Losing SoonerCare
DID YOU RECEIVE THE PURPLE LETTER?
If you’re losing SoonerCare/Medicaid, you have 3 options to stay covered and healthy while avoiding the biggest bills.
Check your SoonerCare account information.
You might still be eligible.
Health plan from your job
or your spouse’s job.
You can enroll up to 60 days
after losing SoonerCare.
Health Insurance Marketplace plans on Healthcare.gov.
Discounts are based on income and household size.
1. Check your SoonerCare account information.
Look for information in the letter you received from SoonerCare / Medicaid (or MySoonerCare.org account)
- Who is losing coverage?
- Are any children staying on Medicaid? Or are there children losing coverage on a different date?
- Does the letter ask for documents, IDs, income information, or pay stubs needed to keep coverage? Mail them with your SoonerCare ID number or upload pictures to your MySoonerCare.org account.
Check your SoonerCare / Medicaid application for needed updates to keep your coverage. You might still be eligible.
- You can see your application at MySoonerCare.org or by calling 1-800-987-7767.
- Is income accurate for the current month for everyone in the household? Click HERE to learn more about gross and net income.
How many jobs are listed? Do old jobs or sources of income need to be deleted?
Update any changes in household size or marital status. Also, make changes in status that affect eligibility:
- Pregnancy
- Disability
- SSI
- Medicare
SoonerCare Income Levels
How much income will still qualify you for SoonerCare? Click HERE to see SoonerCare Income Guidelines.
When SoonerCare / Medicaid is ending for you.
- What is the last date of Medicaid coverage? It could be different dates for adults and children. Use SoonerCare/Medicaid as usual until the end date – see doctors, providers, get refills, etc.
- You may have other health coverage options from your job, spouse’s job, or the Health Insurance Marketplace. Apply early for these other health plans so that it starts when SoonerCare ends, leaving no gap in coverage.
2. Health plan from your job or spouse’s job.
You can enroll in a job plan within 60 days after your SoonerCare end date.
Most Oklahomans working full-time get their health plan from their job. Ask your manager at work about who you should talk to about signing up for a health plan. You may need to talk with an expert at work who knows everyone losing SoonerCare has a sign-up window for 60-days after the ending date of SoonerCare coverage (called a “Special Enrollment Period”).
Avoid going a month without health coverage – click HERE to learn how.
If the employer/job health plan costs too much for you or for your spouse and children then the Health Insurance Marketplace may offer discounts on a plan you choose.
To find your discounts on Marketplace (HealthCare.gov) application, you’ll need:
- Cost of employer plan for the employee only (lowest-cost medical plan, per week or 2 weeks).
- Cost of employer plan for employee-plus-family.
The Marketplace application on Healthcare.gov also asks for income for everyone in the household. The application form will do the math to calculate discounts based on whether the employer plan costs at least 9.12% of total household income.
3. Health Insurance Marketplace for Oklahoma.
Eligible kids stay on SoonerCare when adults move to a Marketplace plan.
Discounts are generally available when there’s no plan available from your job, your spouse’s job, parent’s job, or when employer plan costs too much for you, your spouse, or children.
You choose from dozens of Marketplace plans from up to 6 major insurance companies. You choose the list of doctors and hospitals. You choose deductibles and premiums. Only the people who want a health plan sign up for it.
More than 200,000 Oklahomans have Marketplace health plans.
- 95% have discounts.
- 4/5 have choice of plan at $10 or less per month.
If the employer/job health plan costs too much for you or for your spouse and children, then the Health Insurance Marketplace may offer discounts on a plan you choose.
To find your discounts on Marketplace (HealthCare.gov) application, you’ll need:
- Cost of employer plan for the employee only (lowest-cost medical plan, per week or 2 weeks).
- Cost of employer plan for employee-plus-family.
The Marketplace application on Healthcare.gov also asks for income for everyone in the household. The application form will do the math to calculate discounts based on whether the employer plan costs at least 9.12% of total household income.
For help with the Health Insurance Marketplace (HealthCare.gov), give us a call and one of My OK Plan’s trained healthcare navigators will assist you through the process and walk you through your options.
WE’RE HERE TO HELP
Speak to one of our trained navigators!
WE’RE HERE TO HELP
Speak to one of our trained navigators!
What can we do for you?
Have questions about your healthcare options? Drop them below.
FYI
For most people, income is “gross” before taxes subtracted. Example: $10/hour and 30 hours/week = $300. For self-employed and independent contractors, income is “net” after subtracting business expenses.
TIP
To avoid going a month without health coverage, sign-up early at work before your SoonerCare ends so your job health plan starts the day after your SoonerCare ends. You don’t have to pay for your employer health plan until it starts.