Rules and Regulations Governing Health Insurance in Oklahoma

With the rising cost of health and medical care services, purchasing health insurance policy is considered quite a good investment for residents of Oklahoma. However, it would be good for potential policyholders to know some of the regulations and rules imposed by the state on this type of insurance product.

For individual health insurance policies, providers are required under state law to offer coverage for several medical procedures and services. These include cervical cancer screening, colorectal cancer screening, prostate cancer screening, mammograms, and pregnancy. Coverage for vaccination and hearing aids for children are also required by the state to be offered by every health insurance provider. The state of Oklahoma also requires all insurance companies offering health insurance products to provide equal benefits for physical and mental health conditions. This is to avoid discriminating against those suffering from mental health illness when it comes to providing health and medical services to them.

There are no limits enforced on pre-existing conditions, allowing insurance providers in the state to deny an application on this basis. Providers may also opt to permanently exclude a pre-existing condition from a policy by requiring the attachment of a permanent rider before approving a health insurance policy. However, once a health insurance policy has been approved and has been in effect for some time, the policyholder also enjoys guaranteed renewal, so long as premiums are paid on time and there are no misrepresentations done by the policyholder. Oklahoma insurance providers must also offer the same insurance policies to all small business owners, which have employees numbering less than 50. However, small business owners must also meet the minimum requirements set by the company in order to continue availing of the policy, including paying a certain amount for premiums of each employee before the policy’s implementation. Insurance companies are also allowed under state law to charge higher premiums due to the health status and other perceived risks associated with offering the policy, though limits are also imposed on just high the premiums are charged.

There are also insurance products offered to self-employed individuals, which typically carry higher premiums than the usual small business insurance or individual insurance premiums. However, policyholders of self-employed health insurance are allowed to list a percentage of their premiums as itemized tax deduction. Because the state of Oklahoma does not prohibit insurance providers from denying applications, it also established an entity to answer the health insurance needs of persons who have been denied by insurance providers due to their health status. This entity is named the High Risk Pool, administered by the Benefit Management Inc. and is non-profit. Premiums offered through this entity is typically higher, though state law requires that it should not exceed 50% above the standard rates offered for health insurance policies. Among the requirements for qualifying into the High Risk Pool is being a resident of Oklahoma for at least a year, have been rejected by at least two insurance companies, and cannot be admitted into a penal facility or into a rehabilitation facility for drug or alcohol abuse.

To address the health insurance needs of those unable to pay for health insurance, the state also implemented several programs. These include SoonerCare, the Medicaid program in Oklahoma for low-income families as well for disabled citizens. There is also Insure Oklahoma designed for both small business employees and individuals who can only afford low-cost insurance plans. Women unable to avail of individual health insurance plans from private insurance providers can also avail of the Oklahoma Cares, which also provide full health insurance benefits for women diagnosed with cancer.

We help our Oklahoma customers in Oklahoma City, Tulsa, Norman, Lawton, Broken Arrow, Edmond, Midwest City, Moore, OK and other cities in the Sooner State lower their premiums and save money on all types of insurance. Use the form above to find low cost auto, homeowners, health, medical, life and long term care insurance. Using our Oklahoma insurance agent and broker network, you can easily compare multiple rates.

Oklahoma Auto Insurance, Life Insurance Oklahoma, Homeowners Insurance | Free OK Rate Quotes