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Health Plans

Dental Plans

Children's Specialty

SoonerSelect Choice Counseling

Members can choose between three health plans:

Health plans cover medically necessary prescriptions, health services, and behavioral health services, except dental services. SoonerSelect dental plans cover dental services. All health plans provide you with the same health care services currently offered by SoonerCare, but some may offer extra benefits to help improve your health. We know that choosing the right health plan for you and your family is a very important decision. SoonerCare call center representatives are prepared to answer questions you may have about your health plan choices and help you make the right choice in your decision.

Members can choose between two dental plans:

Dental plans cover medically necessary preventive and restorative dental care. Additionally, medically necessary orthodontic services are available for children under 21.

Eligible SoonerSelect children and youth will be enrolled in the SoonerSelect Children’s Specialty Program (CSP):

The SoonerSelect children’s specialty program serves SoonerSelect children and youth served by Oklahoma Human Services Child Welfare Services, including children in foster care and receiving adoption assistance, and those involved in the juvenile justice system.

The SoonerSelect Children’s Specialty Program covers medically necessary prescriptions, health, and behavioral health services, except dental services. SoonerSelect Dental plans will cover dental services.

The SoonerSelect Children’s Specialty Program has a strong focus on the unique health and behavioral health needs of those children served. It places special emphasis on early identification of needs and interventions.

Only certain SoonerCare populations can enroll in a SoonerSelect plan. The following SoonerCare groups are eligible to enroll in SoonerSelect:

  • Children, including foster children
  • Low-income parents
  • Pregnant women
  • Non-disabled adults ages 19-64

 

Not all SoonerCare populations will move to SoonerSelect. The following individuals are excluded from enrollment in SoonerSelect and will still have services administered by the Oklahoma Health Care Authority:

  • Dual eligible Individuals 
  • Individuals enrolled in the Medicare Savings Program, QMB, SLMB, QDW and QIs.

  • Persons with a nursing facility or Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) level of care (LOC) 

  • Individuals during a period of presumptive eligibility

  • Individuals infected with tuberculosis eligible for tuberculosis-related services  

  • BCC enrolled individuals

  • Individuals enrolled in a § 1915(c) waiver  

  • Undocumented persons eligible for emergency services only 

  • Insure Oklahoma ESI dependent children 

  • Coverage under Soon-to-be-Sooners

  • ABD individuals, including children covered under the TEFRA program

  • Populations that remain enrolled due to the continuous enrollment and maintenance of effort (MOE) requirement of the Families First Coronavirus Response Act (FFCRA)


American Indian/Alaskan Native (AI/AN) Members

Eligible American Indian/Alaskan Native (AI/AN) members can opt into SoonerSelect. If AI/AN members do not opt into SoonerSelect, they will remain in their current SoonerCare program and continue receiving services in the same way. If an AI/AN member opts in but does not pick a plan, OHCA will assign a SoonerSelect plan to the member. AI/AN members can opt in and enroll with a SoonerSelect plan by: 

  1. Logging into their MySoonerCare.org account and selecting “change plan/provider.” From there, the enrollee can choose to opt in and select their plan of choice.

  2. Calling the choice counseling line at 800-987-7767 to ask questions, receive information on plans, choose to opt in, or to select or change plans.  

The plan the enrollee is enrolled with the day the lock-in period starts (90 days post initial enrollment) is the plan the enrollee will remain in until the next open enrollment period. AI/AN enrollees can request disenrollment from their plan without a good cause reason.  If an AI/AN member chooses not to enroll or to enroll then disenroll, the AI/AN member will be able to opt in again at the next open enrollment period. 

 

FFCC and children receiving adoption assistance

The SoonerSelect Children’s Specialty Program is the health care plan that covers all Medicaid services (other than dental) for children in foster care, former foster care children (FFCC), juvenile justice involved children and children receiving adoption assistance.

FFCC and children receiving adoption assistance are enrolled in the SoonerSelect Children’s Specialty Program automatically. If you are part of these groups, you may opt out of enrollment in the SoonerSelect Children’s Specialty Program and enroll with a SoonerSelect plan.

Former foster care children may opt out of enrollment in the SoonerSelect Children’s Specialty Program and enroll with a SoonerSelect plan by:

  1. Logging into your MySoonerCare.org account and selecting “change plan/provider.” From there, select the plan in which you would like to enroll.

  2. Calling the choice counseling line at 800-987-7767 to ask questions, receive information on plans, or to select or change plans.

Children receiving adoption assistance may opt out of enrollment in the SoonerSelect Children’s Specialty Program and enroll with a SoonerSelect plan by:

  1. Calling the SoonerCare helpline at 800-987-7767 to ask questions, receive information on plans, or to select or change plans.

You can change your plan within the first 90 days after enrollment. The period after the first 90 days until the next open enrollment period is called the lock-in period. Once the lock-in period begins, you will remain in your plan until the next open enrollment period unless a disenrollment request is approved, or you become ineligible for SoonerSelect.

 

Children in Tribal custody

Children in tribal custody and juvenile justice involved children can voluntarily enroll in SoonerSelect Children’s Specialty Plan by choosing to opt in. This population can voluntarily enroll in the SoonerSelect Children’s Specialty Plan at any time. If they would like to enroll in a SoonerSelect plan, they can do so by:

  1. Calling the SoonerCare helpline at 800-987-7767 to ask questions, receive information on plans, or to select or change plans. 

The plan the enrollee is enrolled with the day the lock-in period starts (90 days post initial enrollment) is the plan the enrollee will remain in until the next open enrollment period. AI/AN enrollees can request disenrollment from their plan without a good cause reason.  


SoonerSelect Member Resources

Video Tutorials - Watch step-by-step guides on how to pick or change your SoonerSelect plan(s).


Member Checklist - Have an appointment soon? Save this graphic and make sure you're ready.


SoonerSelect CSP Member Guide - Everything you need to know about the Children's Specialty Program before your child's next appointment.


SoonerSelect Dental Member Guide - Everything you need to know about your SoonerSelect dental plan before your next appointment.


SoonerSelect Health Member Guide - Everything you need to know about your SoonerSelect health plan before your next appointment.


SoonerSelect FAQs - Learn more about SoonerSelect, who qualifies and how to enroll.


Health Plan Information - View benefits guides, provider directories, member handbooks, outreach events and contact information for each health plan.


Dental Plan Information - View benefits guides, provider directories, member handbooks, outreach events and contact information for each dental plan.

OHCA Choice Counseling Hotline

(800) 987-7767
Option 5

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Last Modified on Sep 10, 2024