SoonerCare (Oklahoma Medicaid) is a health coverage program jointly that helps pay some or all medical bills for many people who can’t afford them. The Oklahoma Health Care Authority (OHCA) is the state agency that administers the program and determines financial eligibility for the program.
Who Qualifies for SoonerCare?
To Qualify, a person must:
Reside in Oklahoma
Be A U.S. citizen or qualified alien*
Meet financial income & resources standards in certain categories
*Most immigrants who arrived after August 22, 1996 are barred from the program for five years
There is no cost for those who meet the income guidelines; however, co-pays may apply to some services.
Who will have access to my 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.
What are the 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.
Did you receive the purple letter? If you’re losing SoonerCare (Oklahoma Medicaid), you have options to stay covered and healthy while avoiding the biggest bills.
