Frequently Asked Questions
  • What is my SoonerCare ID number?
    Your SoonerCare ID number can be found in the bottom right corner of your SoonerCare ID card.
  • How can I find out the Status of a Prior Authorization?
    Contact the pharmacy help desk.
  • Will my prior authorization be good at any pharmacy?
    No, all prior authorizations are pharmacy specific.
  • How can I find out if a medication will require a Prior Authorization?
    For a list of medications that require prior authorization call your local pharmacy or the pharmacy help desk.
  • How can I find out why my Prior Authorization was denied?
    Contact the pharmacy help desk.
  • How can I find out how many prescriptions SoonerCare will cover each month?
    For coverage information specific to you contact the pharmacy help desk.
  • How can I get more prescriptions on my SoonerCare card each month?
    Please contact your caseworker to see if you are eligible for additional prescription coverage.
  • How can I find out what my prescriptions co-payment will be?
    For those members 21 years of age or older:
    • $0.65 for prescriptions costing between $0.00 - $10.00
    • $1.20 for prescriptions costing between $10.01 - $25.00
    • $2.40 for prescriptions costing between $25.01 - $50.00
    • $3.50 for prescriptions costing $50.01 or more
     
  • For those members under 21 years of age or in a long-term care facility:
    • There is no co-pay.
  • How can I get my diabetic testing supplies covered through SoonerCare?
    You will have to find a pharmacy that is contracted as a DME provider to do Diabetic Supplies. 
  • Are smoking cessation products covered through SoonerCare?
    Yes, smoking cessation products are covered and do not count against your prescription limit.
  • Is Birth Control covered through SoonerCare?
    Most Birth Control is covered and does not count against your prescription limit.
  • I received a prescription from an out-of-state doctor; will SoonerCare pay for the prescription?
    SoonerCare will pay for prescriptions written by SoonerCare contracted doctors.  If the out-of-state doctor is a SoonerCare doctor, then it will be covered.  If they are not a SoonerCare doctor, the prescription will not be covered by SoonerCare.
  • Can I get a prescription filled at an out of state pharmacy?
    For SoonerCare to pay the out of state pharmacy, the pharmacy must have a current contract with SoonerCare.
  • A recently filled prescription was destroyed or lost.  Can I get it refilled through SoonerCare?
    Have your pharmacist call the  pharmacy help desk to request an override.  Depending on circumstances it may or may not be refilled.
  • Will SoonerCare pay for an early refill if I am going on vacation?
    No, SoonerCare will not authorize early refills due to vacations.
  • How can I get a reimbursement for a prescription I paid for?
    This depends upon the individual pharmacy's policy.  Generally, once the prescription is submitted to SoonerCare and paid, the pharmacy may issue a refund.
  • I cannot afford my co-payment and the pharmacy has already filled my prescription.  How can I get it?
    A pharmacy cannot deny medication based on inability to pay the co-payment, however the pharmacy may bill you for the co-payment.
  • I am eligible for benefits under the Family Planning Program.  What prescriptions are covered under Family Planning?
    Only family planning products or birth control medications.
  • How can I find out if I qualify for SoonerCare or the Advantage Waiver prescription assistance?
    Speak with your local DHS Caseworker or call the Advantage Waiver Program at (800) 435-4711.