A Guide to Health Insurance in Oklahoma (OK)

The good news about Oklahoma Health Insurance is that it is readily accessible and that there is considerable choice for most people in the policy that they choose.

In Oklahoma as a whole it is estimated by the Kaiser Family Foundation that 47% of the population get their healthcare through their place of work, 4% through individual Oklahoma Health Insurance, 32% through Government initiatives such as Medicare and Medicaid and with the remaining 18% being uninsured.

This is a reasonably typical profile that you would see reflected throughout the United States, and in many ways it is the shockingly high number of people who are uninsured that has prompted such legislation as the Affordable Care Act.

Whilst there are many different ways of getting health insurance in Oklahoma, there are three main options that you should first explore:

1/ Getting onto a Group Oklahoma Health Insurance Policy through your work

The option that makes up the biggest sector for health insurance in Oklahoma is that of people securing insurance for their health through their place of work.

Over the years this sector has grown massively and there are a number of different incentives offered by the Government to encourage both large and small businesses to offer work-based schemes to their employees.

For example, there are many tax credit schemes for small businesses especially that mean that in many cases 50% of the premiums will be covered approaching 2014 and beyond.

This encouragement over the years has had a number of effects, not least of which is that getting yourself onto a Group Oklahoma Health Insurance Policy has very much become the “normal” way for most people to get their healthcare insured.

Most businesses now feel like they HAVE to offer cover, because it is what is expected by both present and potential employees, and there are also advantages for those employees because they often end up with better cover then they would otherwise be able to afford privately.

Because of the “non-discrimination” provisions in employer based policies, you cannot be asked to pay more because you have a pre-existing condition, and you cannot be refused coverage.

This same rule also applies to the members of your family, so if your spouse or children have pre-existing conditions then they too must be able to get coverage.

It should be added that there are still certain criteria where an employer can restrict or refuse cover on the policy, but that these cannot be related to the health status of the individual, but only too work based factors such as that they are a part time worker.

It is also quite common for there to be a 90 day waiting period at the commencement of any employment, before workers are eligible to join many work-based Group Oklahoma Health Insurance Plans.

2/ Individual Oklahoma Health Insurance Plans

If you don’t have the option of a work-based scheme, are self-employed or unemployed, then you may want to look into getting an Individual Oklahoma Health Insurance Plan.

The primary difference with these is that normal underwriting rules apply, and so where as you cannot be refused cover on a group policy.

You CAN be refused cover on an individual policy.

One proviso worth knowing however is that once you have been accepted into a plan, that the insurer cannot then turn around and cancel your care or refuse to offer you cover.

There has to be the option available for renewal.

This protects against the circumstances where you develop a condition after you have bought the insurance, and effectively it then becomes much less attractive for the insurance company in Oklahoma to offer you cover.

One good thing about individual health insurance in Oklahoma is that you do automatically have more control over the options that you choose, and so if you are reasonably healthy and do not have any pre-existing conditions, then you will find that you have a great deal of choice when it comes to the policies that are available to you.

3/ The High Risk Pool / Pre-Existing Condition Insurance Plan (PCIP)

There are also two schemes available that are helping people who would otherwise like to buy health insurance, but are getting turned down on the basis of their medical history or pre-existing medical conditions.

The first of these was brought in by the Affordable Care Act on a Federal level, and is called the Pre-Existing Condition Insurance Plan (PCIP).

In order to qualify for coverage under this you need to meet four criteria:

  • Be a legal citizen or present lawfully in the US
  • Have been uninsured for at least six months
  • Have a pre-existing medical condition
  • Have been turned down for cover by a private insurance company

With this program you can get major medical (comprehensive) cover that doesn’t cost any more than normal health insurance would have cost without the pre-existing condition.

The second program runs on a local state level, and is the Oklahoma Health Insurance High Risk Pool.
To qualify for this program you need to meet the following two criteria:

  • Been a resident in Oklahoma for at least 12 months
  • Been denied cover by a private insurance company

Additionally, there are also a list of specific ailments and conditions that if you suffer from, then you can automatically apply to the High Risk Pool, such as Hepatitis C, diabetes, breast cancer or cystic fibrosis.

Also, if you have health insurance in Oklahoma, but are paying more as a result of a pre-existing condition, or are eligible for the Health Coverage Tax Credit or HIPAA then you may also qualify.

This works in a similar way to the PCIP Plan in that the intention is still that you purchase and pay for your own health insurance in Oklahoma, but it simply acts to put checks and balances in place on the health insurance companies to ensure that you are not penalized for having got sick in the past.

Each of these three options can help you to get the Oklahoma Health Insurance that you need, so explore the different advantages of each, get some quotes online and sort out some cover today!


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