Oklahoma Medicare Guide

Schedule a free consultation with one of our licensed Oklahoma Medicare Advisors or give us a call at (888) 604-0055 to get started.

This Oklahoma Medicare guide will help you get to know the basics of Medicare, including the various options and when you need to enroll.

Use this table of contents to jump to specific sections:

A Snapshot of Medicare in Oklahoma

There are 764,000 Oklahoma Medicare beneficiaries. This portion of the population makes up 19% of the state’s total population. Most Oklahoma residents receive Medicare benefits due to age, but about 16% are on Medicare due to disability. 16% of Oklahoma Medicare enrollees also receive Medicaid benefits.

When they enroll in Medicare, Americans can choose to stay on Original Medicare or switch to a Medicare Advantage plan (we’ll explain more about how each works later). In Oklahoma, 69% of beneficiaries are on Original Medicare and 31% are on a Medicare Advantage plan.

Oklahoma Medicare Eligibility and Enrollment Steps

All US citizens who are either 65 or older or have certain, qualifying disabilities, like ALS and End-Stage Renal Disease, are eligible for Medicare.

Medicare Enrollment Steps

1. Enroll in Original Medicare (Part A & Part B)

As we mentioned previously, most people are on Medicare due to age. You can enroll in Medicare as soon as your Initial Enrollment Period (IEP) begins. Your IEP is a seven-month window that starts three months before and ends three months after the month you turn 65. Some people choose to delay their Medicare Part B enrollment because they’re still working and receiving employer coverage. Just make sure you’re eligible for a Special Enrollment Period before choosing to delay.

2. Compare additional coverage options

After you enroll in Original Medicare, you can either stay on Original Medicare or switch to Medicare Advantage. Choosing the right type of Medicare coverage is a personal decision that you should make based on your specific healthcare needs. In other words, don’t just choose the same thing your friends and family picked! We’ll explain how both Original Medicare and Medicare Advantage work, and we’re also here to talk! If you have questions about your Medicare options, give us a call at (888) 604-0055 to get free, personalized advice from our licensed Oklahoma Medicare Advisors.

3. Get the most value from Medicare

Especially if you’re on a Medicare Advantage or a Part D plan, we recommend that you review your plan each year during the annual Medicare Open Enrollment Period. During this time you can change your plan without consequence.

Why would you change your plan if you took so much care to find the right one to begin with? Plans change, and your healthcare needs may too! Each year, double check that your preferred doctors and prescriptions are covered by your plan, and check around for plans with better pricing and benefits. It can’t hurt, and it’s saved some people thousands of dollars!

Oklahoma Medicare Advantage Plans

Medicare Advantage plans combine Part A and Part B coverage. They generally also provide Part D (prescription drug) coverage. When you’re on an MA plan, you still need to pay your Original Medicare premiums. Many MA plans have no or low additional premiums and offer various extra benefits that may include:

Dental, vision, and hearing services
Meals
Fitness perks
Transportation services
Telehealth

Who wouldn’t want more benefits with no (or a low) additional premium. So, what’s the catch? Medicare Advantage plans have drawbacks. Some of the big ones are:

Limited networks
Prior authorization requirements and denials
High out-of-pocket costs (compared to Original Medicare + Medigap)

There are 66 Medicare Advantage (MA) plans available in Oklahoma. The exact number available to you depends on your county. For example, Oklahoma County has 41 Medicare Advantage plans from nine different insurance carriers and Pawnee County has 28 plans offered by seven insurance carriers.

Oklahoma Medicare Supplement Plans

Medicare Supplement (also known as Medigap) plans are there to help cover the 20% of costs Medicare doesn’t. They help significantly reduce your out-of-pocket costs. Plans are labeled by letters A through N, and each plan letter (e.g., every Plan A) is identical in coverage. While coverage is identical, pricing from different insurance carriers will vary.

Medigap plan benefits are basically the same as Medicare Advantage plan drawbacks:

No networks - you can see any doctor who accepts Medicare nationwide
No prior authorization requirements for covered services
Lower out-of-pocket costs

When you enroll in a Medigap plan matters! During your Medigap Open Enrollment Period (a six-month window that starts when your Part B takes effect) you are guaranteed acceptance into any Medigap plan. This means insurance companies cannot ask questions about your health history and cannot deny you coverage. Outside of the Medigap Open Enrollment Period and a few other special guaranteed issue periods, insurance companies are allowed to ask about your health history and deny you coverage.

Oklahoma Part D Plans

Original Medicare doesn’t include prescription drug coverage. Many Medicare Advantage plans include prescription coverage. For those who need a separate option to secure prescription coverage, there are 23 Oklahoma Part D plans. Even if you don’t take any prescriptions when you first enroll in Medicare, we generally recommend that you get Part D coverage to avoid a late enrollment penalty later in life.

If you have questions about your Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Oklahoma Medicare Advisors or give us a call at (888) 604-0055.

Get help paying for Medicare in Oklahoma

Oklahoma Medicare enrollees with low income and resources can use these three government programs to get help paying for Medicare-related costs.

Oklahoma Medicaid

Medicaid is a joint federal and state program that’s operated by individual states. Oklahoma’s Medicaid program, SoonerCare, is administered by the Oklahoma Health Care Authority.

SoonerCare has an Aged, Blind, and Disabled Program that assists these populations. In some cases, eligible persons may receive a small cash assistance payment in addition to Medicaid services.

Oklahoma Medicare beneficiaries may also be eligible for Medicaid assistance through SoonerCare Supplemental (Oklahoma Medicare Savings Programs).

Oklahoma Medicare Savings Programs

SoonerCare Supplemental has three plans to help low-income individuals pay for Medicare costs:

Qualified Medicare Beneficiary (QMB) pays the Medicare Part B premium (and sometimes Part A premium). The QMB program also pays for Medicare copayments and deductibles.
Specified Low-Income Medicare Beneficiary (SLMB) pays for members’ Part B premiums.
Qualified Individual-1 (QI-1) pays for members’ Part B premiums.

Medicare Extra Help

Extra Help (also known as the Part D Low-Income Subsidy) helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance.

You automatically qualify for Extra Help if you:

Receive full Medicaid coverage from Oklahoma
Oklahoma pays your Part B premium
Are eligible for Supplemental Security Income (SSI)

If you don’t automatically qualify for Extra Help, you may still qualify. Reach out to one of our licensed Oklahoma Medicare Advisors to get free support with your application.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

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