Tuesday, state residents can begin shopping for health insurance in Oklahoma's new federally run health insurance marketplace, and everyone who applies will be approved. That's because — for coverage effective Jan. 1 — insurers, under new health reform laws, can't disqualify applicants because of pre-existing health conditions.
Any Oklahoma resident is welcome to shop in the marketplace, though it's meant to provide affordable insurance to those who don't have it through work, Medicare or Medicaid. Individuals with incomes between 100 percent and 400 percent of the federal poverty level ($11,490 to $23,550, or $31,322 to $94,200 for families of four, for example) will be eligible for variable subsidies, depending on income and family size.
The Kaiser Family Foundation has posted a calculator at kff.org/interactive/subsidy-calculator/ for people to estimate costs and learn if they qualify for subsidies.
If you qualify, the government will pay that amount directly to the insurance company, and your monthly payment will be lower. Or, you can pay the full premium amount and claim the credit on your federal tax return.
Depending upon your age, whether you smoke and where you live in the state, with subsidies you likely will pay monthly premiums of no more than $300, and in some cases, considerably less, observers say.
Blue Cross and Blue Shield of Oklahoma, Aetna Life Insurance Co., Coventry Health Care Inc., Global Health Inc. and Community Care will offer at least “silver” and “gold” plans on the new marketplace, designed to cover 70 percent and 80 percent of average health care costs, respectively.
If you make your first payment by Dec. 15, coverage will start on Jan. 1. Enrollment runs through March 31.
In addition to monthly premiums, the most any individual consumer in the marketplace will pay per year is $6,350, including doctor's office and hospital co-pays and prescription co-pays.
Researchers estimate some 337,000 Oklahomans — or 9 percent of the state's population — will be eligible to receive subsidized coverage in the marketplace. Still, many observers believe most won't take advantage of the premium assistance. That's because insurance, even with subsidies, still requires a financial commitment, while the fines for not carrying insurance lack teeth — initially anyway.
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Oklahoma's new federally run health insurance marketplace: