Medically Fragile

The Medically Fragile program is a home and community-based alternative to placement in a hospital and/or skilled nursing unit of a nursing facility to receive Medicaid-funded assistance for care. This program allows Medicaid eligible persons who meet institutional level of care requirements to remain at home or in the residential setting of their choosing while receiving the necessary care. 

    Services

    Services may include:

    • Advanced supportive/restorative assistance
    • Case Management
    • Environmental modifications
    • Home-delivered meals
    • Hospice care
    • Prescription drugs
    • Personal emergency response system (PERS)
    • Respite care
    • Skilled nursing
    • Private duty nursing
    • Self-direction services
    • Specialized medical equipment and supplies
    • Therapy Services (Occupational, Physical, Respiratory or Speech)

    Eligibility Requirements

    To be eligible, the following requirements must be met: 

    • Be at least 19 years of age;
    • Meet hospital and/or skilled nursing level of care;
    • Meet SoonerCare financial eligibility;
    • Must be living at home or a residential setting.

    How to Apply

    • You can apply online here.
    • Or submit an application by fax at 405-530-7265 or by mail to OHCA, Attention Medically Fragile, 4345 N. Lincoln Blvd., Oklahoma City, OK 73105.

    Potential members are referred for the Medically Fragile Waiver through the common intake form. Once the intake form is submitted their name is placed on the Medically Fragile waiting list. Once there is a slot available for enrollment the potential member will be assessed for financial eligibility. Once the financial eligibility is approved the potential member will receive a UCAT assessment to determine their medical eligibility. If the potential member meets the financial and medical criteria, they are eligible for the waiver and asked to pick a case management agency.  The case manager will begin the service plan process of enrollment. Each year the member must meet the financial and medical criteria to continue services on the Medically Fragile waiver.   

    Contact Information

    If you have questions about the Medically Fragile Waiver Program, please email medicallyfragilewaiver@okhca.org or contact us at our toll-free number 888-287-2443.