Oklahoma Affordable Healthcare Insurance Coverage
If you are an Oklahoma resident who needs drug or alcohol treatment, finding the right health insurance plan is critical. Substance abuse is one of the essential health services required by the Affordable Care Act, but not all plans are equal. Some will offer more comprehensive coverage than others. It is worth the effort to investigate Affordable Healthcare Insurance options to find the one that works best for your situation.
Blue Cross and Blue Shield Of Oklahoma
Blue Cross and Blue Shield of Oklahoma is one of two insurance providers offering affordable plans to residents. BCBS has seven plans at the Bronze level, four at the Silver, and two Gold. The majority of them are under one of two brand names – Advantage or Preferred.
As with most Bronze level plans, BCBS designed theirs to work in conjunction with a health savings account. This means they have higher deductible rates, but lower monthly premiums. The lowest deductible, $4,500, is found with the Blue Advantage Bronze PPO 104 policy. The remaining six plans all have deductibles between $6,000 and $6,800.
Coverage for substance abuse varies by policy. The one with the highest deductible, Blue Advantage Bronze PPO 105, covers outpatient office visits in full for substance abuse treatment regardless of whether you have met the deductible or not. For inpatient care, you pay $400 per occurrence deductible plus 20% coinsurance if you stay in-network. This indicates that the “per occurrence” charge does not apply to the deductible. If you go out of network, there is a 30% coinsurance charge with outpatient care and $1,500 copay per occurrence deductible plus 50% coinsurance.
The policy with the lowest deductible, Blue Advantage Bronze PPO 104, requires you to make meet the deductible fully and pay a coinsurance fee of 30% for in-network care and 50% for out-of-network service.
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At the Silver level, the deductibles go down to between $2,000 to $4,000. Your contribution towards drug treatment changes, too. The highest deductible plan is the Blue Advantage Silver PPO 103. You do not need to meet the deductible for all substance abuse treatments, however. You make a copayment for outpatient office visits of $15 and $250 per occurrence deductible plus 20% coinsurance. If you go out of network, your contribution changes to 30% coinsurance for office visits and $1,500 per occurrence deductible plus 50% coinsurance.
If you opt for the Silver plan with the lowest deductible, the Blue Advantage Silver PPO 102, there is an office copay of $40 and a $400 per occurrence payment deductible plus 30% coinsurance for inpatient care.
The Gold plans follow that same trend. The Advantage Gold PPO 101 carries a $500 deductible and requires an office copay of $20 plus a $300 per occurrence deductible plus 30% coinsurance.
This company has very strict rules regarding pre-authorizations. Assume you need a pre-authorization for any testing or treatments to avoid a $500 penalty fee.
If you prefer an HMO, consider United Healthcare plans. There are 10 available in Oklahoma: two Bronze, five Silver, and three Gold. The high deductible Bronze plans require you to meet the deductible before they pay for drug rehab. The Bronze Compass HSA 5500 pays in full for both in and outpatient treatment. With the Bronze Compass 6500, you must make a $45 copay for office visits and a 40% coinsurance payment for inpatient care.
Of the five Silver plans, you can expect to make both a per office and per admission copay, exception of the 4500 and 3000 programs. The 4500 plan offers full coverage after the deductible for inpatient care and the 3000 policy covers all substance abuse treatment costs.
The Gold plans have low to no deductible, but you do still need to contribute to substance abuse treatments with a small copay for office visits and a coinsurance fee for inpatient care. Coinsurance charges range from 20% to 30%.
Oklahoma has mixed bag of affordable insurance options available to residents. Contact us at RehabCenter.net to find the ones with the deductible and plan format that best suites your needs.