Soonercare is Oklahoma’s Medicaid program. It provides coverage for low-income residents, children, pregnant women, people with disabilities, and people in nursing homes. Soonercare pays for various medical services, including doctor visits, checkups, hospital care, prescription drugs, and nursing home care. It helps low-income people get the health care they need. Soonercare is funded by the federal government and the state of Oklahoma.
Oklahoma Health Care Authority (OHCA)
The Oklahoma Health Care Authority (OHCA) is the state agency responsible for administering SoonerCare, Oklahoma’s Medicaid program. OHCA provides health insurance coverage to low-income Oklahomans, including children, families, pregnant women, people with disabilities, and seniors.
- OHCA is committed to providing quality health care to its members.
- OHCA works with a network of providers to offer a wide range of health care services, including doctor visits, hospital care, prescription drugs, and mental health services.
- OHCA also offers a variety of programs and services to help members stay healthy, such as preventive care screenings, health education, and disease management programs.
| OHCA Programs | Description |
|---|---|
| SoonerCare | Provides health insurance coverage to low-income Oklahomans. |
| Insure Oklahoma | Provides health insurance coverage to low-income Oklahomans who do not qualify for SoonerCare. |
| Children’s Health Insurance Program (CHIP) | Provides health insurance coverage to uninsured children. |
| Aging Waiver | Provides home and community-based services to elderly and disabled Oklahomans. |
| Developmental Disabilities Waiver | Provides home and community-based services to Oklahomans with developmental disabilities. |
OHCA is committed to providing quality health care to its members and works hard to ensure that they have access to the care they need.
Eligibility
To qualify for SoonerCare Medicaid, you must be a resident of Oklahoma and meet certain income and asset limits. Those who are eligible include:
- Children under age 19
- Pregnant women
- Adults with disabilities
- Some low-income adults
The income limits vary depending on your family size and type. You can find more information about income and asset limits on the Oklahoma Health Care Authority website.
Benefits
SoonerCare Medicaid provides a wide range of benefits to eligible Oklahomans, including:
- Doctor visits
- Hospital stays
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Dental care
- Vision care
- Nursing home care
- Family planning services
The benefits you receive may vary depending on your age, disability status, and other factors.
| Benefit | Eligibility |
|---|---|
| Doctor visits | All eligible individuals |
| Hospital stays | All eligible individuals |
| Prescription drugs | All eligible individuals |
| Mental health services | All eligible individuals |
| Substance abuse treatment | All eligible individuals |
| Dental care | Children under age 21 |
| Vision care | Children under age 21 |
| Nursing home care | Adults age 65 and older, or adults with disabilities |
| Family planning services | Women of childbearing age |
SoonerCare: Oklahoma’s Medicaid Program for Low-Income Individuals and Families
SoonerCare is Oklahoma’s Medicaid program, which provides health insurance coverage to low-income individuals and families. SoonerCare is available to Oklahoma residents who meet specific income and eligibility requirements.
How to Apply for SoonerCare
To apply for SoonerCare, you can:
- Visit the SoonerCare website: https://oklahoma.gov/ohca/
- Call the SoonerCare toll-free number: 1-800-987-7767
- Visit your local SoonerCare office
You will need to provide the following information when you apply for SoonerCare:
- Your name, address, and date of birth
- Your Social Security number
- Your income information
- Information about your household members
- Any other information that is requested on the application
Once you have submitted your application, it will be reviewed by the Oklahoma Health Care Authority (OHCA). If you are approved for SoonerCare, you will receive a SoonerCare ID card. Your ID card will include your name, SoonerCare ID number, and the date your coverage begins.
SoonerCare Benefits
SoonerCare benefits include:
- Medical care, such as doctor visits, hospital stays, and prescription drugs
- Mental health care, such as therapy and counseling
- Dental care
- Vision care
- Long-term care
- Other services that are necessary to maintain health
The specific benefits that you are eligible for will depend on your age, income, and family size.
