Medicaid Guidelines in Oklahoma

Medicaid provides low income and medically needy individuals and families with access to affordable health care with free or reduced expense sharing responsibilities. The program is both federally and state-funded, and each state determines its own eligibility guidelines for its residents. To Oklahoma residents, Medicaid is known as "Sooner Care."

Individual Qualifications

• Only certain Oklahoma residents qualify for Sooner Care. These include families with children, pregnant women, elderly persons over 65, blind persons, permanently disabled individuals and some adults with family planning needs. The program may also cover some uninsured women under age 65 diagnosed with breast or cervical cancer or with previous abnormal mammograms or cancer screenings.

Income Eligibility

• Oklahoma grants Sooner Care benefits to those who meet income eligibility requirements determined by the person applying for coverage and the number of people in her household. Children under age 18 and pregnant women enjoy the most liberal income limits, with a cap of 185 percent of the federal poverty line. Others, including working parents of dependent children, must make 45 percent or less of the federal poverty limits to qualify for benefits. Elderly persons or disabled people who qualify for Supplemental Social Security income also qualify for Sooner Care.

Coverage

• In Oklahoma, Sooner Care provides benefits for emergency services, such as inpatient hospital stays, ambulatory transfers and emergency room visits. Other covered medical care includes prescription drug coverage, office visits, hospital outpatient services, diagnostic screenings and tests, behavioral health services and long term nursing care. Children and pregnant women also have access to a range of dental benefits and maternity services.

Apply

• You can apply for Medicaid in Oklahoma online at the Oklahoma Health Care Authority website at okhca.org. You can also download and print an application to fill out and send by mail, or you can apply in person at your local county human services center. When you apply, you must provide information regarding your current household income, as well as proof that you reside in Oklahoma and are a citizen of the United States. You must also provide recent health records if you are permanently disabled or pregnant.

Renewals

• Those enrolled in Sooner Care must meet renewal standards to stay in the program. With the exception of permanently disabled and blind individuals, adults and children must renew every 12 months through administrative verification of income. The state requires no face-to-face interviews, and no asset tests are necessary for children and pregnant women upon enrollment or renewal.