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Medicare in Oklahoma

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If you’re a Medicare beneficiary in Oklahoma, you might have several options for your Medicare coverage. Understanding these options can help you figure out the Medicare coverage in Oklahoma that best meets your insurance coverage and lifestyle needs.

Original Medicare for Oklahoma residents

Original Medicare (Part A and Part B) is the federal health insurance program for United States citizens and legal residents age 65 and older, as well as some people under the age of 65.

Original Medicare includes Part A and Part B.

  • Medicare Part A generally covers inpatient hospital care, skilled nursing facility care, and hospice care, as well as limited home health services.
  • Medicare Part B may cover outpatient services, including doctor visits, lab tests, mental health care, some preventive care, and some home health care.

570,595 Oklahomans were enrolled in Original Medicare as of January 2018, according to a recent study produced by the Centers for Medicare & Medicaid Services (CMS). Original Medicare is the choice of 80% of Medicare beneficiaries living in Oklahoma in 2018.

If you decide to receive your Medicare benefits from the government-sponsored Original Medicare program, you may want to consider additional insurance to help you pay for services and items that Original Medicare doesn’t cover.

Medicare health and prescription drug plans in Oklahoma

A stand-alone Medicare Part D Prescription Drug Plan can work alongside your Original Medicare (Part A and Part B) benefits. Medicare Prescription Drug Plans are provided by Medicare-approved private insurance companies in Oklahoma, and 23 Medicare Part D Prescription Drug Plans are available in Oklahoma in 2018, according to CMS. To enroll in one of these plans you must have Medicare Part A or Part B (or both) and select a plan that serves the community where you live. Every Medicare Part D Prescription Drug Plan has a list of covered prescription drugs called a formulary. The formularies vary among the plans. You can review plans’ formularies online or by calling the plan to check to see if your prescription medicine is on the list. The formulary may change at any time. You will receive notice from your plan when necessary.

If you enroll in a Medicare Part D Prescription Drug Plan you generally pay a monthly premium, an annual deductible, and copayments or coinsurance for covered prescription drugs. If you have a low income, you might qualify for Extra Help (a government subsidy) with the costs associated with your Part D prescription drugs and coverage. 30% of Oklahomans with Medicare Part D qualified for Extra Help in 2018, according to CMS.

Medicare Supplement (Medigap) insurance in Oklahoma

If you decide to stay with Original Part A and Part B, you may also be able to sign up for a Medicare Supplement (Medigap) insurance plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap insurance plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.

Medicare Advantage plans in Oklahoma

If you’re interested in an alternative way to receive your Original Medicare benefits, you may want to consider a Medicare Advantage plan in Oklahoma. CMS notes that 100% of Medicare beneficiaries living in Oklahoma have access to at least 1 of the 35 Medicare Advantage plans in the state in 2018.

Medicare Advantage plans are offered by private insurance companies that contract with Medicare and must provide at least the same level of coverage as Original Medicare (except for hospice care, which is still covered by Medicare Part A). Many Medicare Advantage plans also include extra benefits such as routine dental and vision care, routine hearing care, or wellness programs. Some plans, called Medicare Advantage Prescription Drug (MA-PD) plans, cover medical and prescription drug benefits.

Every Medicare Advantage plan must provide a yearly out-of-pocket spending limit. If and when your health-care spending for covered services reaches this limit (including the deductible), your Medicare Advantage plan covers 100% of covered medical costs for the rest of the year.

To enroll in a Medicare Advantage plan, you must have Medicare Part A and Part B and live in the Medicare Advantage plan’s service area. You might not be eligible for a Medicare Advantage plan if you have end-stage renal disease, but you can call plans that you’re interested in and ask them. You need to keep paying your Medicare Part B premium, in addition to the plan premium, if any, required by the Medicare Advantage plan.

Medicare resources in Oklahoma

The state of Oklahoma has resources to serve its elderly and disabled residents, such as:

  • State Health Insurance Assistance Program (SHIP)
  • Medicare Assistance Program

Medicare statistical trends in Oklahoma

Some facts from the Center for Medicare & Medicaid Services (CMS) about Medicare coverage in Oklahoma that may be of interest to you appear below.

  • 477,866 people chose to have Medicare Part D (prescription drug coverage) as of January 2018. Approximately 75% of Oklahomans chose a stand-alone Medicare Part D Prescription Drug Plan to provide their prescription drug coverage and 25% got prescription drug coverage through a Medicare Advantage Prescription Drug plan.
  • In 2018, 83% of people with Medicare prescription drug coverage have access to a plan with a lower premium than what they paid in 2017.

Statistical data from the Centers for Medicare & Medicaid Services (CMS), “2018 MA Part D Landscape State-by-State Fact Sheet,” and “Medicare Enrollment Dashboard,”

Data in this article was checked when the article was written and might not be updated as newer data becomes available.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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