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Medicaid Expansion

Overview

On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. This equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four.

Starting June 1, 2021, those adults eligible under the expanded Medicaid guidelines can apply for SoonerCare benefits. Benefits for those who qualify will begin on July 1, 2021.

How can people apply?

  • Apply online at www.MySoonerCare.org.
  • Apply by phone by calling the SoonerCare Helpline 800-987-7767.
  • Fill out an English or Spanish paper application and mail it to the address on the application.
  • Apply through one of our agency partner facilities.
     

Training opportunities are available for community partners.
Email CommunityPartners@okhca.org if your organization is interested in training.
A toolkit is available for community partners at on our Community Partners page.


2021 SoonerCare Income Guidelines for Expansion Adults (effective: 07/01/2021)

Size of Family 1 2 3 4 5 6 7 8 9 10
Monthly
Income
$1,483 $2,004 $2,526 $3,049 $3,571 $4,092 $4,615 $5,130 $5,652 $6,175

Cont'd

Size of Family 11 12 13 14 15 16 17 18 19 20
Monthly
Income
$6,696 $7,218 $7,741 $8,263 $8,784 $9,307 $9,829 $10,350 $10,874 $11,395

Medicaid Expansion Funding

Ninety percent of costs for expansion enrollees will be paid by the federal government.  

Maximizing federal funding allows the state the ability to:

  • Promote integrated care and improve health outcomes, explore reinstating an adult dental benefit in SoonerCare, with a focus on preventive dental services. 
  • Pursue substance use disorder and serious mental illness waivers to expand access to prevention and treatment services. 
  • Coordinate with jails and prisons to help former inmates apply for SoonerCare coverage upon release, helping them get access to important behavioral health services immediately, thus reducing the risk of recidivism. 
  • Help jails and prisons capture additional SoonerCare funding for hospitalizations and surgeries as allowed under federal Medicaid law.

Frequently Asked Questions

Benefits for those eligible adults will go into effect on July 1, 2021.

Those who are eligible for SoonerCare benefits through Medicaid Expansion will be able to apply beginning June 1, 2021. Enrollment for benefits will start on July 1, 2021.

Benefits for existing SoonerCare members will not change because of Medicaid expansion.

This is the income limit allowed for the adult expansion population under federal law. However, with applicable income disregards, the effective FPL is 138% FPL.

There are no premiums for members in the newly expanded SoonerCare population.

However, non-pregnant adults will be charged copayments up to the 5% out-of-pocket cost sharing limit, unless exempted from cost sharing requirements.

No, to qualify for Medicaid expansion you cannot have Medicare or be entitled to Medicare. (OAC 317:35-5-9)