Quick answers
- What does Part A cover?
- Inpatient hospital care, skilled nursing facility care after a qualifying hospital stay, hospice and some home health care. Most people pay no Part A premium.
- What does Part B cover?
- Doctor visits, outpatient care, lab tests, medical equipment, ambulance and preventive services. The standard premium is $202.90 a month in 2026.
- Does Medicare cover dental, glasses or hearing aids?
- Original Medicare doesn't cover routine dental care, routine eye exams and glasses, or hearing aids. Some Medicare Advantage plans offer these as extra benefits, with limits that vary by plan.
- Does Medicare pay for a nursing home?
- Only short-term skilled nursing care after a hospital stay of at least 3 days. Long-term custodial care isn't covered; SoonerCare can pay for nursing facility care for people who qualify.
- Does Medicare cover prescriptions?
- Through Part D, a standalone drug plan or one built into a Medicare Advantage plan. In 2026 your out-of-pocket costs for covered drugs are capped at $2,100.
What Medicare is
Medicare is a federal health insurance program. It covers people 65 and older, people under 65 who have received Social Security disability benefits for 24 months, and people with end-stage renal disease (permanent kidney failure) or ALS. The rules, the coverage and the standard costs are the same in Oklahoma as in every other state. What changes from place to place is the private coverage you can add, and in Oklahoma that ranges from dozens of plan choices in Oklahoma and Tulsa counties to none open to everyone in parts of the Panhandle.
Several agencies handle different jobs:
- The Social Security Administration signs you up, decides whether you qualify and collects most premiums. It has field offices across Oklahoma.
- The Centers for Medicare & Medicaid Services (CMS) runs Medicare, sets the rules and approves the Medicare Advantage and Part D plans sold in each county.
- The Oklahoma Insurance Department (OID) licenses insurance agents, regulates Medigap (Medicare Supplement) policies sold in Oklahoma under Title 36 of the Oklahoma Statutes and the Oklahoma Administrative Code, and takes complaints.
- The Oklahoma Health Care Authority (OHCA) runs SoonerCare, Oklahoma's Medicaid program, which can pay Medicare premiums and costs for people with limited income. The Oklahoma Department of Human Services (OKDHS) takes applications for help with Medicare premiums at its Human Services Centers.
The four parts of Medicare
Part A: hospital insurance
Inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice and some home health care. Most people pay no Part A premium because they or a spouse worked and paid Medicare taxes for at least 10 years.
Part B: medical insurance
Doctor visits, outpatient care, lab tests, imaging, durable medical equipment, ambulance and many preventive services. Part B has a monthly premium ($202.90 standard in 2026) and a yearly deductible of $283.
Part C: Medicare Advantage
Private plans approved by Medicare that provide your Part A and Part B coverage, and usually Part D drug coverage too, through a network of providers.
Part D: prescription drugs
Private drug plans that cover outpatient prescriptions. In 2026 your out-of-pocket costs for covered drugs are capped at $2,100 for the year.
Should I choose Original Medicare or Medicare Advantage?
Once you have Parts A and B, you get your benefits one of two ways.
| Question | Original Medicare | Medicare Advantage |
|---|---|---|
| Which doctors and hospitals? | Any provider in the U.S. that accepts Medicare, no referrals | Usually the plan's network (HMO or PPO); rules for out-of-network care vary |
| Yearly limit on your costs? | None, unless you add Medigap | Yes, for Part A and B services: in-network up to $9,250 in 2026 |
| Drug coverage | Add a standalone Part D plan | Most plans include Part D |
| Can you add Medigap? | Yes | No |
| Where it's available in Oklahoma | Every county | Depends on the county; none open to everyone in seven counties for 2027 |
Original Medicare
With Original Medicare you pay the Part B deductible and generally 20% of the Medicare-approved amount for doctor and outpatient care, with no yearly cap. Most people on this path add two things:
- A Medigap (Medicare Supplement) policy to cover some or most of the deductibles and coinsurance. Oklahoma has a Medigap birthday rule that lets policyholders switch to equal or lesser coverage without health questions; see Medigap in Oklahoma.
- A Part D drug plan. For 2027, CMS lists 9 standalone Part D plans in Oklahoma.
