay the premium before the coverage begins.
Insure Oklahoma also has a plan that covers college students. They have to be between the ages of 19 and 22 and they have to be attending one of the accredited colleges in the state on a fulltime basis.
Oklahoma Open Enrollment 2019 & Oklahoma Obamacare Insurance
The Oklahoma Open Enrollment period for health insurance in 2019 will run from November 1st, 2018 to December 15th, 2019.
For all your other questions regarding health insurance in Oklahoma, please do not hesitate to give us a call at 1-855-614-5057. We stand ready to guide you so that you can get the health & medical insurance coverage you need and deserve.