Short-term plan in Oklahoma
- As of November 2019, Oklahoma allows short-term plans to follow federal duration rules. Insurers are allowed to sell plans with terms of up to 364 days, with renewal available for a total duration of up to 36 months.
- Prior to November 2019, state law limited short-term health insurance in Oklahoma to six months and prohibited renewal. But a new state law changed that in November 2019.
- At least seven insurers offer short-term health insurance in Oklahoma.
Short-term plans duration in Oklahoma
As of November 1, 2019, short-term health insurance in Oklahoma was sanctioned by the state to follow federal maximum duration rules. That means plans are allowed to have initial terms of up to 364 days, and total short-term plan duration, including renewals, of up to 36 months. This is clarified in Oklahoma Title 36, Section 4419.
Prior to November 2019, however, Oklahoma law limited short-term health insurance plans to six months and prohibited renewal.
Oklahoma’s short-term health insurance regulations
Oklahoma revised state short-term health insurance rules to adopt the new federal rules, instead of the previous six-month plan duration limit. This is referenced in 36 O.S. § 6060.4(C)(2)(f), and a 2011 bulletin from the Oklahoma Insurance Department (LH 2011-01) noted that “short-term health insurance issued on a nonrenewable basis” was exempt from the state’s rate filing and review process. The Oklahoma Insurance Department confirmed this in a bulletin (LH 2018-03) issued in September 2018, and it continued to be in effect through October 2019.
Oklahoma’s new rule — allowing short-term plans to comply with federal duration limits instead of the six-month limit the state had previously imposed — is a result of SB993, which was enacted in Oklahoma in June 2019 and took effect November 1, 2019.
Which insurers offer short-term plans in Oklahoma?
At least seven insurers offer short-term healthcare insurance in Oklahoma as of late 2020:
- Aspen Insurance
- Companion Life
- Everest Reinsurance
- Independence American Insurance Company
- National General
- UnitedHealthcare (Golden Rule)
- United Security Health and Casualty
Some of these insurance companies allow the plans to have initial terms of 364 days and total duration, with renewals, of three years. But others limit their plans to shorter durations. The insurers that offer short-term healthcare plans in Oklahoma provide a variety of different plans, and you’ll want to check the specifics of the plan details to see if a certain service is covered.
Who can get short-term health insurance in Oklahoma
Short-term health insurance in Oklahoma can be purchased by applicants who meet the underwriting guidelines the insurers use. In general, this means being under 65 years old (some insurers put the age limit at 64 years) and in fairly good health.
Short-term health plans generally include blanket exclusions for pre-existing conditions, so they are not adequate for residents of the Sooner State who are in need of imminent medical care and are seeking a plan that will cover those needs. Short-term insurance plans also tend to have a wide range of exclusions and limitations, as they are not required to cover the ACA’s essential health benefits. The most commonly excluded services are maternity care, prescription drugs, and mental health care, although the benefits and exclusions will vary considerably from one policy to another.
If you need health insurance coverage in Oklahoma, start by checking to see if you can enroll in an ACA-compliant major medical plan (Obamacare) — even if you’re only going to need the coverage for a few months. Open enrollment for these plans, on-exchange and off-exchange, runs from November 1 to December 15. Outside of that window, you can enroll if you have a qualifying life event that triggers a special enrollment period. The availability of ACA-compliant plans does not depend on your medical history, but enrollment is only possible during the open enrollment period or a special enrollment period.
ACA-compliant major medical plans are purchased on a month-to-month basis, so you can enroll in one even if you only need coverage for a few months before another policy takes effect. So for example, if you’ll soon be enrolled in Medicare or an employer-sponsored healthcare plan, you can sign up for an ACA-compliant plan during open enrollment or a special enrollment period, and then cancel it when the new coverage takes effect.
And there are premium subsidies available in the Oklahoma exchange/marketplace based on your household income. A single person can qualify for a premium subsidy for 2021 with an income of more than $51,000, and a family of four can qualify for a subsidy with an income of $104,800. So subsidy eligibility extends well into the middle class, and can make ACA-compliant health plan (Obamacare) premiums much less costly than you might have expected — in many cases, even less expensive than a short-term plan. You can use our subsidy calculator to see the subsidy amount that you’ll receive to offset the cost of 2021 health insurance obtained via Oklahoma’s exchange.
But if you’re not able to enroll in an ACA-compliant individual market plan or a plan through your employer, a short-term plan is certainly better than nothing, and can help you bridge the gap until a more robust plan becomes available.
When should I consider short-term health insurance in Oklahoma?
There are times when a short-term health insurance plan might be the only option, for example:
- If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event to trigger a special enrollment period.
- You’ve enrolled in an ACA-compliant health plan, but have a waiting period of up to several weeks before it takes effect (ie, January 1 if you enroll during open enrollment, or the first of the following month or second-following month if you enroll during a special enrollment period).
- You’re newly employed and the business has a waiting period of up to three months before you can enroll in the employer-sponsored health plan.
- You’ll soon be enrolled in Medicare, and aren’t eligible for any other plan to cover you in the meantime. If your Medicare start date is only a few months out, the short-term plan might be all you’ll need. But if your Medicare coverage won’t start until after the start of the coming year, it’s wise to consider enrolling in an ACA-compliant plan during open enrollment — with coverage effective January 1 — and then canceling it when your Medicare coverage takes effect.
- If you’re not eligible for Medicaid or a premium subsidy, making an ACA-compliant plan potentially unaffordable. You may be ineligible for premium subsidies if you:
- Earn more than 400% of the poverty level. (For 2021 coverage, that amounts to $51,040 for a single person. If your ACA-specific modified adjusted gross income is just a little above the subsidy-eligible threshold, there are steps you can take to reduce it).
- People who are caught by the ACA’s family glitch.
- People who cannot enroll in a healthcare plan through the exchange because they’re not lawfully present in the US. Lawfully present immigrants can get premium subsidies, but immigrants without a valid immigration status are not able to enroll through the exchange at all.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.