Medicare Advantage (Part C)
A Medicare Advantage plan replaces Original Medicare as the way you get your Part A and B benefits. Plans use networks, set their own copays and coinsurance, and must cap your in-network costs for Part A and B services. Most include Part D. Medicare Advantage plans may offer extra benefits Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
You can't use a Medigap policy with a Medicare Advantage plan. If you start with Medicare Advantage and later want Medigap, insurers can usually review your health once your Medigap open enrollment period has passed, unless you have a guaranteed-issue right. Compare the two on Medigap vs. Medicare Advantage in Oklahoma.
What does Medicare not cover?
Original Medicare leaves out several things older Oklahomans often need. Plan for them separately:
- Routine dental care such as cleanings, fillings, extractions and dentures. Medicare covers dental work only in limited cases tied to another covered treatment.
- Routine vision care: eye exams for glasses and contacts, and the glasses themselves. Medicare does cover some eye care for conditions such as glaucoma, diabetic eye disease and cataract surgery, including one pair of glasses after cataract surgery with an intraocular lens.
- Hearing aids and exams to fit them. Part B covers diagnostic hearing and balance exams when your doctor orders them.
- Long-term custodial care: help with daily activities in a nursing home, assisted living or at home. In Oklahoma, SoonerCare can pay for nursing facility care, and the ADvantage waiver can pay for home and community-based services, for people who qualify. See the ADvantage waiver and SoonerCare and Medicare.
- Care outside the U.S., except in rare cases.
How many plans are there in my Oklahoma county?
Medicare Advantage plans are approved county by county. For 2027, CMS lists 50 Medicare Advantage plans open to everyone across Oklahoma, from 9 companies, plus 27 special needs plans. No county has all of them:
| County | Medicare Advantage plans open to everyone | Companies offering them |
|---|---|---|
| Oklahoma (Oklahoma City) | 35 | 8 |
| Cleveland (Norman, Moore) | 33 | 8 |
| Tulsa | 32 | 8 |
| Muskogee | 25 | 7 |
| Comanche (Lawton) | 19 | 4 |
| Garfield (Enid) | 14 | 4 |
| McCurtain (Idabel) | 7 | 2 |
| Woodward | 4 | 2 |
Source: CMS 2027 Medicare Advantage Landscape file. In Beaver, Cimarron, Ellis, Harmon, Harper, Roger Mills and Texas counties, the only Medicare Advantage options for 2027 are special needs plans for people who qualify. If you lived there and had a regular plan in 2026, see Oklahoma plans ending in 2027.
Original Medicare, Medigap and Part D work in all 77 counties. If you drive to Oklahoma City, Tulsa, Amarillo or Wichita Falls for specialty care, check that those providers are in a plan's network before you choose it. Look up your county on Medicare by Oklahoma county (for example, Tulsa County), or see plans for your ZIP code.
How do Oklahomans get started with Medicare?
- Check whether you'll be enrolled automatically. If you already get Social Security retirement or disability benefits, you're usually enrolled in Parts A and B and your card arrives in the mail. See Medicare eligibility.
- If not, sign up with Social Security. Your Initial Enrollment Period is the 7 months around your 65th birthday month. Apply at ssa.gov, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or at a Social Security office; use the office locator at ssa.gov to find the one for your ZIP code.
- Decide about Part B if you're still working. If you or your spouse has coverage from a current employer, you may be able to delay Part B without a penalty. See working past 65.
- Retiring from the State of Oklahoma or a school? HealthChoice and the other EGID retiree plans coordinate with Medicare. Read state and teacher retirees and Medicare first.
- Choose how you'll get your coverage. Original Medicare with Medigap and Part D, or a Medicare Advantage plan. For 2027 coverage, the Annual Enrollment Period runs October 15 to December 7, 2026. See enrollment periods.
- Check for help with costs. Oklahoma's Medicare Savings Programs can pay the Part B premium, and Extra Help lowers drug costs. See Medicare Savings Programs in Oklahoma.
Don't miss your window. If you don't sign up for Part B when you're first eligible and don't have job-based coverage from current work, you may pay a late enrollment penalty of 10% for each full 12 months you waited, for as long as you have Part B.
