What 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. The Oklahoma Health Care Authority (OHCA) is the state agency that administers the program and determines financial eligibility for the program.
To qualify for SoonerCare, a person must:
- Reside in Oklahoma;
- Be a U.S. citizen or qualified alien (most immigrants who arrived after August 22, 1996 are barred from the program for five years);
- Meet financial income and resources standards in certain categories.
What services are paid?
Covered health care services may include doctor visits, hospitalization and prescriptions. For more details please see the Benefits page.
What does it cost?
There is no cost for those who meet the income guidelines; however, co-pays may apply to some services.
Access to Medical Records
OHCA may get medical records for case management purposes
directly from SoonerCare contracted medical providers or through Health
Information Exchange Organizations. We
contract with two Health Information Exchange (HIE) Organizations: 1) Coordinated
Care Oklahoma and 2) MyHealth Access Network.
As a SoonerCare member, or as the member’s personal
representative, you may opt out of having medical information shared by the HIE
at your primary care provider’s office or at the hospital providing care.
To find out if your medical records are being shared within
an HIE, please contact your medical provider.
If your records are being shared within an HIE, and you wish to opt out,
your medical provider will provide you with the appropriate standard form and
instructions on how to submit the form, or you may obtain an opt out form
directly from either of the HIE organizations’ websites in the sections for
patients (accessible under the drop-down menu on each website).
To learn more about the HIE Organizations, please visit
their websites at:
Coordinated Care Oklahoma: http://www.coordinatedcareok.com/
MyHealth Access Network: http://myhealthaccess.net/
What about Medicare?
Medicare is different from SoonerCare (Oklahoma Medicaid). Medicare is a federal health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). Medicare provides coverage mostly to individuals age 65 or older and some people with disabilities.
If you are on Medicare and you qualify for SoonerCare, most of your health care costs are covered. If you have low income and limited assets, SoonerCare may help pay some or all of Medicare premiums and cost sharing expenses. To apply for Medicare benefits, visit or call your local Social Security Office.
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