Qualifications For Medicaid In Oklahoma


How To Apply For Medicaid

Oklahomans eligible for Medicaid expansion can now apply

Enter your zip code to get started.

Medicaid is jointly funded by federal and state government. The program provides medical benefits to low-income individuals living in Oklahoma who cannot afford private insurance. As a result, the program ensures long-term care and basic health services for the underprivileged.

Since Oklahoma hasn’t accepted federal Medicaid expansion, the eligibility rules for the program remain the same as of 2013. As a result, the new premium subsidies are not available for low-income individuals in Oklahoma.

To receive Medicaid benefits in Oklahoma, you need to meet eligibility guidelines for the program. The eligibility for the program is based on household income but applicants will also need to fall into one of the basic eligibility category for Medicaid.

If you meet the eligibility criteria for Medicaid in Oklahoma, you can easily apply for the program by completing an application online. You can also apply for the benefits by visiting your nearest Medicaid office in Oklahoma.

In addition to Medicaid, residents of Oklahoma can apply for various other low-income health programs. Individuals who fail to meet income guidelines for Medicaid can qualify for some of these programs in most cases.

Medicaid Expansion Ballot Measure: The Backstory

The process of getting a Medicaid expansion measure on the ballot and approved by voters took a substantial amount of work. Medicaid expansion supporters in Oklahoma gathered signatures in 2019 for Question 802, which called for Medicaid expansion under the terms outlined in the ACA . They needed 177,958 valid signatures by October 28, 2019, and reportedly submitted 313,000 the most signatures that had ever been collected for a ballot initiative in the state. In January 2020, Oklahomas Secretary of State confirmed that the measure would appear on the ballot in 2020.

However, it was up to Gov. Kevin Stitt a Republican who opposes Medicaid expansion and had expressed opposition to the ballot initiative to determine whether the Medicaid expansion question should be on the primary ballot in June, or on the general election ballot in November. Stitt ultimately determined that the measure would appear on the June 30, 2020, primary ballot. Its rare for a governor to opt to put a ballot initiative on the primary ballot, although former Gov. Mary Fallin did so with a medical marijuana initiative in 2018.

A month later, voters in Oklahoma approved ballot Question 802, paving the way for full Medicaid expansion to take effect in the state as of July 2021.

Federal poverty level calculator

What Is Oklahoma Medicaid

The Oklahoma Health Care Authority is the agency that oversees the states Medicaid health care program. The agency is responsible for a variety of medical treatments for children and adults who have limited income and few assets. Oklahoma Medicaid is supported by federal and state taxes and must meet certain guidelines set by the federal government. Each state has its own Medicaid program and must follow certain national rules, but most have flexibility in how they operate their assistance programs.

The Oklahoma Medicaid program supports more than 833,000 individuals who are pregnant, under 18, disabled or 65 and older. The health care assistance program also helps women who have been diagnosed with breast or cervical cancer.

You May Like: Apply For Medicaid Online Nys

Qualifying For Medicaid In Oklahoma

Qualifying for long-term or nursing home care with Medicaid can be difficult. In Oklahoma, Medicaid eligibility is determined by the following:

  • You must have limited income.
  • You must have limited assets.
  • You must be over the age of 65 and meet certain medical criteria.
  • The financial rules change depending upon marital status.
  • Gifts can create periods of ineligibility.

We have the experience to help you qualify for Medicaid benefits. You should consider visiting with an experienced professional who can provide guidance and expertise in understanding your options. We can visit with you and evaluate your specific needs, discuss any available courses of action, and answer all of your questions.

Oklahoma Medicaid Enrollment Numbers

Medicaid Eligibility Expanded in Oklahoma

As of April 2022, there were 1,232,438 Oklahoma residents enrolled in SoonerCare, the states Medicaid program. Fifty-five percent of them were children.

For perspective, SoonerCare enrollment stood at 790,051 at the end of 2013, and had been at just under 808,000 as of April 2020. But Medicaid programs all across the country have seen ballooning enrollment since 2020, amid the COVID-19 pandemic, and this was true even in states that hadnt expanded Medicaid under the ACA.

The increased enrollment was partially due to the widespread job losses during the early days of the pandemic. But continued enrollment growth has been driven largely by the Families First Coronavirus Response Act. Under that legislation, all states are receiving additional federal Medicaid funding but on the condition that they not disenroll anyone from Medicaid until the end of the COVID public health emergency . So the normal eligibility redetermination process has been paused since early 2020, with nationwide Medicaid enrollment continuing to grow.

