Medicare Plans in Oklahoma
With the wide variety of Medicare plans in Oklahoma, finding the ideal Medicare coverage for your needs can be intimidating. That’s why we’re here, to help you sort through your options and find your perfect plan.
Who’s eligible for a Medicare Plans in Oklahoma?
Medicare is a federal health insurance program that serves citizens 65 and older, as well as those with certain disabilities.
If you’re 65 or older, you can qualify if:
- You are an American citizen or have been a permanent resident for 5 continuous years, and
- You or your spouse have worked and paid Medicare taxes for a sufficient amount of time (usually about 10 years)
Most enrollees qualify based on age, but people under 65 can also qualify if they:
- Have received Social Security Disability Insurance (SSDI) for 2 years, or
- Have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End Stage Renal Disease (ESRD)
We can help determine your eligibility if you’re unsure or will be turning 65 in the next 6 months. You can view available plans online or speak with a licensed insurance agent by giving us a call.
What are the Medicare Plans in Oklahoma?
Orginial Medicare Part A & Part B
Original Medicare is the federal component of Medicare, which has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, hospice, skilled nursing facility care, and nursing home care (as long as custodial care isn’t the only care needed).
Part B (Medical Insurance) covers outpatient services and supplies, like mental health, ambulance services, and durable medical equipment (blood sugar monitors, walkers, canes, etc). Part B also covers certain services that prevent or detect illnesses early, like flu shots, cardiovascular and diabetes screenings.
Original Medicare doesn’t cover everything. Services generally not covered by Original Medicare include:
- Long term care (custodial care)
- Most outpatient prescription drugs
- Hearing aids
- Eye exams and eyeglasses
- Most dental care and dentures
- Routine foot care
- Cosmetic surgery
- Acupuncture
Medicare doesn’t cover everything and isn’t intended to pay 100% of your medical bills. Medicare beneficiaries typically pay a portion of medical expenses in the form of deductibles, coinsurance, and copayments. For this reason, a variety of Medicare plans are available through Medicare-approved private insurance companies for more comprehensive coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are provided by Medicare-approved private insurance companies and work as an alternative to Original Medicare (Parts A and B). These plans must provide the same coverage as Original Medicare (with the exception of hospice care, which remains covered by Part A). They can also provide additional benefits, such as dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
To enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Premiums for these plans can start at $0, increasing with the level of coverage selected. You’ll need to continue paying your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Prescription Drug coverage is generally not covered by Original Medicare or Medigap Plans. Stand-alone Prescription Drug plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare (Parts A and B) to add prescription drug coverage. With these plans, a tier system is used to grade medications, and copays/coinsurance for each medication are set in accordance with their tiers. Drugs graded in the lowest tiers have the lowest copays/coinsurance, and vice versa. Each plan provides a drug formulary for you to see which tier(s) your medications fall into. This allows you to compare plans and select one with the best overall value for your specific prescription needs.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans add an additional layer of coverage to your Original Medicare by filling in coverage gaps. Medigap plans are provided by Medicare-approved private insurance companies and work alongside your Original Medicare to help reduce your out-of-pocket costs by paying certain healthcare costs, like copayments, coinsurance, and deductibles.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
You are first eligible to sign up for Medicare plans in Oklahoma during your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and continues for an additional three months. This means you have a total of seven months to enroll.
Following this period, you will be able to make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs once per year, from October 15th to December 7th.
Medicare Initial Enrollment Period
7-Month Initial Enrollment Period | Begins 3 months before the month you turn 65
*Signing up for Parts A and B during months 5,6, and 7 may result in delayed coverage.
KEY FACT: The General Enrollment Period provides you an opportunity to enroll in Original Medicare if you missed your IEP. This period occurs every year from January 1st to March 31st. Then, you’ll have an opportunity to select a Medicare Advantage Plan from April 1st through June 30th.
Additional Medicare Resources in Oklahoma
The Senior Health Insurance Counseling Program (SHIP) is a non-profit organization helping to inform the public about Medicare plans in Oklahoma and other senior health insurance issues.
SoonerCare (Oklahoma Medicaid) is a health coverage program jointly funded by the federal and state government. This program helps pay some or all medical bills for many people who can’t afford them.
Sources: Medicare.gov; www.ok.gov; www.okhca.org