Tribal health and military coverage
Many Oklahomans get care through the Indian Health Service, a tribal health system or an urban Indian health program. CMS points out that IHS is not health insurance, and Medicare works alongside it: you can keep using your Indian health clinic and use Medicare for care elsewhere. See tribal health and Medicare in Oklahoma. Military retirees need Part B to keep TRICARE For Life; see veterans, TRICARE and military retirees.
Where can I get help in Oklahoma?
- Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), 24 hours a day.
- Social Security: ssa.gov or 1-800-772-1213, for enrolling, your Medicare card, premiums and income-related adjustments.
- OHCA and OKDHS: SoonerCare and the Medicare Savings Programs. OKDHS takes applications for help paying Medicare premiums at its Human Services Centers.
- Oklahoma Insurance Department: the regulator for Medigap policies and insurance agents; 1-800-522-0071 for questions and complaints, and an online license lookup.
- A licensed insurance agent: to go over Medigap, Part D or Medicare Advantage plans from the companies they work with, at no cost to you, you can request a call from a licensed insurance agent, or find a licensed insurance agent in Oklahoma.
Every number in one place: Oklahoma Medicare contacts. Terms are explained in the glossary, and short answers are on Medicare questions.
Sources
- Medicare.gov — Parts of Medicare
- Medicare.gov — What's not covered by Part A and Part B
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- CMS — CY2027 Medicare Advantage and Part D Landscape files
- CMS — 10 important facts about Indian Health Service and health insurance
- Social Security Administration — Medicare
- Social Security Administration — Office locator
- Oklahoma Insurance Department — 65 and over
- Oklahoma Insurance Department — Amendment to the Medicare supplement regulations, OAC 365:10-5-129(f)
- Oklahoma Health Care Authority — SoonerCare benefits (Medicare Part B premium)
- Oklahoma Human Services — Help paying Medicare premiums
Every question in this guide
Frequently asked questions
Is Medicare the same as SoonerCare?
No. Medicare is the federal health insurance program, run by the Centers for Medicare & Medicaid Services, mostly for people 65 and older. SoonerCare is Oklahoma's Medicaid program, run by the Oklahoma Health Care Authority (OHCA) and based on income and resources. Some Oklahomans have both. Then Medicare pays first, and SoonerCare can pay the Part B premium and some of the costs Medicare leaves.
Do I have to sign up for Medicare at 65 if I already get Social Security?
No. If you already get Social Security retirement benefits, you are usually enrolled in Parts A and B automatically, and your Medicare card arrives in the mail about three months before your 65th birthday. If you don't get Social Security yet, you sign up yourself at ssa.gov, by phone at 1-800-772-1213, or at a Social Security office in Oklahoma.
What does Original Medicare not cover?
Original Medicare doesn't cover most routine dental care, routine eye exams and glasses, hearing aids, or long-term custodial care such as help with bathing and dressing in a nursing home. It has no yearly limit on what you pay out of pocket. It also doesn't include most outpatient prescription drugs; for those you add a Part D plan or choose a Medicare Advantage plan with drug coverage.
Why do some Oklahoma counties have no regular Medicare Advantage plans for 2027?
Medicare Advantage plans are approved county by county, and companies decide where to offer them. For 2027, CMS data show seven Panhandle and western counties (Beaver, Cimarron, Ellis, Harmon, Harper, Roger Mills and Texas) with only special needs plans, which are limited to people with certain conditions or Medicaid. Original Medicare, Medigap and Part D still work there.
Who regulates Medigap and Medicare insurance agents in Oklahoma?
The Oklahoma Insurance Department (OID). It licenses insurance agents, enforces Oklahoma's Medicare supplement rules and takes complaints about insurance companies and agents. You can check an agent's Oklahoma license on the OID website. Medicare Advantage and Part D plans themselves are approved and overseen by CMS.
Medicare in your Oklahoma county
Plans, local agents and help, county by county: Oklahoma · Tulsa · Cleveland · Canadian · Comanche · Rogers · Wagoner · Payne · Pottawatomie · Creek · Muskogee · Garfield · Grady · Washington · Logan · Bryan · Le Flore · Carter · Cherokee · McClain · All 77 counties →
