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Oklahoma has chosen to develop and implement two, separately managed care delivery systems within its Medicaid program. The Oklahoma Health Care Authority (OHCA) operates these programs under the SoonerCare program: SoonerCare Plus and SoonerCare Choice. SoonerCare Choice provides transportation services through SoonerRide to allow people to get to the services they need, while the Health Maintenance Organizations (HMOs) are responsible for the transportation of clients enrolled in the SoonerCare Plus program.
NOTE: The SoonerCare Plus Program was discontinued effective January 1, 2004. This information is for archival purposes only. See the SoonerCare Plus - Discontinued topic for additional information.
SoonerCare Plus is a program where the Oklahoma Health Care Authority (OHCA) contracts directly with Health Plans (commonly referred to as "Health Maintenance Organizations" or "HMOs") to provide all medically necessary services to recipients residing in Oklahoma City, Tulsa, Lawton, and the counties immediately surrounding these metropolitan areas of Oklahoma. The SoonerCare Plus program is currently available in these counties only and there are at least two health plans from which to choose in these areas.
SoonerCare Choice is a program where OHCA contracts directly with Primary Care Providers throughout the state to provide basic health care services. The program is partially capitated in that providers are paid a monthly capitated rate for a fixed set of services with non-capitated services remaining compensable on a fee-for-service basis.
The word "Choice" in the SoonerCare Choice program name refers to the recipient’s ability to change health care providers up to four times per year, unlike recipients enrolled in SoonerCare Plus, who are "locked in" with a Primary Care Provider (PCP). This allows providers to be added in rural areas of Oklahoma on a continuous basis - especially in areas of the state that may be historically under-served or limited on the types of available providers.
The Oklahoma Medical Assistance Application form is available for download from the Department of Human Services website. You may also download the SoonerCare Health Benefits Application Form (SC-1) in PDF format (requires Adobe Acrobat Reader). Get the form at:
http://www.okhca.org/publications/pdflib/SCapplication_english.pdf
SoonerCare - Eligibility Overview- Oklahoma
SoonerCare - Financial Eligibility - Oklahoma
SoonerCare - Service Provider Locations - Oklahoma
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