How to Get Oklahoma Medicaid Benefits | Best Answers

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We have scoured the internet to provide all you need to know about the Oklahoma Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income individuals who meet certain requirements, including kids, pregnant women, the elderly, and individuals with disabilities. Applying for Medicaid in person, via telephone, or online is simple.

This post will teach you all you need to learn about Medicaid in Oklahoma.

What is the Oklahoma Medical Program?

Oklahoma Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the Oklahoma Medical Program?

Oklahoma Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*For households with more than eight people, add $6,277 per additional person.


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How do I contact Medicaid in Oklahoma?

Phone

(800) 987-7767

Mailing Address

Oklahoma Health Care Authority

4345 N. Lincoln Blvd.

Oklahoma City, OK 73105

Website: www.insureoklahoma.org

What are the Medicaid plans in Oklahoma?

Sooner Care

Oklahoma introduced SoonerCare, which at first included programs: 

(1) SoonerCare Plus, which utilized a fully capitated delivery system to contract with health plans in the state’s urban areas, and (2) SoonerCare Choice, a primary care case management solution, offered services in the state’s rural areas.

Program of All-inclusive Care for the Elderly (PACE)

For individuals over 55 who need nursing facility level care and live in the five-county service region, Oklahoma has operated a Program of All-inclusive Care for the Elderly (PACE) that includes all Medicare and Medicaid services.

SoonerRide

A limited benefit out-pass transportation program called SoonerRide has also been run by the state for Medicaid enrollees, except dual eligibles or HCBS waiver recipients. 

To better organize and improve care for SoonerCare Choice participants, the state established “Health Access Networks” in 2012. These organizations collaborate with linked providers.

For more details regarding Oklahoma Medicaid plans, visit here.

How do I apply for Oklahoma Medicaid?

Call (800) 987-7767 to enroll. 

Apply in person at Oklahoma Health Care Authority.

Online:  Download and print the application.

Mail: To 4345 N. Lincoln Blvd, Oklahoma City, OK 73105

Website: www.insureoklahoma.org

What is covered by Oklahoma Medicaid?

Oklahoma Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

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Can I have both Oklahoma Medicaid and Medicare?

If you qualify for both Medicaid and Medicare, you can have them. They will work together to keep your costs minimum and provide you with health insurance.

Oklahoma Waiver

  • Advantage Waiver;
  • Community;
  • Homebound;
  • In-Home Supports Waiver for Children;
  • In-Home Supports Waiver for Adults;
  • Medically Fragile;
  • Sooner Services;
  • Seniors and People with Disabilities

Copayments?

They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by Oklahoma Medicaid?

In Oklahoma, Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for Oklahoma Medicaid?

The highest income limit for Oklahoma Medicaid is $18,075 for an individual and $24,353 for a family of two per year.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for Oklahoma Medicaid, thanks to the asset spend down option.  

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy;
  • When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

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What is the best Medicaid in Oklahoma?

The best plan for you is the one that meets your demands and offers the most benefits in terms of health insurance and monetary help because it varies from person to person.

Where do I find the letter showing the reason(s) for denial or discontinuance from Oklahoma Medicaid?

By signing into your account at Portal, you can see the progress of your Oklahoma Medicaid application.


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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