SoonerCare Eligibility
To be eligible for SoonerCare, you must meet the following requirements:
- You must be an Oklahoma resident.
- You must be a U.S. citizen or a qualified non-citizen.
- You must meet the income and asset limits.
- You must not be eligible for other health insurance coverage.
The income and asset limits for SoonerCare vary depending on your age, family size, and disability status. For more information about SoonerCare eligibility, visit the SoonerCare website or call the SoonerCare toll-free number.
SoonerCare Costs
SoonerCare is free for most people. However, some people may have to pay a small monthly premium. The amount of your premium will depend on your income and family size.
How to Use SoonerCare
To use SoonerCare, you can:
- Visit any doctor or hospital that accepts SoonerCare.
- Show your SoonerCare ID card to the doctor or hospital staff.
- Your doctor or hospital will bill SoonerCare for your care.
You can also use SoonerCare to get prescription drugs. To get prescription drugs, you can:
- Take your prescription to any pharmacy that accepts SoonerCare.
- Show your SoonerCare ID card to the pharmacist.
- The pharmacist will bill SoonerCare for your prescription.
SoonerCare Contact Information
If you have questions about SoonerCare, you can:
- Visit the SoonerCare website: https://oklahoma.gov/ohca/
- Call the SoonerCare toll-free number: 1-800-987-7767
- Visit your local SoonerCare office
SoonerCare Eligibility Requirements
| Category | Income Limits | Asset Limits |
|---|---|---|
| Adults (19-64) | 138% of the Federal Poverty Level | $2,000 for individuals, $3,000 for couples |
| Children (0-18) | 138% of the Federal Poverty Level | $2,000 for individuals, $3,000 for couples |
| Pregnant Women | 138% of the Federal Poverty Level | $2,000 for individuals, $3,000 for couples |
| Disabled Adults (19-64) | 100% of the Federal Poverty Level | $2,000 for individuals, $3,000 for couples |
| Aged Adults (65+) | 100% of the Federal Poverty Level | $2,000 for individuals, $3,000 for couples |
Changes to SoonerCare
SoonerCare is the Medicaid program in Oklahoma. It provides health insurance to eligible low-income Oklahomans. In recent years, SoonerCare has undergone a number of changes, including:
- Expansion of eligibility: In 2021, Oklahoma expanded Medicaid eligibility to include adults with incomes up to 138% of the federal poverty level. This expansion added an estimated 200,000 people to the SoonerCare program.
- Work requirements: In 2018, Oklahoma implemented a work requirement for certain SoonerCare recipients. This requirement applies to adults ages 19 to 64 who are not pregnant, disabled, or caring for a child under the age of 6. To keep their SoonerCare coverage, these individuals must work or participate in a qualified work activity for at least 80 hours per month.
- Premiums: In 2019, Oklahoma began charging premiums for some SoonerCare recipients. These premiums are based on a percentage of the individual’s income.
- Provider reimbursement rates: Oklahoma has also made changes to the way it reimburses healthcare providers for SoonerCare services. These changes have resulted in lower reimbursement rates for some providers.
The changes to SoonerCare have had a mixed impact on the program. The expansion of eligibility has increased access to health insurance for low-income Oklahomans, but the work requirement and premium changes have made it more difficult for some people to keep their coverage. The changes to provider reimbursement rates have also led to some providers dropping out of the SoonerCare program.
SoonerCare Eligibility Changes Date Change 2018 Work requirement implemented for certain SoonerCare recipients 2019 Premiums introduced for some SoonerCare recipients 2021 Medicaid eligibility expanded to include adults with incomes up to 138% of the federal poverty level Hey dear, I really appreciate you taking the time to read this article about Soonercare Medicaid. I hope it helped shed some light on this important topic. If you have any questions or concerns, please don’t hesitate to reach out to me. I’m always here to help.
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