Introduction to Medicare Part C in Oklahoma (Medicare Advantage)

Seniors should be very careful when it comes to the unfortunate coverage gaps which are inherent in Medicare Parts A and B. They may seem insignificant now when you are relatively new to Medicare, but they can become quite expensive over time if you don’t protect yourself from them early. There are many different supplements which are designed to protect retirees from the out of pocket costs associated with these coverage gaps. Medicare Advantage, or Medicare Part C, is one of them. We’ll give you valuable information on this popular insurance policy below, as well as some informational resources for you to learn more.

Federal Regulations for Medicare Advantage

First, you should understand what Medicare Advantage plans are. A Medicare Advantage plan is sometimes called a Medicare “replacement” policy because that’s what it effectively does. Once you purchase a Medicare Part C health insurance policy from a private company, the government is no longer responsible for paying out claims on your federal Medicare benefits. That responsibility is transferred to your new insurance provider. Also, keep in mind that no insurance company can legally sell you less coverage than what Original Medicare offers.

Medicare Advantage Enrollment In Oklahoma

Medicare Advantage isn’t the preferred option for Oklahoma seniors, but it still has a strong presence in the state. More than 16% of retired persons in the state are protecting their Medicare benefits with a Medicare Advantage policy. In the chart below, you can see which of these plans (yes, there are several to choose from) are the most popular among seniors:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Several different factors regarding your health status and where you live will all be factored together when your rates are calculated. A female smoker in Yukon will probably pay a different monthly premium than a male beneficiary in Tulsa. Below, you can see a sample of estimated rates available near you:

Most Popular Medicare Advantage Plans in Oklahoma

Depending on which plan you choose, you will have a very specific network of providers assigned to your policy. Smaller networks, such as HMOs, are popular because they are also less expensive than PPOs or PFFS networks. However, they can have very tough restrictions and give you very little choice when it comes to receiving medical care. Plans with larger networks give you more choice with fewer restrictions, but consequently cost more.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

One major feature which varies from one Advantage plan to the next is the provider network attached to the plan. Different provider networks offer more (or fewer) options when it comes to choosing your doctors, hospitals, and facilities. Some networks come with fees for getting care outside of your network, and some have such stringent restrictions that you can be refused service by a non-network provider (unless you are having a medical emergency, of course).

Doctor/Providers List

Drug, Vision and Dental Coverage

One advantage which Medicare Part C has over other Medicare supplements is convenience. This convenience comes in the form additional coverage options which you can incorporate into the same, simple insurance policy. These include vision, dental, and/or prescription drug options (common with MAPD plans). You can pick and choose which options to add, or stick to your basic Medicare benefits with gap coverage. Just remember that adding more options means adding a higher premium to your plan.

Enrollment Options & Best Time To Enroll

Enrolling within your first 6 months of turning 65 is your best option when it comes to Medicare and Medicare Advantage. The sooner you get in, the easier it will be to get approved for coverage. If you already have coverage but decide to enroll later, you may qualify for a Special Enrollment Period (more on that below). However, applying outside of these timeframes could make it difficult and more expensive to get covered. There are additional challenges for people with pre-existing conditions, such as End Stage Renal Disease. Your state department will have more information, as will your local insurance agent. You should also take a look at our Medicare Advantage Enrollment Options page.

  • Initial Enrollment Period: The enrollment period during your first 6 months of being enrolled in Medicare.
  • Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): Circumstances which happen outside of the AEP window, such as employer coverage loss or moving out of state, which may require you to find new coverage immediately.

What Medicare Advantage Plan Is Best For Me?

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