Oklahomas Medicaid enrollment growth has also been driven by the states expansion of Medicaid, which covered more than 291,000 people as of May 2022.

Don’t Miss: Yearly Income To Qualify For Medicaid

Whats Changing With Medicaid In Oklahoma

Last year, Oklahoma voters passed State Question 802, which expanded Medicaid eligibility to include many low-income adults.

Oklahomas Medicaid program, called SoonerCare, has covered children, pregnant women, elderly adults and disabled people. Under the expanded eligibility guidelines, over 200,000 more people will be eligible for coverage, according to the Oklahoma Health Care Authority, which oversees the program.

More:Enrollment for Oklahoma’s Medicaid expansion begins June 1

Its been nearly one year since Oklahomans voted to expand SoonerCare, giving access to affordable quality health care to more Oklahomans than ever before, Kevin Corbett, CEO of the Oklahoma Health Care Authority, said in a statement. We look forward to welcoming and serving these new members on SoonerCare, and helping Oklahoma become a Top 10 state for positive health outcomes.

Those who are newly eligible for Medicaid will receive the same benefits as current Medicaid recipients.

The expansion will cost roughly $1.3 billion, and the federal government will cover 90% of the costs.

Expanded Medicaid In Oklahoma

Starting July 2021, Oklahomas Medicaid program, SoonerCare, will be expanded to include eligibility for adults between 19 and 64 whose income is 138% of the federal poverty level or lower. This means an individual who earns an estimated $16,970 per year would qualify, and a family of four could earn up to $34,846 a year. The federal program will pay up to 90% of medical costs for expansion enrollees, and there will be no premiums for members. Non-pregnant adults will be charged up to 5% for co-payments.

Recommended Reading: Does Medicare And Medicaid Cover Hearing Aids

Medicaid Eligibility Expansion Initiative Approved By Voters Took Effect July 2021

Oklahoma Medicaid was expanded as of July 2021, with coverage newly available to non-elderly adults earning up to 138% of the poverty level. More than 291,000 people have gained coverage as a result of Medicaid expansion in Oklahoma.

Although Medicaid expansion had been in the works in Oklahoma since the summer of 2020, the state still benefits from the American Rescue Plans two years of additional federal funding for states that newly expand Medicaid after March 2021. In Oklahomas case, this amounts to about $500 million in additional funding, on top of the 90% funding that the federal government will provide indefinitely for costs associated with the newly eligible population.

In June 2020, voters in Oklahoma passed a Medicaid expansion ballot initiative, paving the way for Medicaid expansion to take effect in Oklahoma. The measure passed by a slim margin, garnering 50.5% of the vote. Oklahoma joined several other states Maine, Utah, Idaho, Nebraska, and Missouri where voters have approved Medicaid expansion ballot initiatives over the last few years, after state lawmakers or governors had rejected Medicaid expansion for several prior years.

What Is Considered Low

Oklahoma Watch – Medicaid

Enrollees must meet certain income and asset eligibility requirements to qualify for benefits. Medicaid eligibility is determined by your modified adjusted gross income , which is your taxable income plus certain allowable deductions such as non-taxable Social Security benefits, retirement contributions and tax-exempt interest payments. The maximum income amount youre allowed to earn while still receiving Medicaid depends on where you live in the United States but is typically based on income, age, your role in the household and medical need.

To be eligible for Medicaid in Oklahoma, an individuals household income limit cannot exceed $16,971 for one person, $22,930 for two people or $34,846 for four people. There are different income criteria for households with children under 19.

Children can access health care through the State Childrens Health Insurance Program, also known as SCHIP. It covers uninsured infants, children and teenagers in Oklahoma. For example, to qualify for SCHIP in Oklahoma, the income limit for a family of four is $48,470 annually.

Read Also: Check To See If You Have Medicaid

Oklahoma Will Implement Medicaid Expansion By Summer 2021

  • 1,232,428 Number of Oklahomans covered by Medicaid/CHIP as of April 2022
  • 442,377 Increase in the number of Oklahomans covered by Medicaid/CHIP fall 2013 to April 2022
  • 24% Reduction in the uninsured rate from 2010 to 2019
  • 56% Increase in total Medicaid/CHIP enrollment in Oklahoma since late 2013

Prescription Drugs With Medicaid In Oklahoma

Prescription drugs that are covered by SoonerCare can be filled at any pharmacy or drugstore that accepts SoonerCare.

