Before enrolling in SoonerCare, make sure you understand what it covers. This article will discuss Medicaid, Medicare Savings Programs, Family planning, and the costs of SoonerCare. Then, you can choose the best plan that meets your needs. If you are unsure, consult with your primary care physician for more information. In addition, it’s important to learn about the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, which provides expanded services for children ages 0-20.


While the Governor’s veto of the state’s funding bill for Medicaid expansion may be a political red herring, it’s not all bad news. The expansion was part of SoonerCare 2.0. The plan originally called for expanding Medicaid coverage by July 2020, but the COVID-19 pandemic changed that timeline. Meanwhile, the bill would have cost more than originally planned. In a bid to keep the state’s budget under control, Stitt vetoed the funding bill and state plan amendment that called for Medicaid expansion.

To opt out of HIE sharing, SoonerCare members can contact their primary care provider or hospital to request that information not be shared. If a medical provider can’t provide a form, the patient can download the form directly from the HIE organization’s website. Afterward, the patient must fill out a short form to notify SoonerCare of their decision. Once notified of their decision, they will receive an opt-out form.

Oklahoma has long sought federal permission to impose a work requirement on its Medicaid population. Before the voter-approved expansion, the state had rejected the proposal. However, a recent executive order signed by then-Governor Mary Fallin prompted Oklahoma’s Health Care Authority to seek federal approval. The new work requirement requires non-exempt SoonerCare enrollees to work 20 hours a week or participate in various community engagement activities for 20 hours each week.

SoonerCare is Oklahoma’s Medicaid program. It provides health care coverage for people over 65 and disabled individuals. In Oklahoma, Medicaid and SoonerCare overlap in several areas. While the Medicaid program covers the majority of health care expenses, SoonerCare also covers premiums and cost-sharing costs. To apply, contact your local Social Security office. So, if you or a loved one needs medical care, apply now. It’s easy to get qualified for Medicaid! You can even find a provider who is part of SoonerCare!

Medicare Savings Programs

In addition to the federal Medicare Savings Programs, some states have their own Medicaid programs. Medicaid is a health insurance program for people with low incomes. Eligibility varies by state, but basic services can include doctor visits, outpatient and inpatient hospital care, lab tests and x-rays, medical transportation, family planning, and mental health services. Medicare is a federal health insurance program for people 65 and older and certain disabled individuals. Medicaid programs offer different types of coverage, but they are all designed to help pay the costs of Medicare.

These programs provide financial assistance for Medicare premiums and coinsurance and can cover most of the cost-sharing expenses. The best part is that by enrolling in an MSP, you’re automatically enrolled in Extra Help, a Medicaid program that pays most of your Part D costs. But if you’re on a budget and don’t qualify for Extra Help, you can still qualify for Medicare Savings Programs.

Once you’ve qualified for the program, the next step is to apply. Generally, there are three types of programs: Qualified Medicare Beneficiary Program, Specified Low Income Program, and Qualifying Individual Program. These programs differ from one another, but all three have income requirements that are low enough to qualify for a savings program. The maximum amount you can save varies by state and income. For example, if you’re on a fixed income and you make less than $50,000 annually, you may qualify for Extra Help with your Medicare drug coverage.

OHCA and its partners use extensive automated data searches to ensure that the eligibility of each applicant is as low as possible. They can spot red flags before you apply and request additional documentation. To apply, you must create an account and obtain a member ID number. Once you’ve set up your account, you can fill out the application. It’s important to understand that the SoonerCare Supplemental program may help you meet Medicare Part B and Part D cost sharing requirements.

Family planning

Family planning at SoonerCare is provided to Medicaid-eligible individuals. This coverage includes examinations and various forms of contraception. The clinic also notifies those receiving Temporary Assistance for Needy Families (TANF) of these services. Adults who are not eligible for SoonerCare may be able to receive family planning services through SoonerPlan. However, this option is only available to those who meet certain income guidelines.

The SoonerPlan family plan in Oklahoma covers tubal ligations and vasectomies for those who qualify. The program also covers birth control methods, such as condoms and spermicides. In addition, it covers certain services for men who want to prevent pregnancy. In order to receive these services, the individual must be an Oklahoma resident. Regardless of age, the patient can print a medical ID card online to verify the coverage.

The Oklahoma Family Planning Program provides services to both males and females of reproductive age. Services are provided by Certified Advanced Practice Nurse Practitioners, Public Health Nurses, and Registered Nurses. Appointments are available only at regional hub locations. Family planning services are confidential and are provided on a free, voluntary basis. No one will be denied services because they cannot afford them. These services are provided by public health nurses and Advanced Practice Registered Nurse-Certified Nurse Practitioners.

If you are eligible for SoonerCare, you can choose to enroll in the SoonerPlan Family Planning Program. This program is not intended for Medicaid-eligible individuals who are Medicare beneficiaries or who have creditable health insurance coverage. You do not have to provide income verification for this plan. However, you must submit an application for the program online. If you are eligible, you can apply online for the program. It is possible to obtain a Provider ID by logging in to the SoonerCare Provider Portal.

Costs of SoonerCare

The state is expected to save about $30 million each year with SoonerCare. The federal government must cover 100% of the new adult group costs in 2014-2016 and up to 90% by 2020. Medicaid spending in Oklahoma is 61% federal, but some services receive higher percentages. These numbers are included in the SoonerCare costs. Those figures also include the cost of the woodwork population and administrative costs. The cost savings will help state government officials determine how to cut costs.

The cost of expanding SoonerCare to a new adult group is estimated to be $196 million over five years. But the state expects to save more than that because of the new coverage group. The state also expects to save about $7 million if more adults get coverage. The new coverage group is expected to grow in number as soon as 2019, but the state expects the savings to be more than the costs. In fact, the cost savings would exceed the state’s expenses by $297 million over the same five-year period.

There are two types of co-payments for SoonerCare. Premiums will be determined by the household income and the number of individuals. The monthly premium amount will not exceed 2% of household income, and will be lower for beneficiaries who live in Tier I than for those in Tier II or higher. The cost of enrolling in SoonerCare will depend on your income, so it’s important to know how much you’re going to spend.

OHCA pays a portion of the cost of Part B prescription drugs. Both parts will vary in coverage and premium cost. Some consumers will pay more for Part D coverage than others, and those with higher incomes will have to pay more for premiums. With SoonerCare, there are no co-payments for health care services, but you’ll need to meet certain income requirements to qualify. The cost of prescription drugs will also depend on your income.

During the initial phase, the state looked to save money by reducing the number of optional services. In 2002, the state sought additional Medicaid savings by eliminating optional services and imposing cost sharing and benefit limits. In 2003, the state also implemented a risk-adjusting MCO rates system. It also allowed MCOS to impose service limits. These measures were then compared to those under SoonerCare Choice and SoonerCare Plus. After all, these new MCOs are more expensive.