Prescriptions (Drugs)

Prescriptions that are covered may be filled at any pharmacy or drugstore that accepts SoonerCare.

Frequently Asked Questions

Adult members:

  • There is a limit of six covered prescriptions per month (including up to two brand-name drugs). The pharmacy has to give you a generic drug when one is available. Your doctor may need to have some drugs approved by SoonerCare.
  • There is a monthly limit for birth control, some drugs for HIV/AIDS, some cancer drugs and some smoking cessation products.
  • There is a co-payment of $4 for each prescription.

Members younger than 21:

  • There are no limits or co-payments for medically necessary prescriptions.

Always show your SoonerCare I.D. card to get your prescriptions. The pharmacy may not fill your prescription if you do not have your card.

If you are not sure a drug is covered, call the Pharmacy Help Desk at (405) 522-6205 or (800) 522-0114.

Prior Authorizations

Some services require a Prior Authorization (PA). A PA is not the same as a referral. It means the services must be approved by SoonerCare before you receive them.

  • Your doctor must send medical records with the PA to show a medical need for the services.
  • You and the provider will get a letter from SoonerCare when the services are approved or denied.
  • A PA is not a promise of payment.
  • Please read your notice.

If you have questions, call the Pharmacy Help Desk at (405) 522-6205 or (800) 522-0114, option 4.

Ready to quit smoking? Help is Here!

Smoking and tobacco can cause many major health problems. SoonerCare offers free smoking cessation benefits. Ask your health care provider about medications or call the Oklahoma Tobacco Helpline for coaching.

Covered products include nicotine patches, gums and lozenges, as well as other pills that combat cravings.

You can get smoking cessation products as a pharmacy benefit for up to 6 months. Those products will not count toward the monthly limits for members age 21 and older.

For more information

Oklahoma Tobacco Helpline:
1-800-784-8669 (English)
1-800-793-1552 (Spanish)
1-877-777-6534 (TTY)