Oklahoma ranks 38th most affluent state in the US based on its median household income. With a poverty rate of 16.6%, it’s not surprising that a significant percentage of the population cannot quite afford to pay the average premium for health insurance at $445 a month. So it’s a relief for many that Oklahoma Medicare insurance is available in the state.
Medicare is a health insurance program funded by the federal government, though the state government of Oklahoma also has public programs to support Medicare beneficiaries. It’s primarily for citizens over the age of 65. However, some workers with disabilities may also qualify.
The most basic coverage comes from Original Medicare, which is obtainable from the Medicare agency itself. It is made up of Part A and Part B. Medicare Part A covers inpatient care and other services associated with hospital insurance. Medicare Part B covers medically necessary treatments and outpatient care, along with preventive screenings and durable medical supplies.
Part A typically does not require beneficiaries to pay a premium, though a premium is usually required for Medicare Part B. Both aspects of Original Medicare also require the beneficiaries to cover the costs of copays, deductibles, and coinsurance.
Supplemental plans for Original Medicare may be purchased from Medicare-approved private carriers to increase the coverage. These plans will also require an additional premium apart from the premium required by Medicare Part B.
Additional benefits are often in the form of coverage for Medicare prescription drugs, and this type of coverage is called Medicare Part D. Other plans also include extra coverage for health services not covered by Part A and Part B. Some plans even help pay for the deductibles and other out-of-pocket expenses incurred with Original Medicare.
Some beneficiaries may choose to purchase Medicare Advantage Plans instead, which are also known as Medicare Part C. This plan conveniently combines the coverage of Original Medicare, plus any other extra benefits that may come from supplemental plans.
These plans may be purchased from Medicare-approved carriers as well. They may have different costs, and each plan may have different extra benefits aside from the core Original Medicare coverage.
Some Oklahoma residents do not have enough income and resources to cover Medicare expenses, but they can receive assistance from the Medicare Savings Programs (MSP) offered by the state government.
The most generous of these MSPs is the program for Qualified Medicare Beneficiaries (QMB). It pays for the premiums for Part A and Part B, along with the deductibles, copayments, and coinsurance. To qualify, an individual’s monthly income cannot exceed $1,032 a month. Married couples have a combined income ceiling of $1,392 a month.
The program for Specified Low-Income Medicare Beneficiaries (SLMB) only pays for Part B premiums. Individuals can qualify with a monthly income of less than $1,234. Married couples can also be eligible with a combined monthly income of no more than $1,666.
The program for Qualified Individuals (QI) also pays just the Part B premiums, and it has limited funding. An individual’s monthly income cannot be more than $1,386. Married couples cannot earn more than $1,872.
The QMB, SLMB, and QI programs also have an asset limit, but this does not factor in the cost of the beneficiary’s house and one car. The limit for an individual’s assets is $7,560 while for married couples it is $11,340.
The beneficiaries for any of these MSPs may also receive Low-Income Subsidy (also known as “Extra Help”) to cover the costs of Medicare Part D (prescription drugs). The annual income limit for qualified individuals is $17,820 while for married couples it is $24,030.
Oklahoma also offers a program for the Qualified Disabled and Working Individuals, which pays for the Part A premium. The monthly income limits are $4,132 for an individual and $5,572 for a married couple. The resources limits are $4,000 for an individual and $6,000 for a married couple.
The federal law requires each state to form and run an organization to offer free and unbiased counselling for Medicare beneficiaries. In Oklahoma, this is called the Senior Health Insurance Counseling Program or SHICP. Medicare beneficiaries can call the Senior Help Line at 1-800-763-2828.