Oklahoma Health Insurance

Oklahoma is a great state to live in, but unfortunately, the worst in the country when it comes to health care, according to a report published recently in Newsweek magazine. The state was ranked low because of its restrictive access to medical coverage, the low quality of health care, and the large amount of "avoidable hospital use and costs."

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These facts may concern you, especially if you do not know much about purchasing health insurance. To help make life a bit easier for you, we've put together the below information to help you get informed about your options. We can also help you compare carriers in Oklahoma and get you a quote for the type of plan you need.

Buying Individual Health Insurance in Oklahoma (OK)

Looking for a health care plan for yourself or another individual? Before you start comparing rates and carriers, be sure you know about the rights that you have under Oklahoma law, and the actions that health insurance companies are allowed to take. Here is a short list of such regulations.

Your Oklahoma health insurance rights:

• Your insurance cannot be cancelled if you fall ill after coverage has begun.
• You are HIPAA-eligible if you have lost your group health insurance and meet a few other criteria. You will then be able to join Oklahoma's high-risk pool.

Rights of health insurance carriers in OK:

• Carriers can deny you coverage if you have a medical problem.
• Insurance companies can set no-limit exclusion periods for those with preexisting health conditions.
• Creditable coverage is not available in Oklahoma.
• The state does not limit the costs of policies. Carriers can also increase costs when you renew your health plan.

Oklahoma Medical Plans for Families (OK)

Group health plans in Oklahoma are subject to more regulations than individual plans, so if you're looking to take out a policy for your family, you're in luck. You can choose from group networks, such as HMOs, PPOs, POSs, and HSAs, or spend more money and purchase an individual plan more tailored to your needs. Below, some information we've gathered to help you decide:

• Nondiscrimination — Group health insurers cannot bar you and your family from taking out a policy on the basis of a health problem. They also cannot charge you higher rates because of that problem.
• Certain family changes related to marriage, job transition, and children will affect your opportunities for coverage.
• HMOs in Oklahoma cannot require exclusion periods.
• However, other carriers can impose exclusion periods of up to one year.
• Creditable coverage — If you do not have gaps in coverage of more than 63 days, you will receive credit toward exclusion periods.

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Preexisting Health Conditions and Health Insurance Challenges

Unfortunately, if you have a preexisting condition, it will most likely be very difficult for you to find good health care plans in Oklahoma. The state has few regulations governing how insurance companies approach applicants with conditions such as cancer and diabetes. For example:

• State law in Oklahoma does not prohibit a private insurance company from neglecting coverage to any individual.
• Insurance companies can freely apply elimination riders to applicants' policies, meaning their preexisting conditions will not be covered under the policy.
• There are no legal policies on how long a preexisting condition exclusion can last. The exclusion period is based solely on the insurance company.
• In addition, there is no standard definition for a preexisting condition in Oklahoma insurance law, meaning that insurance companies do not have to apply a standard in determining whether a preexisting condition exists.
• In Oklahoma, insurance companies can refer to pregnancy as a preexisting condition, and genetic information cannot be used in determining a condition, without a diagnosis.
• Insurance companies also are not required to credit prior health coverage, no matter how long an applicant's previous policy was in place, for a preexisting condition exclusion period.

There is still some hope for those with major medical issues. There are companies in Oklahoma that will accept preexisting coverage after an exclusion period. Also, it is possible to get temporary coverage for your preexisting condition during your exclusion period. Just make sure your policy states when the inclusion period will end, so that you can avoid being charged double premiums.

If you have been turned down or offered a policy with restrictions and reductions, you may qualify for coverage in the Oklahoma Health Insurance High Risk Pool. The high-risk pool is a need-based, first-come, first-served organization so not every resident will be granted coverage.

Switching Health Plans in Oklahoma (OK)

Certain big changes in your life, such as a marriage or divorce, getting a new job in Oklahoma or transitioning between jobs, will make it necessary for you to purchase a new medical plan.

• If you've just left your job and are worried about losing your employee health benefits, check to see if you are eligible for COBRA, which can help you to keep some of those benefits temporarily.
• Oklahoma Extension of Coverage Law— If you lose group health insurance due to changes in your working or marriage conditions, or for other reasons, you have a 30-day grace period where you will maintain coverage. This does not, however, apply to HMO plans, and is dependent on health status.
• Certain non-government employers do not follow the same group health insurance regulations, so check with your employer to see what your benefits are.

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