For adults, there is a limit of six covered prescriptions per month and your pharmacy must give you a generic drug when one is available. Your doctor may also need to have some prescriptions approved by SoonerCare. Prescriptions for birth control, some drugs for HIV/AIDS, some cancer drugs and some smoking cessation products will not count against your prescription limit. There is a co-payment of $4 for each prescription.

For SoonerCare members younger than 21, there are no limits or co-payments for medically necessary prescriptions.

SoonerCare offers free smoking cessation benefits. Covered products include nicotine patches, gums and lozenges, as well as other pills that combat cravings.

Members can get smoking cessation products as a pharmacy benefit for up to 6 months. Those products will not count toward the monthly limits for members age 21 and older.

For more details, call the Oklahoma Tobacco Helpline at 1-800-784-8669.

Recommended Reading: Family Doctors In Charleston Wv That Accept Medicaid

Learn About Requirements For Medicaid In Oklahoma

The process for how to qualify for Medicaid in Oklahoma includes gathering eligibility information and providing it to state officials who review applications. Satisfying OK Medicaid eligibility requirements means potential beneficiaries receive vital assistance that helps with obtaining health care coverage. In Oklahoma, Medicaid is known as SoonerCare and is a program funded by the federal and state governments to help low-income individuals and families that cannot afford health insurance. Additionally, the Oklahoma Health Care Authority manages the program and will determine Medicaid benefits eligibility based on a range of qualifying factors, including verifying all information provided by an applicant. Learn who is eligible for Medicaid and what are the requirements for Medicaid in Oklahoma by reading the outlined material below.

Who qualifies for Medicaid in Oklahoma?

Oklahoma residents who are eligible for Medicaid are those who meet the personal and financial requirements. Medicaid benefits eligibility includes adults with minor children, children younger than 19 years of age, pregnant women and women older than 65 years of age with need of breast or cervical cancer treatment. Additionally, households with a family member who is a senior citizen or disabled can also initiate applying for Medicaid benefits.

How do I qualify for Medicaid in Oklahoma?

Find out more about Medicaid requirements by reviewing the information in our free guide.

Oklahoma Medicaid Eligibility Requirements

Idaho Medicaid and Idalink Guide

This page provides general guidelines for the Oklahoma Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is Oklahoma Health Care Authority. The name of the state program is SoonerCare. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the Oklahoma Medicaid office.

Recommended Reading: How Do I Enroll My Newborn In Medicaid

Contact Our Experienced Oklahoma Medicaid Attorneys Today

While the rules on transferring assets can be complex, mistakes can cause a suspension of your Medicaid eligibility. Talk to an experienced professional who has helped many clients like you understand their options. Our Oklahoma City Medicaid lawyers have years of experience in this complex process and would love the chance to talk with you about how we can help. For more information on our services, and to learn how you can qualify for Medicaid while preserving your assets, contact our experienced Warr Acres, Oklahoma Medicaid attorneys at and speak with our legal team today.

All Information About Who Qualifies For Medicaid In Oklahoma

At dayofdifference.org.au you will find all the information about Who Qualifies For Medicaid In Oklahoma. We have collected a lot of medical information. Check out the links below.


Read Also: Can You Have Insurance And Medicaid

Oklahoma Medicaid Eligibility: 2022 Income & Asset Limits

    Medicaid is a health care insurance program, jointly funded by the state and federal government, for low-income individuals of all ages. While there are many different eligibility groups, this page is focused specifically on Medicaid eligibility for senior Oklahoma residents . That said, the focal point will be on â¦

How To Apply / Learn More

Breaking down Oklahoma’s Medicaid expansion with benefits set to begin July 1

The ADvantage Waiver is a SoonerCare program managed by the Aging Services Division of the Oklahoma Department of Human Services. It has replaced two older state waivers, My Life My Choice and Sooner Seniors.

While available throughout Oklahoma, waiting lists may exist. The waivers CD-PASS option, where family members are eligible to be hired and paid as caregivers for their elderly relatives, is currently available throughout the state.

