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The Oklahoma Health Insurance High Risk Pool was created to serve those who are considered medically uninsurable or high risk. In layman's terms, that means people who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums, again due to a serious health condition.
It is a non-profit, legal entity created by the Oklahoma Legislature in 1995. The Oklahoma Insurance Department was asked to design, launch and assist in coordinating its operations. However, a nine-member board of directors governs it.
The pool policy is administered by Blue Cross and Blue Shield of Oklahoma (BCBSOK), a third party administrator located at P.O. Box 3283, Tulsa, OK 74102-3283. Questions can be directed to BCBSOK or the Oklahoma City manager, Frazier Farley, at (405) 741-8434. For more information, please contact BCBSOK call toll free at 1-877-885-3717.
The pool charges premiums for its insurance, just as traditional health insurers do. Premiums could seem high because they are not partially paid by an employer. However, the premiums will be no more than 50 percent above standard health insurance rates. Because the Pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable.
While every situation cannot be covered here, generally speaking, the pool's primary purpose is to provide insurance coverage for those with grave or chronic health problems. This is done to limit the pool to Oklahomans who truly need it. Specific guidelines are described in the contract, but generally, you:
Note: Other exclusions/limitations may apply.