Open enrollment for the Healthcare Marketplace is the time of year Oklahomans can find out how much their advanced premium tax credit (APTC) will be and whether that is enough to make coverage for their family truly affordable.
“Bah, humbug,” you say, thinking insurance coverage is never truly affordable unless you have it through your job.
But, if you take a look at 2023 prices you may change your mind. Congress’ threeyear extension of the American Rescue Plan Act and passage of the Inflation Reduction Act have lowered some premiums in Oklahoma to zero dollars per month. Oklahoma families of four earning $82,000 per year or less can enroll in complete health coverage through the federal Marketplace without paying a penny. If the family lives in rural Oklahoma, the allowable annual maximum income for zero premium coverage goes up to $101,000, also available through the Marketplace.
A quick call to an Oklahoma health Navigator—a federally- certified non-profit employee who is trained to make it easier for consumers to work through the Marketplace— can help consumers know their options. In a 30-minute phone call, a Navigator can provide a tax credit estimate based on income and number of people in the household.
To request help from a certified Navigator, Oklahomans can call the statewide Navigator line at 1-833-465-7526 (833-4OKPLAN).
In addition, an Oklahoma Marketplace website – myOKplan.org – has been created to provide an overview, key points and next steps for enrollment.
The Navigator Program at Legal Aid Services of Oklahoma (LASO) is funded by a federal grant from the Center for Medicare and Medicaid Services (CMS), and as a result of the grant, LASO has organized a group of more than 50 professionals from nonprofit organizations across the state to operate as Navigators, providing unbiased assistance to Oklahomans who ask for help understanding the general concepts in health insurance as well as the particular issues that may concern a family, such as whether their doctor is included or if a prescription medicine is covered.
For the past several years, LASO, the statewide law firm for low-income Oklahomans, has received the statewide Navigator grant to help Oklahomans. Navigators are not insurance agents but are strictly regulated by CMS and the Oklahoma Insurance Department. Navigator services are free and payment or gifts are not allowed.
Seven private companies offer Marketplace coverage for 2023 in Oklahoma-Ambetter of Oklahoma, Blue Cross Blue Shield of Oklahoma (BCBSOK), Community Care Oklahoma (CCOK), Friday Health Plans, Medica Insurance Co., Oscar Health and United Health Care (UHC).
Together they offer more than 100 different plans, allowing consumers to choose their own doctors, hospitals, premiums and deductibles.
All Marketplace plans cover essential health benefits including doctors; hospitals; emergency rooms, outpatient care, chronic disease management; preventive and wellness care; pregnancy, maternity and newborn care; prescription drugs; lab work; as well as behavioral health and substance abuse.
Pre-existing conditions are covered. BCBSOK and Medica offer statewide plans while the other carriers’ plans will be available in selected counties.
As soon as an application is completed, consumers receive an online estimate of their tax credit, allowing them to review policies available in their areas, view the monthly premium before the tax credit is deducted and compute the premium amount after the tax savings.
This year’s open enrollment period lasts until Jan. 15. However, for a new policy to become effective Jan. 1, enrollment must be completed by Jan. 15.