Everything You Need to Know About Soonercare Insurance

Soonercare Insurance is a healthcare program in Oklahoma that is funded by the state and federal government. The program is designed to provide healthcare coverage for individuals and families who meet certain income and eligibility requirements. In this article, we will explore everything you need to know about Soonercare Insurance, including what it is, how it works, and who is eligible for coverage.

What is Soonercare Insurance?

Soonercare Insurance is a Medicaid program that provides healthcare coverage to low-income families, pregnant women, elderly individuals, and people with disabilities who meet certain income requirements. The program is administered by the Oklahoma Health Care Authority (OHCA) and is funded by both state and federal funds. The program offers a range of healthcare services, including doctor visits, hospital care, prescription drugs, and more.

Soonercare Insurance is designed to help individuals and families who cannot afford healthcare coverage on their own. The program aims to improve the health outcomes of Oklahoma residents by providing access to quality healthcare services, regardless of their income or financial situation.

How does Soonercare Insurance work?

Soonercare Insurance works by providing healthcare coverage to eligible individuals and families who meet certain income and eligibility requirements. The program offers a range of healthcare services, including:

Individuals and families who are eligible for Soonercare Insurance will receive a SoonerCare ID card. They can use this card to access healthcare services from providers who accept Soonercare Insurance. Providers are reimbursed by the OHCA for services provided to eligible Soonercare members.

Who is eligible for Soonercare Insurance?

To be eligible for Soonercare Insurance, individuals and families must meet certain income and eligibility requirements. The eligibility requirements vary depending on the category of coverage. Here are the current income and eligibility requirements for each category:

Children’s Coverage

Children who are under the age of 19 may be eligible for Soonercare Insurance if they meet the following eligibility requirements:

• The child must be a resident of Oklahoma.
• The child must be a U.S. citizen or a qualified non-citizen.
• The family’s income must be at or below 210% of the federal poverty level.
• The child must not have access to other health insurance coverage.

Pregnancy Coverage

Pregnant women may be eligible for Soonercare Insurance if they meet the following eligibility requirements:

• The woman must be a resident of Oklahoma.
• The woman must be pregnant and expecting a baby.
• The woman’s income must be at or below 185% of the federal poverty level.
• The woman must not have access to other health insurance coverage.

Adult Coverage

Adults may be eligible for Soonercare Insurance if they meet the following eligibility requirements:

• The individual must be a resident of Oklahoma.
• The individual must be a U.S. citizen or a qualified non-citizen.
• The individual’s income must be at or below 133% of the federal poverty level.
• The individual must not have access to other health insurance coverage.

Senior and Disabled Coverage

Seniors and individuals with disabilities may be eligible for Soonercare Insurance if they meet the following eligibility requirements:

• The individual must be a resident of Oklahoma.
• The individual must be a U.S. citizen or a qualified non-citizen.
• The individual’s income must be at or below 300% of the federal poverty level.
• The individual must have a documented disability or be over the age of 65.

FAQ about Soonercare Insurance

What healthcare services are covered by Soonercare Insurance?

Soonercare Insurance covers a wide range of healthcare services, including doctor visits, hospital care, prescription drugs, dental care, and mental health services. The program also covers some long-term care services, such as nursing home care and home health services.

How do I apply for Soonercare Insurance?

You can apply for Soonercare Insurance by visiting the OHCA website or by calling the SoonerCare Helpline at 1-800-987-7767. You can also apply in person at your local Department of Human Services (DHS) office.

Can I choose my own healthcare provider with Soonercare Insurance?

Yes, you can choose your own healthcare provider as long as they accept Soonercare Insurance. You can search for providers who accept Soonercare Insurance on the OHCA website or by calling the SoonerCare Helpline.

Is there a cost for Soonercare Insurance?

There is no cost for Soonercare Insurance for eligible individuals and families. However, some services may require co-payments or other out-of-pocket expenses.

How long does Soonercare Insurance last?

Soonercare Insurance lasts for 12 months from the date you are enrolled. You will need to renew your coverage each year to maintain your eligibility.

Can I have other health insurance coverage and still be eligible for Soonercare Insurance?

If you have other health insurance coverage, you may still be eligible for Soonercare Insurance if you meet the income and eligibility requirements. However, Soonercare Insurance will be the payer of last resort, meaning that it will only cover services that are not covered by your other insurance.

Conclusion

Soonercare Insurance is a vital healthcare program in Oklahoma that provides coverage for low-income families, pregnant women, elderly individuals, and people with disabilities. The program covers a wide range of healthcare services, including doctor visits, hospital care, prescription drugs, and more. Eligibility requirements vary depending on the category of coverage, but generally require meeting certain income and residency requirements. If you are in need of healthcare coverage and meet the eligibility requirements, we encourage you to explore Soonercare Insurance as an option for you and your family.