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SoonerCare Renewals Are Coming Back

You could be at risk of losing SoonerCare for you and your family if you do not update your information.

Due to the COVID-19 pandemic, routine SoonerCare eligibility renewals were paused as part of the Public Health Emergency (PHE). Medicaid agencies were required to continue health care coverage for members, even if their eligibility changed. This means members could continue being covered by SoonerCare during the PHE, even if they no longer qualified.

Oklahoma will soon be required to restart eligibility reviews for all SoonerCare member due to the passage of federal legislation in December.

Eligibility renewals will resume beginning in spring 2023. Currently, OHCA plans to first notify impacted members in February.

If you do not receive a notice from OHCA then your coverage will not be impacted and you do not need to take any further action.

Below is a timeline of events and additional information. Please review the information before calling the SoonerCare helpline. If you need further assistance, call the helpline at 800-987-7767.

What is next?

Timeline of events

OHCA will alert affected members beginning Feb. 2023. Those members determined to be eligible will continue to receive SoonerCare benefits.

Those members determined to be ineligible for benefits will be removed from SoonerCare in phases throughout the year using a compassionate risk-based approach, focusing on member utilization and critical health issues.

First Letter

 

The first letter will let impacted members know that renewals are restarting and will be printed on purple paper.

 

Second Letter

The second letter will include the member’s coverage end date and the reason for ineligibility. At this time, the coverage end date will be listed on MySoonerCare.org.
 

Third Letter

 

OHCA will send a third letter 45 days before coverage end date.



 

Fourth Letter

 

OHCA will send a fourth letter 10 days before coverage ends. This will be the member’s last chance to verify eligibility if all SoonerCare requirements are met.


Steps to take if you are no longer eligible for SoonerCare.

Members should take time to think about their health care needs and plan in case their SoonerCare coverage ends.

If your account information is not current, your SoonerCare coverage may end when renewals begin. Please update your account to reflect changes in any of the following:

  • Phone number
  • Email address
  • Mailing address
  • Income
  • Household
  • Missing documents or social security number
  • Pregnancy status

Losing coverage is a Qualifying Life Event (QLE), which allows an individual to enroll in a Federal Health Insurance Marketplace plan outside of the Open Enrollment Period.

There will be a special enrollment period on the Affordable Care Act Marketplace for those who lose their Medicaid coverage due to the return of eligibility renewals. The special enrollment period will stretch from March 31, 2023 to July 31, 2024. If a member is no longer eligible for SoonerCare, OHCA will send their information to the ACA Marketplace. To find local, in-person help with finding a health care plan that is right for you on the ACA Marketplace, go to www.healthcare.gov/find-assistance.

Members are encouraged to visit HealthCare.gov or call the Federal Health Insurance Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

Members can also send a paper application (English / Spanish) to the federal health insurance marketplace at:

Health Insurance Marketplace
Dept. of Health and Human Services
465 Industrial Blvd.
London, KY 40750-0001

CMS - Health Insurance Marketplace Outreach and Education
HealthCare.gov
HealthCare.gov - Qualify for Special Enrollment Period
MySoonerCare.org
OHCA – Individual Resources
Oklahoma Insurance Department - Insurance Basics
Oklahoma Insurance Department - Health Insurance Basics

2022 Oklahoma Issuers Coverage
BCBSOK

All 77 counties in Oklahoma

Medica

All 77 counties in Oklahoma

Ambetter

Canadian, Carter, Cleveland, Comanche, Creek, Garvin, Lincoln, Logan, Mayes, McClain, Muskogee, Oklahoma, Okmulgee, Payne, Pontotoc, Pottawatomie, Rogers, Seminole, Tulsa

Community Care of OK (CCOK)

Cleveland, Craig, Creek, Huges, Mayes, McIntosh, Muskogee, Nowata, Oklahoma, Okmulgee, Osage, Pawnee, Pittsburg, Rogers, Tulsa, Wagoner, Washington

Friday Health

Comanche, Canadian, Cleveland, Oklahoma, Okmulgee, Osage, Rogers, Tulsa, Wagoner, Garfield, Mayes, Payne, Stephens

Oscar Health

Canadian, Cleveland, Logan, Oklahoma

United Health Care (UHC)

Canadian, Cleveland, Oklahoma, Rogers, Tulsa

Navigate Low-Cost Insurance

Tulsa Responds navigators can help SoonerCare members, who may lose coverage at the end of the PHE, by helping them enroll in an affordable healthcare plan through the marketplace. These services are available to all Oklahomans via phone appointment. Navigators also offer SoonerCare enrollment assistance and benefit support via phone and in-person staffing at several locations throughout Tulsa. Members can select their desired location to see available appointments at that site. Walk-ins are also welcome at in-person locations.


MyOKPlan has free, local non-profit navigators statewide to assist Oklahomans with healthcare.gov applications to find discounts when enrolling in Marketplace plans. MyOKPlan is sponsored by the non-profit Legal Aid Services of Oklahoma. More than 189,000 Oklahomans use the Federal Health Insurance Marketplace health care plans and 95% of those receive financial assistance to lower costs.


Community health centers offer comprehensive primary care to over 300,000 Oklahomans regardless of income or insurance status. Twenty-two community health centers operate 140+ sites, with many providing dental, optometry, behavioral health, and substance use disorder services. Services are provided on a sliding fee scale based on income for patients with incomes below 200% of the federal poverty level. For more information about community health centers, visit www.okpca.org/community-health-centers and contact your local health center.


There are several additional community resources available to Oklahomans that may be helpful for members and their families.


Unite Oklahoma

The Oklahoma Health Care Authority and Unite Oklahoma have partnered to help SoonerCare members who may no longer be eligible due to Medicaid renewals. Unite Oklahoma is a coordinated partnership between community-based organizations, healthcare providers, and government agencies. Unite Oklahoma will help impacted members find alternative forms of coverage and other supportive services.

After you submit this form you will be contacted by someone from Unite Oklahoma (a number that starts with 866) to help you find assistance.

Last Modified on Jul 06, 2023