High deductible health plans; directing plans to count certain self-paid claims toward an insured's deductible regardless of network status. Effective date.
Impact
The implementation of SB845 is expected to modify how deductibles are calculated for individuals with high deductible health plans, thereby influencing healthcare financial dynamics in Oklahoma. Consumers may be incentivized to self-pay for services, knowing that these payments directly contribute to fulfilling their deductible obligations. This could lead to a shift in consumer behavior where individuals choose to seek cash payment options more frequently, possibly driving down costs negotiated by insurance companies due to increased price transparency.
Summary
Senate Bill 845 introduces significant changes to the framework of high deductible health plans by mandating that self-paid claims will count towards the insured's deductible, regardless of whether the service is provided by an in-network or out-of-network provider. This policy aims to provide individuals with greater flexibility and potential cost savings when seeking healthcare services, encouraging them to pay out-of-pocket when it is economically favorable, and potentially increasing their engagement with healthcare costs.
Contention
While proponents of SB845 argue that the bill enhances consumer rights and provides clearer pathways for individuals to manage their healthcare expenses, some critics may raise concerns about the implications for traditional insurance models. There could be worries regarding the viability of out-of-network providers and whether the bill unintentionally leads to higher overall healthcare costs in the long term if not properly regulated. Additionally, the requirement for the Insurance Department to establish rules could provoke discussions about what the specific guidelines would entail and how they might affect both providers and patients.
Carry Over
High deductible health plans; directing plans to count certain self-paid claims toward an insured's deductible regardless of network status. Effective date.
High deductible health plans; directing plans to count certain self-paid claims toward an insured's deductible regardless of network status. Effective date.
Health insurance; requiring certain high deductible health plans to allow an insured to set aside funds for medical expenses subject to certain limitations. Effective date.
Health benefit plan directories; directing plans to publish certain information in a publicly accessible manner; requiring reporting to Insurance Commissioner. Effective date.
Behavioral health; requiring health insurer to cover certain out-of-network services under certain circumstances; providing exceptions. Effective date.