OK-SAFE, Inc. Blog

September 6, 2013

Insure Oklahoma to continue for another year. Changes include using federal exchange

OK-SAFE, Inc. – OK Governor Fallin today issued a press release announcing the extension of the Insure Oklahoma program for working, low-income Oklahomans.

The Insure Oklahoma program was set to expire at the end of this year. The one-year extension continues the program through 2014 and includes directing some low-income Oklahomans to use the federal insurance exchange (known as the  federal Health Insurance Marketplace.)

To meet the mandates of the (Un)Affordable Care Act, this Health Insurance Marketplace is supposed to be up and running by October 1, 2013.  There is some doubt, however, as to whether the federal system will actually be ready to go by then.  (Really?)

Click here for Governor Fallin’s Sept. 6th press release on the Insure Oklahoma extension.

IO-ex-01

 

Highlights of the changes are below:

“Though the Insure Oklahoma program was set to expire December 31, 2013, the federal government has approved a request for a one year extension with certain modifications which are outlined below. For more information, please visit www.insureoklahoma.org or call 1-888-365-3742.

·         Agreement extends Insure Oklahoma through December 31, 2014

·         No changes in Insure Oklahoma through December 31, 2013

·         No changes in Insure Oklahoma ESI plan through December 31, 2014

·         Changes in Insure Oklahoma IP plan, effective January 1, 2014

o   To qualify, income must be at or below 100 percent of the Federal Poverty Level ($23,550 annually for a family of four). This is a change from the current qualification level of at or below 200 percent of the Federal Poverty Level ($47,100 annually for a family of four). There are currently about 5,300 individuals who are at or below 100 percent of the Federal Poverty Level enrolled in the Insure Oklahoma IP.

o   IP members will have the following co-payments for services

§  Pharmacy: $4 generic prescriptions and $8 brand prescriptions (decrease from $5 and $10, respectively)

§  Inpatient Hospital Services: $50 per stay (no change)

§  Outpatient Services and Physician Visits: $4 per visit (decrease from $10 – $25 range)

§  Emergency Room Services: $30 per visit (no change)

o   Those individuals above 100 percent of the Federal Poverty Level qualify for the federal Health Insurance Marketplace and related advance premium tax credits, which will be offered to individuals and families earning up to 400 percent of the Federal Poverty Level. There are currently about 8,000 individuals in this category currently enrolled in the Insure Oklahoma IP.”

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