Oklahoma Health Insurance Consumer Guide

oklahoma_health_insurance

This guide, including the FAQs below, was developed to help you understand the Oklahoma health insurance options available for you and your family.

The options found in Oklahoma’s ACA Marketplace may be a good choice for many consumers. Oklahoma uses the federally run health insurance exchange (Marketplace), Healthcare.gov , where residents can purchase ACA-compliant Marketplace plans.

The Oklahoma Marketplace provides access to health insurance plans from seven private insurers for 2024, 1 although insurer participation varies significantly from one area to another. 2 All seven insurers plan to continue to offer coverage in 2025. 3

Depending on your income and other circumstances, you may also get help to lower your monthly insurance premium (the amount you pay to enroll in the coverage), and possibly your out-of-pocket expenses , when you enroll in a policy through the Oklahoma Health Insurance Marketplace.

Explore our other comprehensive guides to coverage in Oklahoma

Dental coverage in Oklahoma

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Hoping to improve your smile? Dental insurance may be a smart addition to your health coverage. Our guide explores dental coverage options in Oklahoma.

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Oklahoma’s Medicaid program

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Learn about Oklahoma's Medicaid expansion, the state’s Medicaid enrollment and Medicaid eligibility.

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Medicare coverage and enrollment in Oklahoma

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Use our guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in Oklahoma as well as the state’s Medicare supplement (Medigap) regulations.

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Short-term coverage in Oklahoma

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Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage. Learn more about short-term plan availability in Oklahoma.

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Frequently asked questions about health insurance in Oklahoma

Frequently asked questions about health insurance in Oklahoma

Who can buy Marketplace health insurance?

To be able to enroll in a health plan through the Oklahoma Marketplace, you must: 4

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income. In addition, to qualify for financial assistance with your Marketplace plan you must:

When can I enroll in an ACA-compliant plan in Oklahoma?

In Oklahoma, open enrollment for individual and family health coverage runs from November 1 to January 15. 7

Your coverage will start on January 1 if you enroll before December 15. But if you apply between December 16 and January 15, your coverage will begin on February 1. 7

Outside of open enrollment, a special enrollment period (typically linked to a specific qualifying life event ) is necessary to enroll or make changes to your coverage.

If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment . We also have a comprehensive guide to special enrollment periods .

How do I enroll in an Oklahoma Marketplace plan?

To enroll in an ACA Marketplace plan in Oklahoma, you can:

You can reach HealthCare.gov’s call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, except holidays.

How can I find affordable health insurance in Oklahoma?

Oklahoma uses the federally run exchange/Marketplace for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.

Ninety-seven percent of Oklahoma Marketplace enrollees save money on their 2024 premium payments, because they qualify for advance premium tax credits (premium subsidies). The average subsidy in Oklahoma amounts to $574/month, bringing the average net premium down to just $79/month. 9

In addition to premium tax credits (subsidies), the Affordable Care Act provides cost-sharing reductions (CSR) that will reduce out-of-pocket costs on Silver-level plans if your household income isn’t more than 250% of the poverty level. 10 In 2024, half of Oklahoma Marketplace enrollees were receiving CSR benefits. 9

(Note that the numbers above are based on effectuated enrollment in early 2024, while the numbers in the graphic below are based on everyone who enrolled during the open enrollment period for 2024 coverage. So there’s some variation in the numbers and the metrics reported.)

Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan in the Oklahoma Health Insurance Marketplace provides the best value for your health insurance needs.

Here are the facts for Oklahoma’s insurance Marketplace: Average savings - $575/month. Average net premium - $57/month for a person receiving a subsidy through advance premium tax credits. Expanded subsidy help - 9 in 10 enrollees save money though premium tax credits. 56% of enrollees pay less than $10/month.

Oklahoma implemented the ACA’s expansion of Medicaid starting in mid-2021, under the terms of a voter-approved ballot measure. So Medicaid is available to Oklahoma adults under age 65 with household income up to 138% of the poverty level — currently a little under $21,000 in annual income for a single person. 12 (Medicaid was already available to children with even higher household income, 13 and is available to older adults but with both income and asset limits.)

