Insure Oklahoma

Insure Oklahoma State-Sponsored Health Insurance Program
The Insure Oklahoma program is designed to provide an affordable health care option for individuals and their spouses that do not qualify for medicaid or an employer-sponsored plan.  Your children are ineligible through this program, but eligible through SoonerCare.  The eligibility requirements are fairly straightforward:

  • You must be a legal resident of Oklahoma
  • You must be between the ages of 19-64
  • You must be eligible for Unemployment Benefits in Oklahoma
  • You cannot be eligible for the Insure Oklahoma employer-sponsored health plan
  • You cannot be involved with Medicaid or Medicare
  • You cannot earn more than the income limits

Income Guidelines
Your household cannot earn more than a certain level of gross annual income, which varies with the number of family members and the number of wage-earners.  For a single-earner family of four, this is $45,000.  One aim of the program is to specifically address the unemployed population, so it is unlikely that your unemployment benefits will surpass this income threshold.

For more information, click here.

How It Works
Insure Oklahoma is highly subsidized.  You choose a Primary Care Provider (which can be virtually any doctor that is accepting patients), and that PCP acts as your gateway to health care.  Except for emergencies, all health care requests go through your PCP. This includes requests for specialists.  You can apply online by clicking here.

Benefits
The set of benefits is standardized, regardless of which PCP you go through.  There is a $1,000,000 lifetime maximum for each member. You are covered for:

  • Physician visits
  • Inpatient and outpatient hospital services
  • Emergency care
  • X-rays and laboratory
  • Maternity care
  • Durable medical equipment
  • Pharmacy

The following are NOT covered:

  • Dental
  • Vision
  • Ambulence

For more information, download the complete member handbook here.

Cost
The premium cost depends upon your gross annual household income, and will not exceed 4% of that figure.  Some types of care also require a copay at the time of service.  Doctor visits are $10, generic drugs are $5, hospital inpatient stay is $25, hospital outpatient stay is $50.  For a complete list, consult the member handbook.

In Conclusion
Over 3 million Oklahomans get their health care through this program.  This program won an award for “Honor Roll Coverage” from the Healthcare Leadership Council.  If you are eligible, it well be your best bet.