Medicare in Oklahoma
- Want more guidance on enrolling in Medicare? Start with this guide to Medicare in Oklahoma, which includes information about plans and enrollment dates.
What Oklahoma Medicare Plans Are Available?
Signing up for Medicare doesn't have to be a complex process for those that understand the various parts, eligibility requirements and enrollment periods. Medicare in Oklahoma can help those enrolled to contend with healthcare expenses ranging from co-pays to prescriptions.
Medicare plans in Oklahoma are comprised of the traditional components of the national program.
Part A is the original component of the program and covers hospital stays. It also provides coverage for hospice stays, skilled nursing facilities and other healthcare facility services. Medicare Part A does not carry a premium for those that paid into the program via payroll taxes. However, it is available for purchase by those that did not as long as they purchase both Parts A and B.
Part B is the aspect of Medicare that functions similar to private insurance. It provides coverage for routine doctor's visits and other aspects of preventative care. It is different from Part A in that it does carry a monthly premium based on the income of the covered party. Those eligible must sign up during the designated enrollment period or risk a penalty for every 12 months of failing to do so. Exceptions include those that did not sign up because they had existing coverage and lost it without prior warning.
Parts A and B both cover different aspects of home health care as well.
Part C is the also called the Medicare Advantage program. It is a specialized form of insurance managed by private insurance companies. It replaces Parts A and B for those who select it. It's also required to cover at least all the benefits covered under those programs. In some cases, Part C plans actually offer more coverage, but they do come with premiums, deductibles and copays.
Part D is the prescription drug benefit program. It provides assistance in paying for prescription medications for those enrolled in the program. This portion also charges a monthly premium (also based on income and eligibility).
Finally, there is the Medigap program. It acts as a gap between the various components of Medicare to help with those expenses not covered by one of the aforementioned programs. For instance, Part B may cover in-office visits but not the co-pays associated with them. This is where Medigap coverage comes in.
Nearly 750,000 Oklahoma citizens are enrolled in Medicare. The state was the first to guarantee access to at least one Medigap plan for those under age 65. Insurers cannot charge these individuals higher premiums because of their age or preexisting conditions. Roughly 25% of those in the Medicare program have an Advantage plan. There are up to 30 plans available in some parts of the state.
Oklahoma has 29 stand-alone Part D programs as of 2019, and nearly half of those enrolled in Medicare programs have taken advantage of a Part D plan.
Who Is Eligible for Oklahoma Medicare?
Oklahomans aged 65 and up are available for Medicare. Eligibility is also offered to those receiving disability benefits through the Social Security Administration and those with a few approved health conditions. Enrollment is automatic for those eligible for Social Security benefits at age 65. The process begins 4 months prior to an individual's 65th birthday.
The official enrollment period for those that need to sign-up is 3 months before their 65th birthday and extending 3 months past that month. While individuals can enroll after that time, depending on the circumstances, they may incur a penalty for doing so.
The Medicare program does have specific enrollment periods. One takes place between January 1 and March 31, with coverage starting July 1. The other is between October 15 and December 8, with coverage starting January 1.
Special enrollment options are available for those enrolled in the Medicare Advantage plan that have opted to switch to a five-star plan when one becomes available. However, the enrollment must take place between December 8 and November 30 and may only be utilized one time during this period.
There are also special enrollment options for those who had employer-sponsored healthcare through their place of employment or via a spouse's plan to replace a sudden loss in coverage.
How Do I Enroll in Medicare in Oklahoma?
Individuals interested in enrolling in Medicare in Oklahoma have several options for doing so:
- Call the Social Security Administration Monday through Friday from 7 a.m.-7 p.m. at (800) 772-1213.
- Visit the Social Security Administration website at SocialSecurity.gov.
- Make an appointment at one of the local Social Security Administration offices for help with the enrollment process.
Contact Information for Oklahoma Medicare, Medicaid and Insurance Help
Given the complexities of Oklahoma Medicare, Medicaid and insurance programs, assistance is available to those interested in signing up. Those in need of such assistance can visit the Oklahoma Insurance Department's website. Assistance is also available via phone at (800) 522-0071.
Oklahoma also offers help via the Senior Health Insurance Counseling Program and the Senior Medicare Patrol, both of which can be reached via phone at (800) 763-2828.
If you're interested in Medicaid coverage, check out the HelpAdvisor page on Oklahoma Medicaid. If you can't afford Medicare supplemental insurance (Medigap), you may be able to apply for Medicaid and have it act as the insurance that is secondary to Medicare.