How many insurers offer Marketplace coverage in Oklahoma?

For 2025, seven insurers will offer health plans through the Oklahoma exchange, all of which also offered coverage in 2024. 3

In 2024, insurer participation varies significantly from one area to another. Some counties have just one insurer offering Marketplace plans, while others have at least five. 2

For 2025, Taro Health is expanding its individual market coverage area in Oklahoma from three counties to 27 counties. 14

Are Marketplace health insurance premiums increasing in Oklahoma?

Oklahoma’s Marketplace insurers have proposed the following average rate changes for 2025: 3

Oklahoma’s ACA Marketplace Plan 2025 PROPOSED Rate Increases by Insurance Company

The proposed rate changes apply to full-price premiums, but most Oklahoma Marketplace enrollees qualify for premium subsidies and thus do not pay full price for their coverage. 9

Most of the filings have their enrollment numbers redacted, but BCBSOK’s filing notes that they have 147,775 enrollees in individual market plans in Oklahoma. 15 In most states, virtually all of the individual market is on-exchange, and Oklahoma’s entire on-exchange enrollment stood at 194,387 people as of early 2024. 9 So BCBSOK likely had about three-quarters of the market share, giving their proposed 4% rate increase a lot of weight in terms of an overall weighted average.

Oklahoma is one of only three states that do not have their own effective rate review programs, so Oklahoma health insurance rates are reviewed by federal regulators. 16

For perspective, here’s an overview of how full-price (pre-subsidy) premiums have changed over time in Oklahoma’s individual/family market:

Oklahoma submitted a 1332 waiver proposal to the federal government in 2017. The goal was to create a reinsurance program to reduce full-price premiums in the state’s individual market, followed by additional extensive state-led reforms. But amid approval delays the state withdrew the waiver proposal and has not revisited the issue since. 28

How many people are insured through Oklahoma’s Marketplace?

During the open enrollment period for 2024 coverage, 277,436 people enrolled in private individual market plans through Oklahoma’s exchange. 29 This was the sixth year in a row that Oklahoma’s exchange enrollment had hit a record high, and the enrollment growth was particularly large for 2024 (see chart below).

The surge in enrollment during these years was due in part to American Rescue Plan (ARP) provisions that made ACA’s premium subsidies more substantial. Under the ARP – now extended by the Inflation Reduction Act – subsidies are more significant and accessible through the end of 2025. 30

The 2024 enrollment growth was also partially due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. By April 2024, CMS reported that nearly 118,000 Oklahoma residents had transitioned from Medicaid to a Marketplace plan by that point during the unwinding period. 31

Oklahoma’s ACA Marketplace enrollments - Since 2018, enrollments have grown each year.

Source: 2014, 32 2015, 33 2016, 34 2017, 35 2018, 36 2019, 37 2020, 38 2021, 39 2022, 40 2023, 41 2024 42

What health insurance resources are available to Oklahoma residents?

State Exchange Profile: Oklahoma
The Henry J. Kaiser Family Foundation overview of Oklahoma’s progress toward creating a state health insurance exchange.

Oklahoma Insurance Department
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care. (405) 521-2991 / Toll Free in OK: (800) 522-0071 / [email protected]

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.

