Policy Documents for Individual Pre-Affordable Care Act Plans

Below is a list of actual Blue Cross and Blue Shield of Oklahoma policy documents for Pre-Affordable Care Act policies in the individual market, also called grandfathered and transitional plans. These policies describe how the plans generally work and include eligible expenses, claim filing steps, appeals procedures, coverage limitations and exceptions, and more.

The following is true for those with pre-Affordable Care Act individual coverage: 

• You enrolled in a health plan on your own (instead of through an employer),
• Your plan was effective before January 1, 2014, 
• Your policy is a grandfathered or transitional plan, and
• Your plan is not a metallic (platinum, gold, silver or bronze) health plan.

Help locating your policy

• Get your policy documents through your online account .
• Get your policy document through the BCBSOK app. Learn more about the BCBSOK app. 
• Contact a customer service representative at 1-866-520-2507 to get help finding or accessing your policy documents.
• If you know you have an Individual Pre-Affordable Care Act plan, and you know its name, find it below and download the policy. 

Policy Documents

• Health Check Basic - $1000 Deductible
• Health Check Basic - $2500 Deductible
• Health Check Basic - $3500 Deductible
• Health Check Basic - $500 Deductible
• Health Check Basic - $5000 Deductible
• Health Check Basic - $7500 Deductible
• Health Check HSA 100% OPX 2500
• Health Check HSA 100% OPX 3500
• Health Check HSA 100% OPX 3500
• Health Check HSA 80% OPX 3000 - $1500 Deductible
• Health Check HSA 80% OPX 3000 - $2000 Deductible
• Health Check HSA 80% OPX 3000 - $2500 Deductible
• Health Check HSA 80% OPX 4000
• Health Check HSA 80% OPX 5000 - $1500 Deductible
• Health Check HSA 80% OPX 5000 - $3000 Deductible
• Health Check HSA 80% OPX 5000 - $3500 Deductible
• Health Check Select - $1000 Deductible
• Health Check Select - $1500 Deductible
• Health Check Select - $200 Deductible
• Health Check Select - $2500 Deductible
• Health Check Select - $500 Deductible
• Health Check Select - $5000 Deductible
• Personal Blue