Getting sick or injured can be scary enough without having to worry about how you can pay for the medical expenses. The reality is: quality healthcare often comes with a high price tag - one that many Oklahomans are struggling to afford.
The Oklahoma Medicaid program provides essential health insurance to low-income residents by covering doctor visits, hospital stays, prescriptions, and more. This vital public health insurance program helps families in the state access essential medical services during times of need.
This article will walk you through the system of Medicaid in Oklahoma, including the eligibility requirements, its health coverage, applications, and enrollment procedure.
Medicaid Eligibility Requirements in Oklahoma
To be eligible for the state's medicaid program, Oklahoma residents must meet certain requirements, including thresholds for income, assets, state residency, immigration status, and fitting into a covered eligibility category.
Let us go through the key criteria one by one:
Income Limits - How Much Money You Earn
This depends on your age, family size, and if you're pregnant or disabled. For example:
- Pregnant women can earn up to $1,872 per month for a family of 1.
- Children ages 1 to 5 can earn up to $2,386 per month for a family of 3.
- Disabled adults can earn up to $841 per month.
Assets - How Much Your Stuff is Worth
This includes money in the bank and any property. In general, an applicant's assets cannot exceed $2,000 in value for a single individual and $3,000 for couples. Certain assets like primary homes, vehicles, and retirement accounts are exempt from the limit.
Oklahoma Residency - Where you live in Oklahoma
You must be living in Oklahoma and plan to stay permanently or indefinitely. Provide proof of state residency like a rental agreement or mortgage, utility bills, driver's license, or mail with your full address.
U.S. Citizenship/Immigration Status
You must either be a U.S. citizen or have a qualified immigration status, such as permanent resident, refugee, asylum recipient, or trafficking victim. Documents verifying current status are required.
Applicants must meet one of the Medicaid eligibility categories, including aged (65+ years), being blind, disabled, pregnant women, children under 19, and parents/caretaker relatives of minor children.
To get Medicaid, you must present documents that show you meet ALL the rules above for income, assets, residency, status, and category. Start collecting your proofs like pay stubs, leases, IDs, and medical records. This will make it easier for you to navigate the application process.
Healthcare Services Covered by Oklahoma Medicaid
Oklahoma's Medicaid program, known as SoonerCare, covers a wide range of healthcare services including:
- Doctor Visits for Primary Care, Checkups and Treatment of Illnesses
- Inpatient and Outpatient Hospital Care Including Surgeries
- Emergency Room Visits for Emergencies
- Prenatal Care, Labor/Delivery and Postpartum Care for Pregnant Women
- Prescription Drugs with Minimal Copays
- Medical Equipment and Supplies like Wheelchairs and Oxygen
- Home Health Care with Doctor Authorization
- Mental Health Services like Counseling, Therapy and Addiction Treatment
- Dental Care like Cleanings, Fillings, Extractions for Adults and Children
- Vision Care including Annual Eye Exams and Glasses
- Skilled Nursing and Long-term Care in Facilities like Nursing Homes
- Non-Emergency Medical Transportation to and from Appointments
- Preventive Care like Annual Checkups, Cancer Screenings, Vaccines
- Physical, Occupational and Speech Therapy
Certain eligibility categories like pregnant women and children may qualify for added Medicaid programs such as Soon-To-Be-Sooners, which provides enhanced prenatal care coordination.
Children's Health Insurance Program in Oklahoma (CHIP)
The Children's Health Insurance Program is funded jointly by Oklahoma and the federal government. It provides free or low-cost health coverage to uninsured children up to age 19 from families with moderate incomes too high to qualify for Medicaid.
There are no copayments or deductibles for CHIP coverage in Oklahoma. Eligible families who also have access to private insurance may qualify for assistance paying those plan premiums through CHIP instead of direct coverage.
In Oklahoma, CHIP is integrated with Medicaid and administered together under SoonerCare services. Application is made through the same process as Medicaid, you may apply online, in person, by phone, or by mail.
Costs and Choosing a Medicaid Plan in Oklahoma
Most Oklahoma Medicaid recipients do not have to pay any premiums or out-of-pocket costs except small copays for medications, medical equipment or transportation in some cases.
There are several plan options to choose from including:
- SoonerCare Traditional - Fee-for-service Medicaid coverage. Participants can choose any provider who accepts Medicaid.
- SoonerCare Choice - Statewide managed care plans with networks of providers. participants must choose a primary care doctor to coordinate care.
- SoonerPlan - Delivered through contracted MCOs that are primarily Indian health providers.
- Home and Community Based Waivers - Provide added support services for elderly, disabled, and children with special healthcare needs.
How to Apply for Medicaid in Oklahoma
There are a few ways Oklahoma residents can submit Medicaid applications:
OnlineApply on the secure online application at www.MySoonerCare.org. Upload required documentation like proof of income, ID, and residence.
In PersonVisit a local DHS county office to apply in person and provide paperwork. Find locations at www.okdhslive.org.
By PhoneCall the SoonerCare Helpline at 1-800-987-7767 to begin application by phone.
By MailPrint and mail in the Medicaid application with copies of documents to verify eligibility to the OHCA.
Insurance Marketplace WebsiteSubmit the application on the federal insurance marketplace website - Healthcare.gov
No matter how you apply, be prepared to provide personal information and documents like photo ID, pay stubs as proof of income, immigration status papers, Oklahoma residence proof, and eligibility category verification (disability award letter, pregnancy proof, etc.).
Eligibility decisions are usually made within 45 days. If approved, coverage can begin immediately or be backdated up to 3 months. Review all correspondence and be aware of deadlines for any requested follow-up documentation.
Contact EASY Wireless For More Benefits in Oklahoma
Navigating Medicaid benefits can be complex, but Oklahoma aims to provide healthcare access to those in need. Learn the eligibility rules, covered services, costs, plan choices, and application process to enroll in SoonerCare Medicaid.
In fact, apart from medical benefits, there are many other government programs and benefits that aim at providing Oklahomans a better and more affordable living. For example, Lifeline Program and Affordable Connectivity Program are great programs that provide discounted or even free mobile service to eligible low-income households in the state. If you are eligible for Medicaid, it's very likely you will also meet the criteria for these programs.
Contact EASY Wireless for more information about low-cost cell phone services. Our helpful staff will be able to assist you to qualify for these benefits.
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