Availability of short-term health insurance in Oklahoma

Yes. There are at least seven insurers offering short-term health insurance in Oklahoma.

As of November 1, 2019, short-term health insurance in Oklahoma was allowed to follow federal maximum duration rules. That means plans are allowed to have initial terms of up to 364 days, and total short-term plan duration, including renewals, of up to 36 months. This is clarified in Oklahoma Title 36, Section 4419.

Prior to November 2019, however, Oklahoma law limited short-term health insurance plans to six months and prohibited renewal.

Short-term health insurance in Oklahoma can be purchased by applicants who meet the underwriting guidelines the insurers use. In general, this means being under 65 years old (some insurers put the age limit at 64 years) and in fairly good health.

Short-term health plans generally include blanket exclusions for pre-existing conditions, so they are not adequate for residents of the Sooner State who are in need of imminent medical care and are seeking a plan that will cover those needs. Short-term insurance plans also tend to have a wide range of exclusions and limitations, as they are not required to cover the ACA’s essential health benefits. The most commonly excluded services are maternity care, prescription drugs, and mental health care, although the benefits and exclusions will vary considerably from one policy to another.

If you need health insurance coverage in Oklahoma, start by checking to see if you can enroll in an ACA-compliant major medical plan — even if you’re only going to need the coverage for a few months.

Open enrollment for these plans, on-exchange and off-exchange, runs from November 1 to January 15. Outside of that window, you can enroll if you have a qualifying life event that triggers a special enrollment period. The availability of ACA-compliant plans does not depend on your medical history, but enrollment is only possible during the open enrollment period or a special enrollment period.

ACA-compliant major medical plans are purchased on a month-to-month basis, so you can enroll in one even if you only need coverage for a few months before another policy takes effect. So for example, if you’ll soon be enrolled in Medicare or an employer-sponsored healthcare plan, you can sign up for an ACA-compliant plan during open enrollment or a special enrollment period, and then cancel it when the new coverage takes effect.

And there are premium subsidies available in the Oklahoma exchange/marketplace based on your household income. The American Rescue Plan made these subsidies larger and more widely available, and the Inflation Reduction Act extended that through 2025.

Subsidy amounts are income-based, and can make ACA-compliant health plan premiums much less costly than you might have expected — in many cases, even less expensive than a short-term plan. You can use our subsidy calculator to see the subsidy amount that you’ll receive to offset the cost of health insurance obtained via Oklahoma’s exchange.

But if you’re not able to enroll in an ACA-compliant individual market plan or a plan through your employer, a short-term plan is certainly better than nothing, and can help you bridge the gap until a more robust plan becomes available.

There are times when a short-term health insurance plan might be the only option, for example:

• If you missed open enrollment for ACA-compliant coverage and do not have a qualifying life event to trigger a special enrollment period.
• You’ve enrolled in an ACA-compliant health plan, but have a waiting period of up to several weeks before it takes effect (ie, January 1 if you enroll during open enrollment, or the first of the following month if you enroll during a special enrollment period).
• You’re newly employed and the business has a waiting period of up to three months before you can enroll in the employer-sponsored health plan (and you don’t have a qualifying life event that would allow you to get an ACA-compliant plan to cover those months).
• You’ll soon be enrolled in Medicare, and aren’t eligible for any other plan to cover you in the meantime. If your Medicare start date is only a few months out, the short-term plan might be all you’ll need. But if your Medicare coverage won’t start until after the start of the coming year, it’s wise to consider enrolling in an ACA-compliant plan during open enrollment — with coverage effective January 1 — and then canceling it when your Medicare coverage takes effect.
• If you’re not eligible for Medicaid or a premium subsidy, making an ACA-compliant plan potentially unaffordable.

People who are ineligible for premium subsidies include:

• Folks who earn too much money to be subsidy-eligible. This normally applies to households with an income of more than 400% of the poverty level, but the American Rescue Plan and Inflation Reduction Act have eliminated that limit through 2025. (Subsidies are only available through the Oklahoma exchange/marketplace.)
• People who cannot enroll in a healthcare plan through the exchange because they’re not lawfully present in the US. Lawfully present immigrants can get premium subsidies, but immigrants without a valid immigration status are not able to enroll through the exchange at all.

Oklahoma revised state short-term health insurance rules to adopt the new federal rules, instead of the previous six-month plan duration limit. This is referenced in 36 O.S. § 6060.4(C)(2)(f), and a 2011 bulletin from the Oklahoma Insurance Department (LH 2011-01) noted that “short-term health insurance issued on a nonrenewable basis” was exempt from the state’s rate filing and review process. The Oklahoma Insurance Department confirmed this in a bulletin (LH 2018-03) issued in September 2018, and it continued to be in effect through October 2019.

Oklahoma’s new rule — allowing short-term plans to comply with federal duration limits instead of the six-month limit the state had previously imposed — is a result of SB993, which was enacted in Oklahoma in June 2019 and took effect November 1, 2019.