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Understand Medicare in Oklahoma

Medicare, the United States federal medical insurance program, provides coverage for more than 500,000 people in Oklahoma who qualify for Medicare.  You can get Medicare if you’re 65 or older or have a qualifying disability.

Your disability typically qualifies if you’ve received at least 24 Social Security or Railroad Retirement Board (RRB) disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $506per month in 2023. Part B costs $164.90 per month but can be more if you have higher income. There are 41 Medicare Advantage Plans in the state that are an alternative to Original Medicare.  Learn more about your Medicare options in Oklahoma.

Medicare Plans in Oklahoma

Compare ratings of Oklahoma’s Medicare plan providers:
Insurance company Medicare rating A.M. Best rating BBB rating J.D. Power ranking
Aetna 4 stars A+ A+ 6th out of 9
Humana 4 stars A- A+ 2nd out of 9
UnitedHealthcare 3.5 stars A+ A- 4th out of 9

 

Medicare Plan Options in Oklahoma

Residents of Oklahoma have multiple Medicare plans to choose from. Many are tiered to help Oklahoma residents find the plan that is best suited to your lifestyle and medical needs. For example, seniors and individuals with disabilities who don’t need much coverage can apply for Original Medicare. Oklahoma’s Medicare Advantage program might be a better option if you need more comprehensive insurance. Some Medicare policies offer additional prescription drug add-ons or supplementary coverage.

Original Medicare (Parts A and B) Original Medicare is the basic Medicare plan, which is a fee-for-service form of insurance. It has two parts: Part A hospital insurance and Part B medical insurance. Part A covers hospital stays and periods spent at skilled nursing facilities, lab tests an individual has performed, and hospice care. Part B covers doctor’s office visits and home health care services. It may also cover some preventive care, such as screenings for cancers and mental illnesses, including depression. With Original Medicare, you’ll pay a deductible along with your share of the fees incurred during an inpatient or outpatient visit:
  • Original Medicare is a good choice if you want flexibility in choosing and accessing providers that accept Medicare anywhere in the U.S.
  • There is no cap on what you could spend for out-of-pocket expenses, and you must purchase drug coverage separately, so it’s a better choice for you if you don’t need much in the way of health care or prescription drugs.
  • If you don’t purchase a Medigap policy to supplement Original Medicare when you are first eligible, you may not be able to purchase one or may have to pay higher premiums, depending on your health status.
Medicare Advantage Plans (Part C) Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare offered by private insurance companies. These plans include both Part A and Part B coverage, except for hospice care. Most services are provided by network providers, and you may need primary care physicians, referrals for specialists, and prior authorizations for treatment and medications. Medicare Advantage offers additional coverage for essential needs, such as prescription drugs, dental and vision care. Some Medicare Advantage Plans also cover gym memberships and transportation to and from medical appointments. Part C may also pay for adult day care services:
  • Medicare Advantage is a good choice if you want to have all of your health care and drug benefits bundled together in one plan and if you don’t mind being restricted in your choice of providers to save on costs.
  • There is a cap on what you can spend for out-of-pocket Medicare-covered expenses.
  • You also have access to services that Medicare doesn’t cover, like routine dental and vision exams.
Medicare Prescription Drug Coverage Plans (Part D) Many Medicare Advantage policies add Part D drug coverage automatically to their package, but you can also add Medicare prescription drug coverage to Original Medicare. Medicare prescription drug coverage is offered to all Medicare enrollees, but you may have to pay a penalty if you wait to enroll after being initially eligible. Medicare Part D plans may not all cover the same drugs or have the same costs as Medicare Advantage policies. Standalone Part D coverage is provided by Medicare-approved private insurers. Most plans require a deductible and a copay for each prescription drug:
  • Part D is a good choice if you have Original Medicare, or if you have a Medicare Advantage Plan ― not a health maintenance organization (HMO) or preferred provider organization (PPO) ― that doesn’t have prescription drug coverage.
  • You pay a penalty if you wait to enroll in a Part D plan, unless you have creditable coverage from an employer-sponsored group plan.
  • If you don’t require medications now, you can enroll in a low-premium Part D plan to avoid late enrollment penalties later.
Medicare Supplement Insurance Plans (Medigap) Some Oklahoma seniors purchase a Medicare Supplement Insurance policy, also known as Medigap. These plans are intended to fill in the gaps Original Medicare doesn’t cover. Some of these gaps include medical coverage while overseas, Part A and Part B copays, and excess Part B charges. Medigap doesn’t pay for anything related to Medicare Advantage. You cannot have a Medigap plan and a Medicare Advantage Plan at the same time.
  • Medigap is a good choice if you have Original Medicare and want help paying for out-of-pocket expenses you incur when you access your Part A and Part B benefits.
  • You pay a monthly premium, and most copays and coinsurance costs are covered.
  • If you have significant health care needs, want the freedom to see any Medicare provider without network restrictions, a Medigap plan offers predictable coverage and costs for Medicare-covered care.
  • Medigap doesn’t cover prescription drugs or other benefits like dental and vision.

Medicare in Oklahoma by the Numbers

People enrolled in Original Medicare  Average plan cost Annual state spending per beneficiary Spending per beneficiary compared to the national average
563,270 Part A: $0 to $506 per month*

Part B: $164.90 per month**

 $11,755 10.00%

*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.

Medicare Resources in Oklahoma

Getting support can help when you’re making Medicare decisions. Oklahoma has numerous locations where enrollees can receive help through the State Health Insurance Program (SHIP), also known as OklahomaCares. OklahomaCares has counselors throughout the state that work with local nonprofits and public health agencies, as well as Area Agencies on Aging (AAAs), to provide seniors with Medicare information.

Legal Aid Services of Oklahoma, Inc.

As a nonprofit agency, Legal Aid Services of Oklahoma, Inc. provides free legal advice and representation to Oklahoma residents age 60 and over. Counselors are available to advocate on your behalf and help resolve health insurance issues, such as denied claims or overcharges. Local offices will help you get public benefits, including Medicare, Medicare Savings Plans and prescription drug coverage.

Contact information: Website | (888) 534-5243

Oklahoma Senior Insurance Counseling Program (SHIP)

The Oklahoma Senior Insurance Counseling  Program (SHIP) is a statewise nonprofit program that provides free health insurance information to seniors and their family members living in the state. You can get help with Medicare Supplement Insurance, Medicare Advantage and prescription drug plans.

Contact information: Website | (800) 763-2828

Oklahoma Insurance Department

The Oklahoma Insurance Department is responsible for regulating insurance policies sold within the state. It advocates on behalf of residents to help ensure everyone has access to fair coverage. The department also provides the Oklahoma State Insurance Information Program (SHIIP), a nonprofit offering free health insurance counseling to seniors, and the Senior Medicare Patrol, a volunteer-run program to help seniors prevent, identify and report Medicare fraud and abuse.

Contact information: Website | (405) 521-2828

Oklahoma Areawide Aging Agency

The Oklahoma Areawide Aging Agency operates in the most populated regions in the state, where seniors can get help with a variety of health coverage concerns. The Agency can also connect you with a SHIP counselor to get free and unbiased health insurance counseling.

Contact information: Website | (405) 942-850

Kelly-Blackwell Headshot
Kelly Blackwell
Certified Senior Advisor (CSA)Ⓡ

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSAⓇ, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Kelly-Blackwell Headshot
Kelly Blackwell
Certified Senior Advisor (CSA)Ⓡ

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSAⓇ, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

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