What all does SoonerPlan cover?

Office visits and physical exams related to family planning; Laboratory tests related to family planning services, including pregnancy tests, Pap smears and screening for some sexually transmitted infections; Tubal ligations for women age 21 and older; Vasectomies for men age 21 and older; and.

What kind of coverage is SoonerCare?

SoonerCare (Oklahoma Medicaid) is a health coverage program jointly funded by the federal and state government. This program helps pay some or all medical bills for many people who can’t afford them.

What does SoonerCare choice cover for adults?

SoonerCare provides coverage for dental care, preventive care, family planning services, behavioral health, and substance abuse services as well as inpatient hospital services.

Does SoonerCare cover all medical expenses?

Will SoonerCare cover all medical services? SoonerCare will pay for most medical services, but not all. If you do not know if a service is covered by SoonerCare, ask your provider or call the SoonerCare helpline at 800-987-7767.

Is SoonerCare considered Medicaid?

SoonerCare is the brand name given to Oklahoma’s Medicaid program. Medicaid is a program that covers medical expenses for certain groups of people who have limited income and resources. The Oklahoma Health Care Authority is the state agency that administers the program.

At what age does SoonerCare stop?

​SoonerCare, Oklahoma’s Medicaid program, provides health care to children under the age of 19, adults with children under the age of 18, pregnant women and people who are older than 65 or have blindness or another disability.

How much is SoonerCare monthly?

Eligible beneficiaries in Oklahoma receive coverage through Medicare Part A at no cost if they have met eligibility requirements. If you don’t meet requirements, then you will need to buy Part A at a cost of up to $437 per month in 2019.

What is the maximum income for SoonerCare?

On June 30, 2020, Oklahomans voted to expand SoonerCare eligibility to adults ages 19-64 whose income is 138% of the federal poverty level or lower through Medicaid expansion. This change equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four.

Does SoonerCare cover glasses?

Vision coverage for SoonerCare adults over the age of 21 is limited to services related to eye disease or injury. There is no routine eye exam or glasses benefit for SoonerCare members who are over 21 years old.

What is the difference between SoonerCare and SoonerCare choice?

SoonerCare Choice is a Primary Care Case Management Program (PCCM) in which each member has a medical home. The medical home provider will coordinate all health care services to qualifying Oklahomans. SoonerCare is administered by the Oklahoma Health Care Authority (OHCA).

Can you get weight loss surgery on SoonerCare?

After considerable research we believe that for SoonerCare members who are 18-64 years old, morbidly obese, and have significant co-morbidities, Bariatric surgery is an appropriate treatment and reduces the risk associated with related long-term health conditions.

Will SoonerCare pay for a vasectomy?

Tubal ligations and vasectomies are paid in accordance with current SoonerCare policy and require the Sterilization Consent form. Medically necessary office visits related to family planning are unlimited for SoonerPlan members younger than 21.

Does SoonerCare pay for dentures?

The OHCA will add dental examinations, x-rays, dental cleanings, fluoride, dental fillings, scaling and root planing, as well as dentures and partial dentures as covered services for SoonerCare adult members. Adult SoonerCare members will have access to the aforementioned dental services effective July 1, 2021.

How often do you have to renew SoonerCare?

Will I need to renew my application? Employees should update their information on their application as information changes. If no changes are incurred, then the application will need renewed at least every 11 months.

Does SoonerCare pay for surgery?

Payment is made to physicians for medical and surgical services for members under the age of twenty-one (21) within the scope of the SoonerCare program, provided the services are medically necessary for the diagnosis and treatment of illness or injury, or to improve the functioning of a malformed body member.

Does SoonerCare cover pregnancy?

SoonerCare allows one (1) assessment per provider and no more than two (2) per pregnancy. (2) Medically necessary real time antepartum diagnostic ultrasounds will be paid in addition to antepartum care, delivery, and postpartum OB care under defined circumstances.

Can you use SoonerCare out of state?

(d) Except as provided in subsections (a)(1), (a)(2),(b)(1) and (c), above, SoonerCare will not pay for any services furnished by an out-of-state provider unless prior authorization has been obtained from the OHCA’s CMO, or his or her designee, before the services are rendered.

Does urgent care take SoonerCare?

We accept Title 19 and Sooner Care Choice.

Can men get SoonerCare?

Individuals 65 and older. Individuals who are blind or who have disabilities. Women under 65 in need of breast or cervical cancer treatment. SoonerPlan – Men and women 19 and older with family planning needs.

Does SoonerCare cover mental health?

A basic package of primary and preventive behavioral services, such as screenings for depression, anxiety and substance abuse is available to every SoonerCare member without prior authorization for services delivered by a Patient-Centered Medical Homes, Indian/Tribal/Urban (I/T/U) Clinics, and Federally Qualified …

Does SoonerCare back date?

apply for benefits for the newborn. Unless a NODOS is done in the hospital, eligibility will not backdate.

Can I have SoonerCare and private insurance?

There is no minimum time limit that members may utilize SoonerCare coverage. Additionally, SoonerCare can act as a supplemental insurance to primary insurance coverage. 10.

How do I get a SoonerCare card?

How do I get my SoonerCare ID number? If you are asked to show an ID card, you can now print it from the member portal if you applied online at www.mysoonercare.org. If you applied through the Department of Human Services, they can print an ID card for you. My Pharmacy said my prescription needs a Prior Authorization.

What is the income limit for food stamps in Oklahoma 2022?

One person in the household: $25,760. Two people in the household: $34,840. Three people in the household: $43,920. Four people in the household: $53,000.

What is considered low income in Oklahoma?

The federal poverty level, which takes into account family size, is $13,590 for a single individual and $27,750 for a family of four in 2022.

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