Finding 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 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 Different Parts of Medicare?
Original Medicare (Parts A and 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
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, offered by Medicare-approved private insurance companies, work as an alternative to the coverage provided by Original Medicare (Parts A and B). These plans provide the same coverage as Original Medicare and can also include additional benefits, like dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
You must be enrolled in both parts of Original Medicare to enroll in a Medicare Advantage plan. Premiums can start at $0 and increase depending on the level of coverage selected. You’ll continue paying your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Prescription drugs are not covered by Original Medicare (Parts A and B) or Medigap plans. Stand-alone Medicare Prescription Drug plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare to limit your out-of-pocket costs for medications. Medications are put into tiers, each tier with a certain copay or coinsurance. Each plan provides a formulary, so you can see what the coinsurance/copay would be for each drug. This way, you can select the plan that best matches your prescription needs.
Medicare Supplement Plans (Medigap)
As mentioned earlier, Medicare beneficiaries are still responsible for paying a portion of their medical bills. This is where Medicare Supplement plans come in. These plans are available through private insurance companies, approved by Medicare, and work alongside Original Medicare to cover certain costs, like copayments, coinsurance, and deductibles. If you plan to stick with Original Medicare, a Medigap plan can help reduce your out-of-pocket costs.
When Can I Enroll in A Medicare Plan?
Medicare Advantage and Prescription Drug Plans
Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. This IEP is a seven-month period, starting three months before your 65th birthday month.
You can then make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period runs from October 15th to December 7th every year.
Key Fact: The General Enrollment Period offers another chance to enroll in Original Medicare, in case you missed your IEP. This period occurs each year from January 1st to March 31st. If you want to enroll in a Medicare Advantage plan, you can do so from April 1st to June 30th every year.
Medicare Supplement Plans
The best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period. This six-month period begins at the start of your 65th birthday month, assuming you’ve enrolled in Medicare Part B. Otherwise, your Medigap Open Enrollment Period would start the same month as your Medicare Part B coverage.
Important Note: You are guaranteed the Medigap plan of your choice if you enroll during this period. But if you don’t enroll within this period, you could be charged higher premiums or be denied coverage entirely.
Special Enrollment Periods
If you’ve recently experienced a qualifying life event, you may be eligible for a Special Enrollment Period. Special Enrollment Periods allow you to make changes to your Medicare coverage outside of the periods discussed above. Qualifying life events include moving outside of your plan’s coverage area, moving into or out of a care facility, and more. Our licensed insurance agents can help determine whether you qualify for a Special Enrollment Period.
How Do I Select a Medicare Plan?
We’re here to help you explore the wide variety of Medicare plans in Oklahoma and find your ideal coverage. You can browse plans online by using the form below, or speak with one of our licensed insurance agents by calling the number above. We’re happy to help you compare plans, determine eligibility or answer any other related questions.
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