  1. Health Insurance Marketplace Open Enrollment Begins in Oklahoma: Secure Your Health Coverage for 2024. Oklahoma Insurance Department. October 2023. ⤶
  2. Plan Year 2024 Qualified Health Plan Choice and Premiums in HealthCare.gov Marketplaces. Centers for Medicare and Medicaid Services. October 25, 2023. ⤶⤶
  3. ”Oklahoma Rate Review Submission” RateReview.HealthCare.gov. Accessed Aug. 5, 2024 ⤶⤶⤶⤶
  4. ” A quick guide to the Health Insurance Marketplace ” HealthCare.gov ⤶
  5. Medicare and the Marketplace, Master FAQ . Centers for Medicare and Medicaid Services. Accessed November 2023. ⤶
  6. Premium Tax Credit — The Basics . Internal Revenue Service. Accessed May 10, 2024 ⤶⤶
  7. “ When can you get health insurance? ” HealthCare.gov, 2023 ⤶⤶
  8. “ Entities Approved to Use Enhanced Direct Enrollment ” CMS.gov, April 28, 2023 ⤶
  9. ” Effectuated Enrollment: Early 2024 Snapshot and Full Year 2023 Average ” CMS.gov, July 2, 2024 ⤶⤶⤶⤶
  10. APTC and CSR Basics. Centers for Medicare and Medicaid Services. June 2023. ⤶
  11. 2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2024 ⤶
  12. 2024 Poverty Guidelines. U.S. Department of Health and Human Services. Accessed Aug. 5, 2024 ⤶
  13. Medicaid, Children’s Health Insurance Program, & Basic Health Program Eligibility Levels. Centers for Medicare and Medicaid Services. December 2023. ⤶
  14. Conversation with Taro Health executive, Aug. 20, 2024 ⤶
  15. “Oklahoma Rate Review Submission” (Consumer Justification Narrative) RateReview.HealthCare.gov. Accessed Aug. 5, 2024 ⤶
  16. State Effective Rate Review Programs. Centers for Medicare and Medicaid Services. Accessed Aug. 5, 2024 ⤶
  17. Oklahoma 2015 Rates: 12.2% Avg. Increase (Weighted); 5.6% Net QHP Increase Since 4/19? ACA Signups. September 2014. ⤶
  18. FINAL PROJECTION: 2016 Weighted Avg. Rate Increases: 12-13% Nationally* ACA Signups. October 2015. ⤶
  19. Avg. UNSUBSIDIZED Indy Mkt Rate Hikes: 25% (49 States + DC) . ACA Signups. October 2016. ⤶
  20. Iowa & Oklahoma: Approved Rate Hikes Of 51% And 8.7% Respectively; BCBSOK Baked In CSR Cost LAST Year! ACA Signups. October 2017. ⤶
  21. 2018 Rate Hikes . ACA Signups. October 2017. ⤶
  22. 2019 Rate Hikes . ACA Signups. October 2018. ⤶
  23. 2020 Rate Changes . ACA Signups. October 2019. ⤶
  24. 2021 Rate Changes . ACA Signups. October 2020. ⤶
  25. Oklahoma: Approved Avg. 2022 #ACA Rate Changes: +4.4% Indy Market (Weighted); +6.3% Sm. Group (Unweighted). ACA Signups. October 2021. ⤶
  26. Insurance Department Announces Health Plans Participating in the 2023 Oklahoma Marketplace. Oklahoma Insurance Department. ⤶
  27. So How’d I Do On My 2024 Avg. Rate Change Project? Not Bad At All! ACA Signups. December 2023. ⤶
  28. Section 1332: State Innovation Waivers. Centers for Medicare and Medicaid Services. Accessed December 2023. ⤶
  29. ”Health Insurance Marketplaces 2024 Open Enrollment Period Report” CMS.gov. March 22, 2024 ⤶
  30. “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023 ⤶
  31. ” HealthCare.gov Marketplace Medicaid Unwinding Report ” Centers for Medicare & Medicaid Services. Data through April 2024; Accessed Aug. 5, 2024 ⤶
  32. “ASPE Issue Brief (2014) ” ASPE, 2015 ⤶
  33. “ Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report ”, HHS.gov, 2015 ⤶
  34. “ HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT ” HHS.gov, 2016 ⤶
  35. “ 2017 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2017 ⤶
  36. “ 2018 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2018 ⤶
  37. “ 2019 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2019 ⤶
  38. “ 2020 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2020 ⤶
  39. “ 2021 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2021 ⤶
  40. “ 2022 Marketplace Open Enrollment Period Public Use Files ” CMS.gov, 2022 ⤶
  41. “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, Accessed August 2023 ⤶
  42. HEALTH INSURANCE MARKETPLACES 2024 OPEN ENROLLMENT REPORT” CMS.gov, 2024 ⤶