State Guides

Oklahoma

Oklahomans are now able to purchase quality health insurance plans available from Pivot Health. These plans, described below, offer Oklahoma individuals and families the ability to choose the benefit structure that best meets their insurance coverage needs and budget.

 

  • Short Term Health InsuranceSometimes called short term medical, or temporary health insurance, this plan provides comprehensive benefits coverage for physician visits, in-hospital care, urgent care facility visits and much more. With no provider network restrictions, you are able to seek treatment from any doctor or hospital to access benefits. Pivot Health’s fast, user-friendly online application process means that you’ll know within minutes of applying if you’ve been approved for coverage.  Qualified applicants may choose any coverage start date – even within 24 hours after you apply.  
  • Supplemental Insurance CoverageIf you find yourself struggling with your major medical insurance plan’s high deductibles and costly coinsurance rates, then supplemental – or “gap” – insurance may provide you the financial support you need.  The cash benefits provided by a supplemental coverage plan help you pay out-of-pocket medical expenses, such as insurance deductibles, copayments or coinsurance.  The cash payments provide you the flexibility to decide how to use them – you may use the cash for any expenses you incur due to a serious illness or accident.  Designed to work with your primary major medical coverage – whether you have an individual plan or employer-sponsored coverage – a supplemental insurance plan helps you protect your financial security from costly expenses related to medical care.

 

Included with your Pivot Health membership package are these additional non-insurance benefits:  

Unlimited access to discounted telehealth doctor consultations.  Skip the doctor’s waiting room!  Instead, connect directly with a doctor at whatever time of day works for you – telehealth is available 24/7.  And it saves money compared to a standard office or urgent care facility visit.

Savings on eye care and eyewear.  Discounts of 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses, make it easy and affordable to maintain good ocular health.  

Discounts on prescription drugs.  Enjoy savings of up to 75 percent on prescription drugs at thousands of pharmacies across the nation.

Health Insurance Exchange Challenges in Oklahoma

A recent County Health Rankings report shows that approximately 21 percent of Oklahoma residents under the age of 65 have no health insurance – more than twice the national uninsured rate of 9.1 percent.  Uninsured rates vary by county:  Canadian County has the lowest rate at 15 percent, while a staggering 30 percent of Cimarrony County residents are uninsured.   

Oklahoma has experienced numerous challenges with its health insurance exchange, which could factor into the state’s high uninsured rate.  Although the state had four insurance carriers participating in its exchange in 2015, that number dropped by half in 2016 when two of the carriers withdrew from the exchange.  Then, in early 2016, UnitedHealthcare announced that it also would exit from the exchange at the end of the year.  For 2017, this means that exchange enrollees in all 77 counties of the state are now left with one insurance carrier choice – Blue Cross Blue Shield of Oklahoma.  

A reduction to a single insurance carrier option was not the only significant change for Oklahoma exchange enrollees this year.  Citing more than $300 million in losses since entering the individual exchange market in 2014, Blue Cross Blue Shield of Oklahoma filed for 2017 premium rate increases ranging from 58 to 96 percent.  The federal Department of Health and Human Services, which oversees premium adjustments in Oklahoma (because the state uses the federal Healthcare.gov enrollment platform), approved the rate increases, which averaged to a 76 percent premium spike for Oklahoma exchange enrollees.

Approximately 87 percent of Oklahomans receive federal premium subsidies to help pay for their exchange plan premiums, and won’t be significantly affected by the 2017 premium cost increases.  However, Oklahomans who purchase exchange plans but don’t receive federal premium subsidies, and those who buy off-exchange plans find the 2017 premium increases shocking – especially as they follow rate hikes that ranged from 22 to 34 percent in 2016.

A higher-than-national-average rate of uninsured residents, only one exchange insurance carrier, and skyrocketing premium rates all underscore the importance of offering Sooner State residents access to a broader range of health insurance choices.  

  • Pivot Health’s short term health insurance enables Oklahoma residents to purchase comprehensive coverage at a fraction of the cost of major medical insurance coverage – with no provider network restrictions.
  • Pivot Health’s supplemental health insurance provides Oklahomans supplemental insurance designed to provide financial support for the costly expenses associated with high deductible major medical insurance plans.  This type of “gap” coverage helps insureds pay for high deductibles, out-of-pocket costs, coinsurance, copayments, and other costs that they typically incur before their high deductible major medical plan begins to pay benefits.

A Report on Oklahoma’s Well-Being

The recent Gallup-Healthways State of American Well-Being report examined how well-being varies by state.  Oklahoma ranked 48th out of the 50 states, based on survey responses to questions covering different categories of well-being.  

