However, if you have specific questions about your health, please talk to your doctor. The medical home provider will coordinate all health care services to qualifying Oklahomans. Wednesday, December 16: You may experience intermittent connectivity to the Oklahoma Health Care Authority website between 4 p.m. and 10 p.m. We apologize for any inconvenience this may cause. Disclaimer: Clinical, legal and other comments are offered for general However, there are limitations that apply to ensure that only medically necessary services are provided. SoonerCare Choice is a Primary Care Case Management (PCCM) program in which each member has a medical home. SoonerCare (Oklahoma Medicaid) covers many health care services. Some members also have a provider that is part of a HAN and therefore have access to increased care coordination. OHCA Contact: Jo Kilgore, Public Information Manager, (405) 522-7474. Ultrasound benefits * Not covered under SoonerCare CHOICE. Part A - hospital related premium Part B - physician related premium Electronic Health Record Incentive Program, SoonerCare Out-of-State Services Rule Changes. SoonerCare Supplemental, a plan for people who are covered by Medicare. For more information on SoonerCare Choice, you can download a SoonerCare Member Handbook which will provide complete enrollment and coverage details. The medical home provider will coordinate all health care services to qualifying Oklahomans. If an eligible person has other medical insurance, that insurance company must be billed before SoonerCare is billed. However, there are limitations that apply to ensure that only... mysoonercare manage my account - Areaknowledge - … benefits, pharmacy, X-rays, maternity care, durable medical equipment, transplants and non-emergency transportation services. SoonerCare Choice is a primary care case management program. Behavioral health and substance abuse services (outpatient) Case management services. Insure Oklahoma provides premium assistance to small business employees and individuals. In exchange for this service, each PCP is prepaid a fixed monthly capitated payment for care … PCPs manage the basic health care needs, including after hours care and specialty referral of the members on their panel. We want to help you understand your SoonerCare Choice benefits. Some services are for children only. The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This website is not compatible with Internet Explorer. If you are experiencing difficulties, please try a different Internet browser (Chrome, Firefox, Edge or Safari). f) SoonerPlan: A limited package of family planning benefits. SoonerCare will pay for most of your medical care. Please visit our Qualification Guidelines page to find out if you qualify. Your PCP/CM may be a physician, a Your Primary Care Provider Both SoonerCare packages have health care providers called Primary Care Providers (PCPs) to take care of you and/ or your family’s basic health care needs. Keep up with your SoonerCare benefits online Family planning Spring is for the birds M is for Medical Home The Oklahoma Health Care Authority appreciates ideas and thoughts from families who receive services through SoonerCare Choice. To find out what insurance your SoonerCare Choice medical home may take, call your medical home's office. Waivers give states flexibility to The Oklahoma Health Care Authority Board Retreat … The following programs may provide additional services or more restrictions to the services covered above for enrollees. Hearing aids; Immunizations; Incontinence Supplies for certain children ages 4-20; Incontinence Supplies (Spanish) Inpatient hospital services for patients in institutions for mental disease; Optometric or optical services, including eyeglasses; Orthodontics It will tell you about any changes or updates to your SoonerCare benefits. If you are experiencing difficulties, please try a different Internet browser (Chrome, Firefox, Edge or Safari). SoonerCare also offers several critical but optional benefits to help members maintain or increase their health status and quality of life. You do not reside in an institution such as a nursing facility; You are not receiving SoonerCare services through a home- and community-based waiver program; You are not in a health maintenance organization. You may be a SoonerCare Choice member if: The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. SoonerCare Helpline (800) 987-7767 (800) 757-5979 (TDD) FAX: (405) 530-3426 www.OKHCA.org. September 20, 2010. All covered benefits must be medically necessary. It will also give you other useful news to help keep you healthy. Please verify coverage or consult with a SoonerCare or Insure OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law. SoonerCare Provider Enrollment Welcome to the online SoonerCare Provider enrollment application. SoonerCare Choice is a program run by the Oklahoma Health Care Authority (OHCA). Eligibility. •Medical home providers will receive traditional fee for service and incentive payments. SoonerCare Tobacco Cessation Benefit Research indicates that no other clinical intervention can reduce illness, prevent death, or increase quality of life more effectively than tobacco cessation. OHCA also pays the monthly Medicare Part B premium for SoonerCare members age 65 or older and for certain blind or disabled persons. When you have questions, please call the SoonerCare Helpline at 800-987-7767 or 711 (TDD). Additional services for children. The SoonerCare CHOICE program is located in the rest of the state. SoonerCare Qualification Guidelines (En español) In addition to the citizenship and the state residency requirements, an applicant must meet categorical and financial requirements. SoonerCare Supplemental. Electronic Health Record Incentive Program, SoonerCare Out-of-State Services Rule Changes, Comparison Chart of SoonerCare Benefits and Co-pay Amounts, Cost Sharing/Out-of-Pocket Cost Exemptions, Behavioral health and substance abuse services, Mental Health and Substance Abuse Services, Prenatal, delivery and postpartum services (maternity services), Incontinence Supplies for certain children ages 4-20, Clinic services including renal dialysis services, Dentures for adults residing in nursing facilities, Federally Qualified Health Center (FQHC) services, Inpatient hospital services in an institution for mental disease for people who are 65 years of age or older *, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) *, Medical supplies and equipment, including diabetic supplies, Transportation to obtain covered medical care (, Inpatient hospital services for patients in institutions for mental disease, Optometric or optical services, including eyeglasses, Speech, hearing and language disorder services, Breast and Cervical Cancer Treatment Services (, Home and community-based services authorized under a waiver (.
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