Looking for health care in Oklahoma? The Sooner State offers plenty of options for residents. But a study by US News found that Oklahoma has the third-worst health care in the country. The study analyzed access, quality, and overall public health.
Health insurance options in Oklahoma
According to the OK Insurance Department, there are several ways for residents to access health care:
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Oklahoma residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 46% | ||
| Individual or family | 6% | ||
| Medicaid | 18% | ||
| Medicare | 15% | ||
| Military | 2% | ||
| Uninsured | 14% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
14 percent of Oklahomans have no insurance, several percent above the national average. That's a setback for policyholders, as a high amount of uninsured people can raise prices for insured people.
Oklahoma health insurance costs and rate factors
OK residents spend an average of $7,627 per year on health care, less than the national average. What affects your health care rates in OK? Prices vary person to person, but rely primarily on these factors:
Plan type
Marketplace plans come in metal tiers: bronze, silver, and gold. Spending more on health insurance will get you a higher level of coverage.
So how much does health insurance cost in Oklahoma? These are the average costs for each plan type for a middle-aged state resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $365 | $527 | $521 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Premiums for a gold plan cost about 43 percent more than for a bronze plan. That's because gold plans cover 80 percent of costs, whereas gold plans cover 60 percent of costs.
You may also qualify for a catastrophic plan if you’re under 30 or have financial exemptions. It’s the lowest level of marketplace coverage. Catastrophic plans have low monthly premiums but a high yearly deductible of $8,150. That high yearly deductible means that you may save money by purchasing a bronze or silver plan if you need to use your insurance.
Body mass index
According to the CDC, a high body mass can lead to several serious health conditions. Because of this, health insurance companies will look at your BMI to determine your risk-level. A high BMI leads to high health insurance rates.
In 2019, OK residents had a 36.8 percent obesity rate, the fourth highest rate in the country. Of the many state residents who used QuoteWizard to compare health insurance plans, 36 percent have a BMI in the obese range.
Tobacco use
Tobacco users pay more for health insurance due to the substantial risks that stem from smoking. About 19.6 percent of Oklahoma residents are smokers, the 36th lowest rate in the country.
Age
Older people tend to pay up to three times more for health care than younger people. OK residents who used QuoteWizard to shop for health insurance are, on average, 40 years old.
Location
A big factor in your rates is where you live. Insurance marketplace rules, regulations, and providers vary from state to state and county to county.
Also, health insurance rates are community-rated. That means prices are partly based on the combined claims everyone files. So, if your neighbors file an abnormally high number of claims, your prices could soar.
The overall health of people in your state can also influence costs. According to America’s Health Rankings, OK is the 43rd healthiest state in the country.
Oklahoma health insurance companies
What are the best health insurance providers in OK? Unfortunately, there are minimal options when it comes to health care in your state.
- BCBSOK
- Bright Health
- Medica
These health insurance companies offer individual and family plans. Check provider sites to see how coverage varies based on your zip code.
Oklahoma health insurance laws
The Affordable Care Act limits what insurance companies can consider when pricing your policy.
- Pre-existing conditions: People with pre-existing used to pay considerably more for health insurance. Now, providers can’t charge you more for a pre-existing condition.
- Gender: The ACA mandates that insurance companies can’t charge women and men different prices for the same policy. That’s good news, especially since women historically paid more for health care.
- Insurance and medical history: The ACA also limits companies from analyzing your medical history and past insurance coverage. People with previous medical problems or lapses in insurance used to face steep premiums.
There’s a limit to how much you can pay for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
OK law requires providers to offer at least some coverage for the following services:
- Mental health
- Inpatient services
- Emergency services
- Eye care
- Home health services
- Immunizations
- Some surgeries
There are additional services that insurance companies need to offer. Find the entire list on cms.gov.
Medicare and Medicaid in Oklahoma
Medicare and Medicaid are both government-funded affordable health care programs. Medicare offers care for seniors, whereas Medicaid provides aid to low-income families and children.
Medicare
Medicare helps people 65 and older gain access to health care. There are several coverage options within Medicare, including parts A, B, C, D, and supplemental coverage plans. OK residents may also qualify for a Medicare Savings Program:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
Medicaid, called SoonerCare in OK, aids low-income families and children. These are the state’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Oklahoma insurance department
- Website:
- Homepage
- Insurance Commissioner:
- John D. Doak
- Insurance Hotline:
- (800) 522 – 0071
- Office Hours:
- Monday - Friday
9:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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