Oklahoma Medicaid Eligibility and Enrollment

What Is Oklahoma Medicaid?

The Oklahoma Health Care Authority is the agency that oversees the state’s 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 1.3 million 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. 

Who Is Eligible for Medicaid in Oklahoma?

Medicaid is a federal program designed to cover certain medically necessary treatments for people who have limited income and few resources to pay for it. Oklahoma has several different Medicaid plans to choose from, depending on your health needs, age and income level. 

SoonerCare is the state’s Medicaid program jointly funded by the federal and state government that helps pay for some or all medical bills for beneficiaries that can’t afford them. SoonerPlan is a medical plan that provides limited services related to family planning and is available to low-income women and men ages 19 and older. The state also offers Oklahoma Cares, a program that provides SoonerCare benefits to uninsured women under the age of 65 who have been diagnosed with breast or cervical cancer. 

What Is Considered Low-Income in Oklahoma?

Enrollees must meet certain income and asset eligibility requirements to qualify for benefits. Medicaid eligibility is determined by your modified adjusted gross income (MAGI), 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 you’re 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 individual’s household income limit cannot exceed $1,579 a month for one person and $2,136 for two people. There are different income criteria for households with children under 19. 

Children can access health care through the State Children’s 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. 

Expanded Medicaid in Oklahoma

Starting July 2021, Oklahoma’s 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. 

How Do I Enroll in Medicaid in Oklahoma?

Applying for Medicaid in Oklahoma is a simple process, and enrollment is available all year. For children, pregnant women and low-income people with children under 18, applications can be completed online at the Oklahoma Health Care Authority website. 

You may apply using the online enrollment form if you fall into one the following categories: 

• Children (up to 19 years of age)
• Pregnant women
• Low-income non-disabled adults with children under the age of 19
• People 19 years and older who need family planning services
• Children and adults who need behavioral health services

If you are employed, self-employed, temporarily out of work or a working disabled person, you may apply online for Insure Oklahoma. 

Contact Information for Oklahoma Medicaid

Send all correspondence to the Oklahoma Health Care Authority at:

4345 N Lincoln Blvd.

Oklahoma City, OK 73105

For assistance with applying for SoonerCare online or other questions about the program, you can call the helpline at (800) 987-7767.