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November 2020
- Cost sharing applies to adults with coverage from ages 19 to 64 and is based on 5% of monthly household income.
- Children up to 18 years of age, pregnancy related services, family planning, tobacco cession products and emergency services are exempt and have no copays or cost sharing.
- American Indian/Alaska Natives do not have cost sharing on services.
- Individuals who applied at a DHS office should contact their case worker if they have questions about their household income.
- If you paid a copay in error, please contact the provider.
- Members with questions or concerns about cost sharing should call the SoonerCare helpline at 800-987-7767 for assistance.
Don't forget! If you or your children have a primary insurance, SoonerCare needs to know! Please update in your member portal or call the SoonerCare helpline at 800-987-7767.
- When sending in documents, please be sure to put a case number, Social Security number or member ID number on each document. This will ensure we have your correct information to update the case.
- Don’t forget to check your e-mail for notifications about your case. We don’t want you to miss important information or new updates!
- If you have not updated your newborn's Social Security number, this must be done prior to your newborn's first birthday.
Do you need proof of receiving unemployment benefits or fraudulent claims? Please contact Oklahoma Employment Security Commission (OESC) for assistance at 405-525-1500 (inside OKC area) or 800-555-1554 (outside OKC area).
For information about reporting a fraudulent unemployment insurance claim visit, www.ui.ok.gov.
SoonerRide is still transporting SoonerCare members to and from doctor appointments. Please be sure to wear your mask during your trip to keep you and other passengers healthy. Below are some of our most common questions about SoonerRide and COVID-19 testing.
Q: I think I may have COVID-19. Can I use SoonerRide to go to the doctor?
A: No. For the safety of other passengers, SoonerRide is not able to transport members who have COVID-19. However, we can assist with gas reimbursement. Please call the SoonerRide helpline at 800-243-5560, extension 2203, between 14 days and 24 hours before your scheduled appointment for more information.
Q: I need a COVID-19 test. Will SoonerRide take me to a drive-thru testing site?
A: No. Since SoonerRide is a curb-to-curb service, they are not able to take members to these sites. However, we can provide gas reimbursement or bus passes. If you have a special circumstance or questions, please call the SoonerRide helpline at 800-243-5560, extension 2203, or the member helpline at 800-987-7767 for more information.
Q: I need a COVID-19 test before my scheduled procedure. Will SoonerRide transport me to my primary care doctor’s office for a test?
A: Yes. As long as you do not have any symptoms of COVID-19 such as cough, high fever or loss of taste or smell.
If you have not gotten a flu shot yet, it is more important than ever to do so. Getting the flu can make the impact of COVID-19 on your body even worse. The flu shot is recommended for almost everyone six months of age or older. It can help prevent the flu or make the illness less severe if you do get it.
SoonerCare members can receive flu vaccines for free at your local county health department or through your primary care provider.
Children up to 18 years of age are eligible to receive vaccines at no charge through the Vaccines for Children (VFC) program if any of the following apply:
- They are Medicaid eligible
- Uninsured
- Native American Indian or Native Alaskan
- Their insurance policy does not cover vaccines.
Free flu shots are available at health care providers enrolled in the VFC program, including all local county health departments and community health centers (CHC).
Uninsured adults may be able to get a flu shot at no out-of-pocket cost at most local county health departments and CHC across Oklahoma.
Insured adults and children are able to get a flu shot for free at their health care provider or at a local pharmacy. Coverage can vary among different insurance plans.
Where people get their flu shot this year may need to change due to the COVID-19 pandemic. Many places follow strict guidelines to create a safe environment for the community. It is easy to find a flu vaccine available at different providers at VaccineFinder.org.
Flu vaccines are covered for adults 19 years of age or above either at a contracted pharmacy that chooses to administer flu vaccines or a contracted provider office. Flu vaccines administered by pharmacies DO NOT count against a member’s monthly prescription limit and have NO copay to members.
If you need to see a medical provider after hours, visit http://afterhoursok.com/ to find one near you. If you are experiencing a medical emergency, please call 911 or go to your nearest emergency room.
SoonerCare dental checkups have decreased during the COVID-19 pandemic. Please make sure your child is getting into a dental provider every six months.
Members seeking orthodontic therapy (braces) will need to be referred to an orthodontist by a general dentist that accepts SoonerCare. This means even if you see a dental provider with other insurance, the referral for braces still must come from a dentist who accepts SoonerCare.
Tooth decay in the form of cavities is the most common dental disease for children, but it is mostly preventable. Once tooth decay begins, it will only continue to get worse if there is no treatment — even in babies. It is important to take care of any necessary dental work to prevent pain and tooth loss.
Tips for Good Oral Health During the COVID-19 Pandemic:
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Brush teeth regularly. Help your children brush their teeth two times a day for two minutes each time and use toothpaste with fluoride.
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Offer fluoridated water. Offer your child plain milk with meals and fluoridated water (tap water if your city fluoridates the water) in between. Avoid juice, especially in sippy cups, as this is likely to cause cavities. Also limit soda.
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Avoid sugary foods and junk food. Diet affects dental health. The longer and more frequently your child's teeth are exposed to sugar and other foods that stick in the teeth (chips, cookies and crackers), the greater the risk of cavities.
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Dental checkups. Dental offices are following CDC and OSHA recommendations to make sure patients and dental team members stay safe. Call your dentist to learn about their new procedures for seeing patients before scheduling a visit.
Need to speak with a SoonerCare helpline representative? Follow the steps below, even if they do not all apply to you, to get connected to a representative. We can check for documents, discuss benefits, help you apply for SoonerCare, or assist you with any other questions or issues you may have.
The SoonerCare and Insure Oklahoma Facebook and Twitter pages are no longer active. Follow Oklahoma Health Care Authority on Facebook and Twitter for updates, new policies, health tips, helpful resources and more! You can find OHCA's profiles by clicking the links below.
Our vision is for Oklahomans to be healthy and to have access to quality health care services regardless of their ability to pay.
OHCA Core Principles:
Passion for Our Purpose
Empowerment and Accountability
Trust and Transparency
Solution-oriented
Servant Leadership
The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.
Please submit any questions, comments or content suggestions to Aaron Askew (aaron.askew@okhca.org) from OHCA's strategic communications office: 405-522-7403.
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