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SoonerCare Plus - Overview - Oklahoma

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.

Under SoonerCare Plus, the Oklahoma Health Care Authority (OHCA) contracts directly with Health Plans (known as Health Maintenance Organizations or HMOs) to provide all medically necessary services to Medicaid recipients residing in the urban areas of Oklahoma City, Tulsa, Lawton and the counties immediately surrounding these metropolitan centers.

The Health Plan is responsible for providing primary care and for locating, coordinating, providing and monitoring other medically necessary medical, behavioral health and rehabilitation services. Health Plans are required to provide 24-hour a day, seven day-a-week, service delivery, as well as consultation and referral services.

The "Plus" in SoonerCare Plus refers to the enhanced benefit package created through the removal of limitations of hospital days, prescriptions and office visits for adults, all of which are present under the SoonerCare Fee-for-Service program.

People within the SoonerCare Plus program select a Primary Care Provider (PCP); this PCP is responsible for coordinating most of the recipient’s health care, including a majority of specialty care and referrals. OHCA does not make Medicaid payments for services delivered outside the SoonerCare Plus program.

New SoonerCare Plus recipients receive six months of continuous guaranteed eligibility from the certification date for the current eligibility period.

The Health Maintenance Organizations (HMOs) are responsible for the transportation of clients enrolled in the SoonerCare Plus program.

Also see:

SoonerCare Plus - Enrollment Requirements - Oklahoma

SoonerCare Plus - Enrollment Ineligibility - Oklahoma

SoonerCare Plus - Services - Oklahoma

SoonerCare Plus - Application Procedures - Oklahoma

SoonerCare Plus - Health Plan Choices - Oklahoma

SoonerCare Plus - Health Plan Changes - Oklahoma

SoonerCare - Service Provider Locations - Oklahoma

SoonerCare - Overview - Oklahoma

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