What is Covered?
SoonerCare (Oklahoma Medicaid) covers many health care services. However, there are limitations that apply to ensure that only medically necessary services are provided. Some services are for children only. The benefits and coverage outlined here may change. Please check Chapter 30 of the OHCA Rules for the most up to date information.
Possible covered services
* Not covered under SoonerCare CHOICE
Additional services for children
- Hearing aids
- Inpatient hospital services for patients in institutions for mental disease
- Optometric or optical services, including eyeglasses
- Other medically necessary services
- Physical and occupational therapy
- Private duty nursing
- Speech, hearing and language disorder services
The following programs may provide additional services or more restrictions to the services covered above for enrollees.
Medicare Cost Sharing and Third Party Liability
SoonerCare pays only the deductibles and a portion of the co-insurance when any of the above items are covered by Medicare. OHCA also pays the monthly Medicare Part B premium for SoonerCare members age 65 or older and for certain blind or disabled persons. If an eligible person has other medical insurance, that insurance company must be billed before SoonerCare is billed.