Are there insurance plan requirements?

Yes. The insurance plan must meet minimum HIFA requirements. At a minimum there must be coverage for hospital services, physician’s services, lab and x-ray, pharmacy, and office visits. If the Health Plan offers co-payments or deductibles, those co-payments or deductibles cannot exceed the limits described below:

  • An annual out of pocket maximum cannot exceed $3,000 per individual. This amount includes any individual, annual deductible amount, except for pharmacy.
  • Office visits cannot require a co-payment exceeding $50 per visit.
  • Annual pharmacy deductibles cannot exceed $500 per individual.
  • A list of health plans qualified for Insure Oklahoma can be found on the website www.insureoklahoma.org under the health plans button.