Choosing the Right Oklahoma Health Insurance Coverage for You

Commissioner's Corner: Health Insurance: Picking the Right Coverage to Protect Your Family's Future

"If you do not have medical insurance to help pay bills, a serious injury or illness can be financially devastating to you and your family. Even if you do have health insurance, too little or the wrong kind of coverage might still mean your family could suffer under the weight of medical bills."

-- Kim Holland, Oklahoma Insurance Commissioner

What Types of Health Insurance Are Available?

Major Medical Plans

This type of policy is usually effective in covering serious illness or injury where costs are high. Hospital care, drugs and doctors' visits are generally covered. These benefits can be delivered in several different ways:

  • Indemnity plans -- These plans usually provide the most flexibility in choosing where to receive care and typically have a deductible; i.e., the amount you pay before the insurance company begins paying benefits.
  • Preferred Provider Organization (PPO) plans -- In these major medical plans, the insurance company enters into contracts with selected hospitals and doctors to furnish services at a discounted rate. As a member of a PPO, you may be able to seek care from a doctor or hospital that is not a preferred provider, but you will probably have to pay a higher deductible, co-insurance, or co-payment.
  • Health Maintenance Organization (HMO) plans -- These major medical plans usually require you to choose a primary care physician (PCP) from a list of network providers. If you need care from any network provider other than your PCP, you might have to get a referral from your PCP to see that provider. You must receive care from a network provider in order to have your claim paid through the HMO. Treatment received outside the network is usually not covered, or covered at a significantly reduced level.
  • Point of Service (POS) plans -- These major medical plans are a hybrid of the PPO and HMO models. They are more flexible than HMOs, but require you to select a primary care physician (PCP). Like a PPO, you can go to an out-of-network provider and pay more of the cost.
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