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Medicaid Program - Eligibility - Oklahoma

In order to receive Medicaid, certain non-financial and financial requirements must be met.

Non-financial requirements include:

·             Establishment of citizenship or qualified alien status (See OAC 317:35-5-25 for details at: OK Department of Human Services Policy)

·             Establishment of residency–the applicant/recipient must be residing in Oklahoma at the time Medicaid is requested (See OAC 317:35-5-26 for details at: OK Department of Human Services Policy)

·             Documentation of a Social Security number

To be eligible for Medicaid benefits, an individual must be related to one of the following programs:

·             Aid to the Aged

·             Aid to the Disabled

·             Aid to the Blind

·             Pregnancy-Related Services

·             Aid to Families with Dependent Children

Categorical relationship for Aid to the Aged, Blind, and Disabled (ABD) is established using the same criteria and definitions of age, disability, and blindness as used by the Social Security Administration in determining eligibility for Supplemental Security Income (SSI).

If individuals are ABD/SSI recipients or are receiving Temporary Aid to Needy Families (TANF) (formerly Aid to Families with Dependent Children [AFDC]), they are categorically eligible for Medicaid.

Categorical relationship to pregnancy-related services is established when medical evidence shows that the individual is or has been pregnant.

Individuals are categorically needy if income and resources are at or below the category of assistance to which they are related.

Individuals are medically needy in income and resources exceed the category of assistance to which they are related, but if their income and resources are not sufficient to meet the cost of medical care.

Families with children under 18 who do not receive TANF may, in some circumstances, receive medical services. They must meet specific income guidelines to be eligible and must also meet resource limits to be eligible for Medicaid.

Income limits for Medicaid eligibility are determined using Federal Poverty Guidelines established by the U.S. Department of Health and Human Services.

If income guidelines cannot be met, it may be possible to meet eligibility standards through the Medical Spend-Down process.

Eligibility for Medicaid is determined at each of the 77 county Department of Human Services (DHS) offices. For DHS county office contact information, see: http://www.okdhs.org/okdhslocal/.

For more information, see:

OAC Title 317 Chapter 35 at OK Department of Human Services Policy

See also:

Medicaid Program - Medical Assistance Application Form - Oklahoma

Medicaid Program - Retroactive Eligibility - Oklahoma

Medicaid Program - Countable Income - Oklahoma

Medicaid Program - Income Disregards - Oklahoma

Medicaid Program - Eligibility for Pregnant Women and Children - Oklahoma

Medicaid Program - Eligibility for Elderly Individuals - Oklahoma

Medicaid Program - Eligibility for People Who Are Blind or Disabled - Oklahoma

Medicaid Program - Eligibility for Non-TANF Families - Oklahoma

Medicaid Program - Overview - Oklahoma

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