SoonerCare
What is soonercare?
SoonerCare (Oklahoma Medicaid) covers many healthcare services. However, there are limitations that apply to ensure that only medically necessary services are provided. Some services are for children only. The Oklahoma Health Care Authority (OHCA) is the state agency that administers the program and determines financial eligibility for the program.
Are you losing SoonerCare?
Did you receive the purple letter? If you’re losing SoonerCare / Medicaid, you have options to stay covered and healthy while avoiding the biggest bills.
Are you losing SoonerCare?
Did you receive the purple letter? If you’re losing SoonerCare / Medicaid, you have options to stay covered and healthy while avoiding the biggest bills.
Who qualifies for SoonerCare?
To qualify for SoonerCare, a person must:
- Reside in Oklahoma.
- Be a U.S. citizen or qualified alien (most immigrants who arrived after August 22, 1996 are barred from the program for five years).
- Meet financial income and resources standards in certain categories. Click HERE to view SoonerCare Income Guidelines.
What services does SoonerCare pay for?
Covered health care services may include doctor visits, hospitalization and prescriptions. Click HERE for more details on benefits.
What does SoonerCare cost?
There is no cost for those who meet the income guidelines; however, co-pays may apply to some services.
Access to Medical Records
OHCA may get medical records for case management purposes directly from SoonerCare contracted medical providers or through contracted Health Information Exchange (HIE) Organizations. Oklahoma currently contracts with MyHealth Access Network.
As a SoonerCare member, or as the member’s personal representative, you may opt out of having medical information shared by the HIE at your primary care provider’s office or at the hospital providing care.
To find out if your medical records are being shared within the HIE, please contact your medical provider. If your records are being shared within the HIE, and you wish to opt out, your medical provider will provide you with the appropriate standard form and instructions on how to submit the form, or you may obtain an opt out form directly from the HIE organization’s website.
To learn more about the HIE Organization, please visit their website at: myhealthaccess.net.
What about Medicare?
Medicare is different from SoonerCare (Oklahoma Medicaid). Medicare is a federal health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). Medicare provides coverage mostly to individuals age 65 or older and some people with disabilities.
If you are on Medicare and you qualify for SoonerCare, most of your health care costs are covered. If you have low income and limited assets, SoonerCare may help pay some or all of Medicare premiums and cost sharing expenses. To apply for Medicare benefits, visit or call your local Social Security Office.
Income guidelines
Based on income, you and members of your household may be eligible for coverage. Guidelines exist for coverage for adults and children as well as for the Pregnancy Full-Scope Coverage Plan and Soon-to-be-Sooners (STBS) Limited Scope Pregnancy Plan.
SoonerCare Resources
SoonerCare News
OHCA Encourages Oklahoma Parents to Check Children's SoonerCare Eligibility Status
August 8, 2023
The Oklahoma Health Care Authority asks all Oklahoma parents affected by the return of eligibility renewals to check their children’s SoonerCare status. Some children’s coverage could have ended due to a procedural denial, such as failure to turn in requested documentation or not completing the renewal process, but may still be eligible for SoonerCare.
Oklahoma Adds Doula Services to SoonerCare Benefits
July 10, 2023
Expecting mothers enrolled in SoonerCare can now receive doula services for emotional, physical and informational support during the prenatal, delivery and postpartum periods. Beginning July 1, all SoonerCare members who are pregnant or within the postpartum period are eligible for up to eight doula visits per pregnancy.
SoonerCare to Restart Renewal Process for Members
February 13, 2023
Due to federal regulation passed in December, SoonerCare will soon restart the renewal process for members as the public health emergency continuous coverage ends. The Oklahoma Health Care Authority (OHCA) will begin the eligibility redetermination process in early March.
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