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July 2022
Oklahoma's new 24/7 mental health hotline launched on July 16, 2022. 988 is a direct, three-digit lifeline that connects callers with trained behavioral health professionals who can talk through what's going on and provide resources for either yourself or your loved one. The lifeline accepts calls, texts and chats from anyone who needs support for a suicidal, mental health and/or substance use crisis.
To learn more about the 988 crisis line, visit the Oklahoma Department of Mental Health and Substance Abuse Services website or watch the video below.
If you or a loved one is experiencing a mental health crisis, dial 988 for support.
School will be back in session before you know it! Is your child ready?
Regular dental visits are important year-round, but a back-to-school checkup is key in fighting the most common chronic disease found in school-age children: cavities. In fact, dental disease causes children to miss more than 51 million school hours each year.
Summer is also a good time to make sure your child's immunizations are up to date. Immunizations are important for your child's health and are covered by SoonerCare. Find immunization schedules and resources on the OHCA website.
At the beginning of the COVID-19 pandemic, the federal government declared a public health emergency (PHE). During the PHE, we are required to continue SoonerCare coverage for all members even though there are some members who no longer qualify for benefits.
Example of reasons why a member may no longer qualify for benefits:
- Your salary is now higher than the required amount to receive SoonerCare benefits.
- Someone has moved in or out of your household.
- Your contact information and/or documents are not updated at mysoonercare.org.
It was recently announced the PHE is extended another 90 days. This means members, who typically wouldn’t qualify for benefits possibly due to the reasons above, will continue to receive their SoonerCare benefits until October 31st.
There will come a time when the PHE will end. Once we know the day, we will send notifications to those people who no longer will receive SoonerCare benefits. Those members determined to be ineligible for benefits will be removed from SoonerCare in phases focusing on the member’s benefit utilization and critical health issues.
Members who are ineligible will receive three notices:
- An initial notification letter will be mailed once the end of the PHE is announced. This notification letter will detail the specific end date of benefits for those determined ineligible. It is important you update your mailing address at mysoonercare.org as soon as possible, so you receive this notification.
- A second notice will be sent to ineligible members 45 days prior to their scheduled end date to inform them of the reason for loss of eligibility, potentially missing documents to verify eligibility and appeal rights.
- A third notice will then go out 10 days before the ineligible member loses eligibility.
Members should take time to think about their health care needs and plan in case their SoonerCare coverage ends. Please go to mysoonercare.org to learn more.
Whether you are new to SoonerCare or have been a member for years, you may have questions about your pharmacy benefits. Here are a few of our most frequently asked questions (FAQs).
Question: If I have Medicare and SoonerCare, can I still get medications covered by SoonerCare?
Answer: If you have both Medicare and SoonerCare, you are known as dual eligible. Currently SoonerCare covers five types of medications for dual eligible members. Even if you do not have Medicare prescription coverage, also known as a part D plan, these are still the only medications SoonerCare covers for dual eligible members. One exception is diabetic testing supplies for members with gestational diabetes. SoonerCare covers those supplies for dual eligible members. Call 1-800-MEDICARE or the Senior Health Insurance Counseling Program at 1-800-763-2828 for more information about Medicare Part D coverage.
Question: How many prescriptions can I get each month? How many can be brand name medications?
Answer: Most adult members can get 6 prescriptions each month, and 2 of those can be brand name medications. Some are available as a 30-day supply, but many are available as a 90-day supply. SoonerCare encourages using a 90-day supply as much as possible! You will pay fewer copays, and it will be easier to have your medication ready when you need it!
Question: What kinds of diabetic testing supplies are covered by SoonerCare?
Answer: SoonerCare covers several brands of testing strips, meters, lancets, and continuous glucose monitors. Some diabetic testing supplies require prior authorization (PA), but for most members with type 2 diabetes, one test strip/lancet per day is covered without needing a PA.
Question: I already was approved for this medication. Why do I need a new authorization?
Answer: PA requests are approved for a specific medication, at a specific pharmacy, and from a specific health care provider. If any of these change, a new PA will be needed. All PAs need to be renewed at the end of 12 months, but some may need to be renewed after a shorter time.
Question: When should I know if a PA has been approved?
Answer: SoonerCare makes a decision within 24 hours of receiving all the necessary information from your pharmacy and provider. You can call the SoonerCare Pharmacy Help Desk at (405) 522-6205, option 4, or toll-free (800) 522-0114, option 4, if you have questions about a particular PA or if you have other pharmacy benefit questions.
For SoonerCare to fulfill your request, please make sure spam blocking is turned off on your phone. Sometimes when we return a call, it can show up as spam. Our phone number may also come up as a Colorado or Florida number on your caller ID.
Please call the SoonerCare helpline at 800-987-7767 if you have questions about your coverage or benefits. For updates on new policies, health tips, helpful resources and more, follow OHCA on Facebook and/or Twitter. 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.
 
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