What You Need to Know
Monthly premiums for short-term health plans are generally less than what you would pay for an Affordable Care Act (ACA) plan without a subsidy.
Coverage is allowed up to 364 days and is renewable for up to 36 months.
Short-term plans don’t have to cover preexisting conditions or essential health benefits like ACA plans do.
Oklahoma categorizes short-term health insurance as a limited benefit plan. For residents looking for health coverage in the Sooner State, a short-term plan might be an affordable option to bridge a gap in coverage.
Illness and accidents can happen at any time, so it’s a smart decision to always have healthcare coverage. Many people experience times when they can’t afford a traditional plan or are waiting for coverage to kick in. In these situations, a short-term plan might be just what the doctor ordered.
What Is Oklahoma Short-Term Health Insurance?
Short-term health insurance plans in Oklahoma provide temporary coverage you can purchase at any time during the year. These medical insurance plans are designed to bridge periods when you may not have health insurance. For most plans, coverage begins as soon as you enroll. Plans are available for up to 364 days and are renewable for up to 36 months.
Short-term plans aren’t required to offer the 10 essential health benefits that ACA plans do. And unlike ACA plans, short-term plans can also exclude coverage for preexisting conditions. This all means that covered services can be limited. However, premiums for short-term plans tend to be more affordable than the cost of an ACA plan without a subsidy.
Bridging the Gap
If you’re between jobs or waiting to enroll in Medicare or an ACA plan, a short-term plan may make sense.
Who Should Buy Short-Term Plans in Oklahoma?
Short-term plans are designed to provide temporary, and affordable health insurance coverage. A short-term plan may make sense if you:
- Don’t qualify for an ACA subsidy and need an affordable alternative.
- Missed the ACA Open Enrollment Period and don’t qualify for a Special Enrollment Period. Enrollment for a short-term plan is open at any time.
- Have enrolled in an ACA plan but need coverage until ACA coverage begins.
- Don’t access healthcare services often because you’re in relatively good health. The high deductibles that come with short-term plans might be an acceptable risk.
- Are aging out of coverage on your parent’s plan.
- Are waiting for coverage under a new employer’s plan.
- Need an affordable alternative to COBRA.
- Are waiting for eligibility for Medicare coverage.
Short-term plans may not be the right fit if have a preexisting condition or need the 10 essential health benefits guaranteed by ACA plans. These benefits include mental health services, maternity care, and prescription drug coverage. Although some short-term plans cover some of these services, also make sure to consider an ACA plan.
PROS AND CONS OF SHORT-TERM HEALTH INSURANCE PLANS
|Plans provide options for people who need to bridge coverage between traditional insurance plans.||Plans tend to have higher deductibles and lower lifetime plan limits than many traditional insurance plans.|
|Most plans offer a limited range of basic covered services but often have options for add-ons such as dental or prescription drug coverage.||Most plans don’t cover preexisting conditions or offer all 10 essential health benefits required by the ACA.|
|Monthly premiums for most plans are less than ACA plans without subsidies.||There are no premium subsidies based on household income.|
|Plans can be renewed up to three times or 36 months.||When the term ends on a temporary plan and can’t be renewed again, that does not make you eligible for an ACA Special Enrollment Period.|
How Much Are Oklahoma Short-Term Plans?
Some plan providers may charge a small one-time enrollment fee. To compare the costs of coverage, consider these factors.
Premium: The amount you pay monthly for your plan. The premium will vary based on factors including lifetime maximum benefit, deductible, coinsurance, and out-of-pocket maximum.
Deductible: The amount you pay each covered year before your plan begins to pay for covered expenses.
Coinsurance: The percentage of each medical bill you pay after you meet your deductible.
Copayment: The fixed amount you pay for a covered health service, such as a visit to your primary care physician.
Out-of-pocket maximum: Covered medical expenses not reimbursed by your policy.
For example, according to Pivot Health, monthly premiums for a 35-year-old woman living in Tulsa range from $97.67 to $479.40.
- The low monthly premium plan has a $10,000 deductible and 30% coinsurance.
- The plan with the higher premium has a $1,000 deductible and 20% coinsurance.
- The out-of-pocket maximum for the low-premium plan is $10,000 versus $3,000 for the higher premium.
Monthly premiums for the same two plans in Oklahoma City, Stillwater, and Broken Arrow are identical.
Consider All Costs
Short-term plans usually have higher out-of-pocket costs than traditional plans do.
What Are Rules Governing Short-Term Plans in Oklahoma?
In 2019, the state revised the rules regarding Oklahoma’s short-term plans to conform with federal rules. Previously, plans were limited to six months and were nonrenewable. Plans are now available for up to 364 days and are renewable for up to 36 months. Some plans limit renewals to two years.
Plans can offer options, such as prescription drug coverage or telemedicine benefits, and charge additional premiums. Insurance companies must issue cards to enrollees which specify they are covered by a short-term plan which does not include all ACA benefits.1
Who Sells Short-Term Plans in Oklahoma?
There are currently six private insurance companies that sell a wide range of short-term health insurance plans in Oklahoma:
Now that you know how short-term health insurance plans work in Oklahoma, it’s time to go shopping. Compare plans to find one that will provide temporary coverage for your health needs and your budget.