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Oklahoma Health Insurance Consumer Guide
This guide was developed to help you understand the health insurance options available for you and your family. The options found in Oklahoma’s ACA Marketplace may be a good choice for many consumers, and we will guide you through the options below.
Oklahoma uses the federally run health insurance exchange Healthcare.gov for residents to purchase its ACA Marketplace plans. The Marketplace provides access to health insurance products from private insurers.
The federal government helps pay for insurance through an advance premium tax credit if you buy coverage from the exchange. Depending on your income and other circumstances, you may also get help to lower your monthly insurance premium (the amount you pay to enroll in the coverage) and possibly your out-of-pocket expenses.
Explore our other comprehensive guides to coverage in Oklahoma
Dental coverage in Oklahoma
Need dental coverage? Learn about available options and find the right dental plan in Oklahoma with our guide.
Oklahoma’s Medicaid program
Oklahoma Medicaid (SoonerCare) eligibility was expanded (as called for in the ACA) in July 2021. Oklahoma's total Medicaid enrollment has grown to more than 1 million people since the expansion of coverage limits. 1
Medicare coverage and enrollment in Oklahoma
As of December 2022, there were 778,724 Oklahoma residents with Medicare coverage. 2 Our Oklahoma Medicare guide explains the various parts of Medicare, as well as Oklahoma regulations pertaining to Medigap (Medicare Supplement) plans.
Short-term coverage in Oklahoma
As of 2023, there were at least seven insurers selling short-term health insurance plans in Oklahoma. 3
Frequently asked questions about health insurance in Oklahoma
Who can buy Marketplace health insurance?
To qualify for health coverage through the Oklahoma Marketplace, you must: 4
- Live in Oklahoma
- Be lawfully present in the United States
- Not be incarcerated
- Not be enrolled in Medicare
Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:
- Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
- Not be eligible for Medicaid or CHIP.
When can I enroll in an ACA-compliant plan in Oklahoma?
In Oklahoma, open enrollment for individual and family health coverage runs from November 1 to January 15. 5
Your coverage will start on January 1 if you enroll before December 15. But if you apply between December 16 and January 15, your coverage will begin on February 1.5
Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage. If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.
How do I enroll in an Oklahoma Marketplace plan?
To enroll in an ACA Marketplace plan in Oklahoma, you can:
- Visit Healthcare.gov to access Oklahoma’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans.
- Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.6
You can reach HealthCare.gov’s call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, except holidays.
How can I find affordable health insurance in Oklahoma?
Oklahoma uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov. About nine out of ten eligible enrollees save money on 2023 premium payments amounting to an average savings of $577/month. After subsidies were applied, the average enrollee’s monthly cost was about $73/month.7
The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset your premium payments to help keep your expenses down. People with household incomes below 250%of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan. In 2023, 96% of Oklahoma Marketplace enrollees were receiving CSR benefits.8
Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.
Source: CMS.gov9
How many insurers offer Marketplace coverage in Oklahoma?
For 2024, seven insurers will offer health plans through the Oklahoma exchange, including newcomer Taro Health:10
- Blue Cross Blue Shield of Oklahoma
- Oscar
- Medica
- CommunityCare
- UnitedHealthcare
- Ambetter (Centene/Celtic)
- Taro Health (new for 2024, with plans available in the Oklahoma City metro area)
In most of Oklahoma’s counties in 2023, at least one insurer was offering health plans. 11
Are Marketplace health insurance premiums increasing in Oklahoma?
For premiums on their 2024 coverage, Oklahoma’s exchange insurers have proposed the following average rate changes, which are under review by federal regulators. (Oklahoma does not have its own effective rate review program.):10
Oklahoma’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company |
|
|---|---|
| Issuer | Percent Increase |
| BCBSOK | 5.0% |
| Oscar | 4.5% |
| Medica | -0.4% |
| CommunityCare | 1.6% |
| UnitedHealthcare | –3.5% |
| Ambetter (Centene/Celtic) | 6.1% |
| Taro Health | New for 2024, so no applicable rate change |
Source: HealthCare.gov10
How many people are insured through Oklahoma’s Marketplace?
During the open enrollment period for 2023 coverage, over 203,157 people enrolled in private individual market plans through Oklahoma’s exchange.12 This was a record high for the state, on the heels of previous record highs in 2022 and 2021.
The surge in enrollment during these years was due in part to American Rescue Plan (ARP) provisions that made ACA’s premium subsidies more substantial. Under the ARP – now extended by the Inflation Reduction Act – subsidies are more significant and accessible through the end of 2025.12
Source: 2014,13 2015, 14 2016,15 2017,16 2018,17 2019,18 2020,19 2021,20 2022,21 2023,12 202422
What health insurance resources are available to Oklahoma residents?
HealthCare.gov
800-318-2596
State Exchange Profile: Oklahoma
The Henry J. Kaiser Family Foundation overview of Oklahoma’s progress toward creating a state health insurance exchange.
Oklahoma Insurance Department
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care. (405) 521-2991 / Toll Free in OK: (800) 522-0071 / [email protected]
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- “April 2023 Medicaid & CHIP Enrollment Data Highlights” Medicaid.gov, April 28, 2023 ⤶
- “Medicare Monthly Enrollment ” CMS.gov, Accessed August 2023 ⤶
- “Availability of short-term health insurance in Oklahoma” healthinsurance.org, Aug. 14, 2023 ⤶
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov ⤶
- “When can you get health insurance?” HealthCare.gov, 2023 ⤶ ⤶
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023 ⤶
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023 ⤶
- “Effectuated Enrollment: Early 2023 Snapshot and Full Year 2022 Average” CMS.gov, March 15, 2023 ⤶
- “2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2024 ⤶
- “Oklahoma Rate Review Submissions” HealthCare.gov, 2023 ⤶ ⤶ ⤶
- “2023 Qualified Health Plans” CMS.gov, Oct. 26. 2022 ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, Accessed August 2023 ⤶ ⤶ ⤶
- “ASPE Issue Brief (2014)” ASPE, 2015 ⤶
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015 ⤶
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016 ⤶
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017 ⤶
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018 ⤶
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019 ⤶
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020 ⤶
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021 ⤶
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022 ⤶
- “HEALTH INSURANCE MARKETPLACES 2024 OPEN ENROLLMENT REPORT” CMS.gov, 2024 ⤶