To apply, contact your local Department of Human Services Office or call 1-800-435-4711. More information is available here.

There are other options available to senior citizens in Oklahoma that do not have waiting lists: Adult Day Care Services and In Home Assistance Services.

Don’t Miss: Ohio Medicaid Managed Care Providers

Who Is Eligible For Medicaid In Oklahoma

Since Medicaid expansion took effect in July 2021, non-elderly adults are eligible for Medicaid with household income up to 138% of the poverty level . Children and pregnant women continue to be eligible for Medicaid at higher income levels, although nothing has changed about Medicaid eligibility rules for people age 65 and older.

As part of a demonstration waiver that was approved in 2019, up to 3,000 full-time college students aged 19 to 22 in Oklahoma could be covered under Medicaid if their incomes dont exceed 200% of the poverty level . The state has clarified that dependent college students must count their parents household income, whereas independent college students can enroll based on their own income.

How To Apply For Medicaid In Ok

    The Medicaid application in Oklahoma only requires adult applicants older than 21 years of age to list other adult relatives in the household whom they file taxes with. However, the number of household members directly influences the Medicaid income limits to be considered eligible.

Recommended Reading: Colorado Medicaid Fraud Control Unit

Gov Stitts Alternative To A Medicaid Expansion Ballot Initiative: Soonercare 20 Expansion But With Strings Attached

As described below, Oklahoma submitted a waiver proposal to CMS in December 2018, seeking permission to implement a Medicaid work requirement. But Governor Stitts administration had also been working on a new approach, called SoonerCare 2.0. Instead of the straight Medicaid expansion called for in the ballot initiative that was ultimately approved by voters in 2020, Stitts proposal was significantly more complicated.

In early 2020, the Stitt administration expressed support for the Trump administrations Healthy Adult Opportunity Medicaid waiver approach, and rolled out a proposal designed to take advantage of the new flexibility the federal government is offering states.

SoonerCare 2.0 called for Medicaid expansion as of July 2020, although as noted above, that was canceled as a result of the COVID-19 pandemic. But the second phase of the program, which would have required federal approval and would have taken effect in July 2021, called for premiums for people eligible due to Medicaid expansion, a per-capita spending cap, a waiver of retroactive coverage, and a Medicaid work requirement .

As described above, Stitt surprised lawmakers in May 2020 when he vetoed the bill they had passed that would have provided funding for the SoonerCare 2.0 program that Stitt had proposed. And the state soon withdrew the state plan amendment that called for Medicaid expansion to take effect in July 2020.

Soonercare Income Guidelines For Expansion Adults

Income Guideline For Medicaid 2020
Size of Family

Ninety percent of costs for expansion enrollees will be paid by the federal government.

Maximizing federal funding allows the state the ability to:

  • Promote integrated care and improve health outcomes, explore reinstating an adult dental benefit in SoonerCare, with a focus on preventive dental services.
  • Pursue substance use disorder and serious mental illness waivers to expand access to prevention and treatment services.
  • Coordinate with jails and prisons to help former inmates apply for SoonerCare coverage upon release, helping them get access to important behavioral health services immediately, thus reducing the risk of recidivism.
  • Help jails and prisons capture additional SoonerCare funding for hospitalizations and surgeries as allowed under federal Medicaid law.

Recommended Reading: Humana Medicaid Long Term Care

Oklahoma City Medicaid Planning & Legal Services

In the United States, there are over 75 million people who rely on Medicaid for their medical coverage. Medicaid is a government program that provides nursing home, healthcare, and financial assistance to those with low incomes and limited resources. In order to qualify for these benefits, you must meet certain eligibility requirements, which can be confusing and complex at times.

Our law firm specializes in assisting clients with Medicaid applications for nursing homes. If you need help understanding how your assets will affect your Medicaid qualification, our experienced Oklahoma Medicaid attorneys can help answer your questions and ensure your rights remain protected. Our legal team has years of experience working with clients within Oklahoma just like yourself who need guidance navigating this process. Contact our Oklahoma City & Warr Acres Medicaid attorneys at today to learn more.


More like this

How Do I Sign Up For Pregnancy Medicaid

Can Uninsured...

Dentist Who Accept Medicaid For Braces

Why Medicaid...

Do Chiropractors Take Medicaid In Nc

I Followed...

How To Find Your Medicaid Number

I'm Not...