Frequently asked questions about health insurance
coverage options in Oklahoma
Oklahoma has a federally facilitated exchange (marketplace), which means individuals and families use the HealthCare.gov website to shop for health insurance.
During the open enrollment period for 2021 health coverage, 171,551 people purchased private individual-market plans through the Oklahoma health insurance marketplace. This was another record high for Oklahoma’s exchange, after previous record highs in both 2019 and 2020.
Open enrollment for health insurance in Oklahoma runs from November 1 through December 15. Outside of the open enrollment period, applying for an individual market plan (on-exchange or off-exchange) normally requires proof of a qualifying event.
But to address the ongoing COVID pandemic and the premium subsidy enhancements created by the American Rescue Plan, a one-time enrollment window has been opened in 2021. It runs through August 15, 2021, and there is no need for a qualifying event in order to use this window.
Just like the annual open enrollment period, the COVID-related enrollment window gives individuals and families a chance to sign up for coverage, regardless of prior coverage history or pre-existing conditions. It’s also an opportunity for existing individual market enrollees to compare the available options and potentially switch to a different plan if it would allow them to better take advantage of the larger premium subsidies available under the American Rescue Plan.
After August 15, 2021, a qualifying event will again be necessary in order to enroll or make a plan change for 2021. Open enrollment for 2022 coverage will start November 1, 2021, with plan selections effective January 1, 2022.
For 2021, six health insurance companies offer health plans through the Oklahoma exchange, including three newcomers: Oscar, UnitedHealthcare, and CommunityCare Oklahoma. They joined the three existing exchange insurers (Bright Health, Blue Cross Blue Shield of Oklahoma, and Medica).
BCBSOK and Medica have service areas that include the entire state, while the other four have much more limited service areas. So plan availability varies from one part of the state to another.
For 2022, Friday Health Plans will join Oklahoma’s marketplace, with plans available in eight counties in the Tulsa and Oklahoma City areas.
Overall, health insurance rates in Oklahoma remained fairly flat for 2021 coverage. Medica and Community Care’s rates decreased for 2021, while Bright Health increased. BCBSOK didn’t report a change. Oscar and UnitedHealthcare are new for 2021, so there are no applicable rate changes.
Oklahoma is one of five states initially considered “diehard hold outs” against Obamacare, according to a 2014 study from Georgetown University. In 2010, both of Oklahoma’s U.S. Senators, Republicans Thomas Coburn and James Inhofe, voted no on the ACA. In the U.S. House, one Democrat, the second district’s Dan Boren, voted yes, while four Republican Representatives from Oklahoma voted no.
As of 2021, the entire U.S. congressional delegation from Oklahoma is Republican.
At the state level, there’s a strong Republican majority in both the House and Senate, and Gov. Kevin Stitt is also a Republican. Stitt opposes Medicaid expansion (although he had proposed SoonerCare 2.0, which called for expansion with subsequent restrictions added to the program, but withdrew his support for it amid the coronavirus pandemic and the resulting increase in the number of people who would need expanded Medicaid) and believes that selling health insurance across state lines is a key to reducing premiums (Oklahoma enacted legislation in 2017 to allow this, but like the handful of other states that have done the same thing, they’ve had no interest from insurers wanting to participate).
But Oklahoma has also worked to try to create state-based healthcare reform solutions within the framework of the ACA. In 2017, Oklahoma submitted a 1332 waiver proposal to CMS, seeking federal pass-through funding for a reinsurance program (and the state was planning extensive additional reform via additional 1332 waivers that were to be submitted subsequently). But Oklahoma ultimately withdrew the waiver proposal amid delays in the federal approval process, when it was clear that the approval wouldn’t happen in time for rates to decrease for 2018.
Oklahoma enacted another bill, in 2018, authorizing the state to seek federal funding for a reinsurance program, but the state did not submit a waiver proposal to the federal government, so there is still no reinsurance program in Oklahoma.
As of November 2020, there were 854,774 Oklahoma residents enrolled in Medicaid (SoonerCare) and CHIP in Oklahoma. That’s an increase of 8% since 2013, although prior to the COVID pandemic, Medicaid/CHIP enrollment had been lower in Oklahoma than it had been in 2013 (in contrast with a substantial nationwide increase, driven largely by Medicaid expansion, which Oklahoma is slated to finally implement in mid-2021).
The coronavirus pandemic has been driving Medicaid enrollment higher throughout the country, even in states where Medicaid has not yet been expanded under the ACA’s rules. And enrollment in Oklahoma Medicaid is expected to increase significantly in the latter half of 2021 and in 2022. Medicaid expansion will be effective in Oklahoma as of July 1, 2021, due to a Medicaid expansion ballot initiative that Oklahoma voters passed in 2020 (eligible residents will be able to submit their enrollments starting June 1, 2021, for coverage effective July 1).
Read more about Medicaid expansion in Oklahoma.
Prior to November 2019, Oklahoma had fairly strict regulations for short-term health insurance plans – the policies couldn’t last more than six months, and couldn’t be renewed. But the state enacted legislation in 2019 that changed those rules.
As of November 2019, short-term health insurance coverage in Oklahoma can follow the federal rules that allow for initial terms of up to 364 days, and total duration, including renewals, of up to three years.
Read more about short-term health insurance in Oklahoma.
As of January 2021, there were 754,414 Oklahoma residents enrolled in Medicare. About a quarter of Oklahoma beneficiaries are enrolled in Medicare Advantage plans, while the rest have Original Medicare.
In most cases, receiving a Medicare card goes along with turning 65. But 18% of the people with Medicare in Oklahoma are under the age of 65 and are eligible for Medicare because of a long-term disability, ALS, or end-stage renal disease.
You can read more about Medicare in Oklahoma, including statistics about state Medicare spending, details about Medicare Advantage and Medicare Part D prescription drug coverage, and Oklahoma’s rules for Medigap (Medicare Supplement) plans.
- Oklahoma Insurance Department — Regulates and licenses health insurance companies, brokers, and agents, and can address consumers’ questions and complaints. But Oklahoma is one of just three states where the insurance department does not conduct the premium rate review process (the federal government handles it instead).
- Legal Aid Services of Oklahoma — The federally-funded Navigator organization in Oklahoma; can help residents understand their health insurance options and enroll in coverage through HealthCare.gov.
- Oklahoma Medicare Assistance Program — Help for Medicare beneficiaries and their caregivers; includes the Senior Health Insurance Counseling Program and Senior Medicare Patrol.
- Medicare Rights Center — A nationwide service that provides information and answers questions about Medicare
Prior to 2014, individual medical insurance was underwritten in nearly every state, including Oklahoma. This meant that pre-existing conditions could prevent an applicant from getting coverage, or could result in significantly higher monthly premiums or policy exclusions.
The Oklahoma Health Insurance High Risk Pool (administered by Blue Cross Blue Shield of Oklahoma) was created in 1995 to provide an alternative for people who were ineligible to purchase individual medical insurance because of their medical history.
Implementation of the ACA and a guaranteed-issue individual market have eliminated the need for high-risk pools, and the Oklahoma Health Insurance High Risk Pool ended operations as of December 31, 2014.