Are you about to qualify for Medicare Oklahoma, or are you considering Medicare plans in Oklahoma? Medicare, the federal health insurance program, regulates premiums and helps people over age 65 access quality healthcare services.
Read on to learn about your options in Oklahoma.
Medicare is divided into several parts, each providing a different level of care. Even if you’re automatically enrolled in Medicare Part A when you turn 65, you’ll still need to manually enroll in other parts of Medicare Oklahoma.
Medicare Part A covers hospital expenses, including:
- inpatient hospital care
- emergency room visits, if ordered by your doctor
- short-term nursing home care
- hospice care
- part-time home healthcare
Medicare Part B covers other medical expenses not covered under Part A. It covers up to 80 percent of the following services:
- outpatient care such as day surgeries
- doctors’ visits
- annual flu vaccine
- certain screening and tests
- mental healthcare
Medicare Part D provides supplemental drug coverage. These plans offer coverage for prescription or over-the-counter medications.
There are a range of Part D plans available, each covering a unique list of drugs. You may choose to add Part D coverage to your original Medicare (parts A and B) coverage in order to offset the cost of prescription medications.
Medicare Part C, also known as Medicare Advantage, offers the most comprehensive coverage of any Medicare plan. Medicare Advantage plans in Oklahoma are offered by private insurance carriers. You’ll find a huge selection of plans with several different premiums and covered services.
Medicare Advantage plans may offer the following coverage:
- all original Medicare coverage
- prescription drug coverage
- dental and vision coverage
- fitness programs or gym memberships
- adult day-care programs
These private insurance providers offer Medicare Advantage plans in Oklahoma with a wide range of premiums and a variety of coverage options to meet your health needs:.
- Care Improvement Plus South Central Insurance Co.
- Cherokee Elder Care
- Community Care HMO
- GHS Health Maintenance Organization
- Life Pace
- Oklahoma Superior Select
- Sierra Health and Life
- Symphonix Health Insurance
- Valir Pace Foundation
Plans vary by county, so when researching providers and plans, make sure the carriers offer coverage in your area.
- be 65 years old or over
- be an American citizen or permanent resident of Oklahoma
You may also be eligible if you’re under age 65 and:
- have a disability and have received disability benefits for at least 24 months
- have a chronic illness such as amyotrophic lateral sclerosis (ALS), end stage renal disease (ESRD), heart disease, or cancer
If you’re receiving Social Security benefits, you’ll be automatically enrolled in Medicare Oklahoma Part A, and won’t pay premiums.
If you’re approaching your 65th birthday, you can enroll during your initial enrollment period. This starts 3 months before your 65th birthday and ends 3 months after your birthday. During this period, you can research plans, decide if you want to enroll in supplemental Part D coverage, or enroll in a Medicare Advantage plan in Oklahoma.
After the initial enrollment period, the best time to enroll in Medicare is during the annual enrollment period from October 15 to December 7. During this time, you can:
- enroll in Medicare plans in Oklahoma
- switch from original Medicare to an Advantage plan
- switch between Medicare Advantage plans in Oklahoma
- add Part D to your existing coverage
You’ll have another opportunity to reevaluate your Medicare Advantage plan during the Medicare open enrollment period from January 1 to March 31. In this period, you can switch between Medicare Advantage plans in Oklahoma or switch back to original Medicare, with or without part D coverage.
Were you unable to enroll during any of these periods? If you didn’t enroll in Medicare at age 65 because you still had employee benefits through work, you can qualify for a special enrollment period. When your job ends and you’re no longer receiving benefits from your employer, you can apply for the special enrollment period.
You may also get a special enrollment period if you move outside the coverage range of your current plan or you move into a nursing home.
When searching for Medicare plans in Oklahoma, you’ll find you have lots of plan options. Narrow them down by following these tips:
- Start by calling your doctor’s office. Medicare Advantage plans in Oklahoma only provide coverage to network-approved doctors, so ask which Medicare plans in Oklahoma your doctor accepts.
- Make a list of all your medications. Advantage plans and Part D plans don’t offer comprehensive drug coverage but do provide a list (known as a formulary) of all the medications they will cover. Narrow your search by finding out what prescriptions are covered by each plan.
- Think about your current healthcare needs and what services you’d like to access. If you want more extensive coverage, consider an Advantage plan that will give you additional coverage.
- See what others have said about the plans you’re considering by checking each plan’s CMS star rating. Medicare provides a 1 to 5 rating of how well each Part C and Part D plan performed in the previous year. A plan with a 4- or 5-star rating was ranked highly by people insured with the plan.
You can find out more about Original Medicare and Medicare Advantage plans in Oklahoma by using the following resources.
- Medicare, 800-633-4227. You can contact Medicare for help finding Medicare plans in Oklahoma, comparing plans, or accessing the CMS star ratings.
- Oklahoma Insurance Department, 1-800-522-0071. Contact the Oklahoma Insurance Department to learn about the Medicare Assistance Program, speak to a State Health Insurance Program (SHIP) counselor, and ask about Senior Medicare Patrol.
- Oklahoma Health Care Authority, 1-800-987-7767. The Oklahoma Health Care Authority administers SoonerCare, providing healthcare information to adults and people over age 65 in Oklahoma.
Have you narrowed your plan options to a just a few? Review your coverage needs and your budget as you think about each plan.
- Use this Medicare tool to compare drug plans and Medicare Advantage plans in Oklahoma.
- Call Medicare or a SHIP counselor to get more advice on selecting a plan to match your needs.
- Call the plan carrier to ask for additional clarification, and begin the application process on the phone or online.