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January 2023
Eligibility renewals for SoonerCare are returning after they were paused by federal legislation in 2020. OHCA will begin processing renewals in 2023, and some members are expected to be ineligible for SoonerCare coverage.
Examples of reasons why a member may no longer qualify for benefits include:
- Your income is now higher than the required amount to receive SoonerCare benefits.
- Someone has moved in or out of your household.
- Your contact information and documents are not updated at MySoonerCare.org.
What You Need to Do
- Ensure your contact information and documentation are current by logging into your account at MySoonerCare.org.
- If you are pregnant, become pregnant or have recently been pregnant, be sure you have notified SoonerCare. This may increase the period you are eligible for coverage.
- Watch your mailbox for a purple letter from SoonerCare. If you are ineligible, this letter will give you more information about the process and what’s next.
- Members who are found ineligible may qualify for coverage through the Federal Health Exchange. You will be provided with more information about what to expect if this applies to you.
Please go to MySoonerCare.org to learn more.
How many people in Oklahoma do you think live with mental illness — 100,000? 200,000? The answer is more than 750,000! Surprised? That means 1 in 4 Oklahomans has a mental health condition.
For some, that means self-medicating their symptoms by binge drinking or smoking. For others, it might mean depression or anxiety. Still others live with schizophrenia or bipolar disorder. For many people, mental health drugs help them feel better, but all drugs come with a chance of side effects. Knowing the possible side effects is important!
So, let’s take a look at antipsychotic drugs. This is one class of drugs that can have more serious side effects than some other mental health drugs. These effects include:
- Weight gain
- High blood sugar
- Low blood pressure
- Feeling sleepy
- Dry eyes
- Dry mouth
- Constipation
- Having trouble urinating
- Changes in menstruation
- Breast changes
- Uncontrollable body movements
- Heart problems
- Cataracts
- Sexual problems
- Liver changes
Some of these can be very serious or even permanent. The risk of side effects is even greater for children, especially for those taking more than one antipsychotic drug. Some side effects, like blood sugar or liver changes, won’t be felt. They can only be found by having regular lab work and other tests. Talk to your health care provider about the risks and benefits of these drugs. Be sure to ask them if it’s time to have your lab work done.
Please visit OHCA to learn which mental health drugs are covered by SoonerCare. Some drugs may need a prior authorization. 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 drug’s coverage or if you have other pharmacy benefit questions.
OHCA is working to improve your SoonerCare member experience. To make it the best it can be, we will be mailing surveys to a random sample of members. The survey covers topics such as adult health, child health, behavioral health and dental services.
If you are a member who receives a survey in the mail, there will be a link and phone number provided so you can choose to complete the survey online or by phone. The survey will be available in English and in Spanish. Each survey only takes a few minutes to complete. Please help us by completing your survey so we can work to better improve your member experience. Thank you!
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Prenatal vitamins help your baby grow. They build healthy bones, teeth, eyes and skin. PNVs have folic acid and other vitamins and minerals. Your baby’s brain and spinal cord need folic acid before you even get pregnant.
Take a daily prenatal vitamin before, during and after pregnancy. Prenatal vitamins have these important vitamins and minerals:
Staying active is good for you and your baby too. Your baby also needs you to eat fruits and vegetables every day. If you’re pregnant, avoid drinking alcohol and smoking. See your health care provider regularly and make a PACT to choose things that will help prevent birth defects.
Ask your health care provider which prenatal vitamin is best for you. SoonerCare covers most prenatal vitamins at no cost for female members of childbearing age. Prenatal vitamins do not count against the monthly script limit. For additional information, please visit SoonerCare Pregnancy Services and Nutrition During Pregnancy. If you have questions about prenatal vitamin coverage, please call the Pharmacy Help Desk at 405-522-6205, option 4, or toll-free at 800-522-0114, option 4.
OHCA has expanded SoonerCare coverage to young adults under 26 who were in foster care at age 18 or older. Coverage is already in place for those who aged out of foster care at the age of 18 in Oklahoma. New expanded coverage extends to those who recently moved to Oklahoma from another state.
To be eligible, individuals need to be former foster care youth who were enrolled in Medicaid in another state when they aged out of foster care at the age of 18 on or after Jan. 1, 2023, and who now reside in the state of Oklahoma. Those individuals are eligible for enrollment up to age 26.
To learn more about eligibility and enrollment, call the SoonerCare helpline at 800-987-7767 or visit MySoonerCare.org.
A new program has launched in Oklahoma that supports mental health care for younger SoonerCare members. The program, OKCAPMAP, is a statewide initiative that allows primary care providers to offer consultation, education and referral assistance to children and adolescents. Services must be provided in a primary care setting.
The OKCAPMAP team will partner with your doctor to detect, diagnose and treat mental health disorders. Awareness, knowledge and information are key steps in supporting a child's mental health journey.
Ask your primary care provider about OKCAPMAP and if it can help your child. Learn more about the program here.
IRS form 1095-B is not required to file your taxes. An IRS 1095-B form will be issued to all SoonerCare members who were listed as the case head on their application for the previous calendar year. The 1095-B form will include all other members listed on that case.
You can print a copy from the letters section of your MySoonerCare.org account. If you would like a form mailed to you, please contact the SoonerCare helpline at 800-987-7767.
If OKDHS made your SoonerCare eligibility determination, then you will not have a MySoonerCare.org account. Instead, you will need to call the SoonerCare helpline at 800-987-7767 to request the form be mailed to you. For more information, please visit the 1095-B tax information page on our website.
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.
About OHCA
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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