Oklahoma residents reported lower-than-average ratings (ranking 46th, 48th and 48th, respectively) for the following categories:

  • Financial:  managing your economic life to reduce stress and increase security  
  • Social: having supportive relationships and love in your life
  • Physical: having good health and enough energy to get things done daily

However, Oklahoma had higher rankings (33rd and 35th, respectively) for well-being in these categories:

  • Community:  liking where you live, feeling safe and having pride in your community
  • Purpose: liking what you do each day and being motivated to achieve your goals

The State of Health in Oklahoma

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Oklahoma an overall ranking of 49 out of 51 (the 50 states plus the District of Columbia).  This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.

The Commonwealth Fund’s Scorecard rated Oklahoma in several areas, including:

  • Uninsured adults aged 19 to 64: 49th ranking (20 percent in Oklahoma, compared to U.S. average of 13 percent)
  • Uninsured children ages 0 to 18:  41st ranking (8 percent, compared to the U.S. average of 5 percent)
  • Adults who went without care because of cost in the previous year:  39th ranking (15 percent in Oklahoma, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income:  45th ranking (18 percent, compared to U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years:  39th ranking (17 percent in Oklahoma, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year: 37th ranking (17 percent, compared to U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings:  49th ranking (60 percent in Oklahoma, compared to the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects:  10th ranking (70 percent, compared to U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 37th ranking (22 in Oklahoma, compared to U.S. average of 20.6)
  • Colorectal cancer deaths per 100,000 people: 45th ranking (16.5 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000:  43rd ranking (19.1 percent in Oklahoma, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations: 44th ranking (30 percent, compared to the U.S. average of 26 percent)
  • Adults who smoke:  43rd ranking (22 percent in Oklahoma, compared to the U.S. average of 17 percent)
  • Adults who are obese: 43rd ranking (35 percent, compared to the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 37th ranking (34 percent in Oklahoma, compared to U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease:  42nd ranking (14 percent, compared to U.S. average of 10 percent)

Oklahoma had positive ratings in other categories, including:

  • Adults who have received age-appropriate vaccines
  • Children ages 19-35 months who received all recommended doses of seven key vaccines
  • Home health patients whose wounds improved or healed after an operation

2017 Health Insurance Plans in Oklahoma

The only insurance company offering individual plans on the exchange in Oklahoma for 2017 is Blue Cross Blue Shield of Oklahoma (offered in all 77 Oklahoma counties).

Pivot Health offers in Oklahoma:

  • Short term health insurance
  • Supplemental health insurance

Medicaid in Oklahoma

Oklahoma is one of 19 states that have chosen not to expand Medicaid under the terms of the Affordable Care Act (ACA).  A recent Kaiser Family Foundation study reported that there are approximately 82,000 Oklahoma residents in the Medicaid “coverage gap.”  These residents have income too high to qualify for traditional Medicaid benefits, yet their income is too low to qualify for subsidies to help pay for insurance plans purchased on the exchange.

Advocates of expansion note that by refusing to grow the Medicaid program, Oklahoma has lost more than $1 billion in funding from the federal government to provide health care coverage to thousands of Oklahomans, many of whom are working poor.  In early 2016, some lawmakers in Oklahoma proposed the state move forward with expanding its SoonerCare Medicaid program, but the effort was eventually defeated in the legislature.

Expansion critics point to recent studies which have shown that states which have expanded Medicaid are facing much higher costs than were initially estimated.  In November of 2016, the Foundation for Government Accountability published a report, noting that expansion enrollment exceeded state projections significantly, ranging from 51 percent in Arkansas to a whopping 322 percent in California.  The Foundation’s research also found that per-enrollee costs were rising more rapidly than anticipated.  State budgets will eventually be swamped by Medicaid costs, concluded the Foundation, as states fully transition to providing a greater percentage of the Medicaid expansion funding between 2017 and 2020.

With thousands of individuals unable to qualify for premium subsidies to purchase exchange plans, and yet also ineligible to qualify for Medicaid, it is more important than ever that Oklahomans have access to affordable, comprehensive health insurance coverage.

Your Health Care Coverage Choices

If you are an Oklahoma resident and do not have health insurance:  Pivot Health’s short term health insurance offers you the choice of comprehensive medical coverage to meet your benefit and budget needs.

If you are an Oklahoman and have a high deductible health insurance plan:  Pivot Health’s supplemental insurance can help relieve the burden of costly out-of-pocket expenses, such as deductibles, coinsurance, copayments and more.

Pivot Health: offering you choices and flexibility that pivot to meet your needs over time.