SoonerCare Traditional Expansion Benefits Guide
Expansion for Adults 19-64
MEMBERS IN SOON-TO-BE SOONERS RECEIVE PREGNANCY AND MATERNITY SERVICES ONLY. THE INDIVIDUAL WHO IS COVERED FOR PREGNANCY-RELATED BENEFITS UNDER SOON-TO-BE-SOONERS RETAINS ELIGIBILITY UNTIL THE END OF THE PREGNANCY. SECTION 317:30-22-8
|Home and CommunityBased Services (HCBS)1915(c) Waiver Programs||HCBS members receive the SoonerCare Traditional services in addition to the HCBS services within the waiver program they are enrolled which are: ·Advantage Waiver Program Services ·Medically Fragile Program Services ·Community Waiver Program Services ·Homeward Bound Program Services ·In-Home Supports for Adults Program Services ·In-Home Supports for Children Program Services Members in HCBS waiver programs only pay copays for prescriptions as follows: $0.65 copay per drug costing $10.00 or less; $1.20 copay per drug costing $10.01-$25.00; $2.40 copay per drug costing $25.01-$50.00; $3.50 copay per drug costing $50.01 or more.|
The covered benefits list provided is not all-inclusive. All covered benefits must be medically necessary. Coverage of above benefits is dependent upon meeting requirements provided in accordance with various state and federal regulations. Please verify coverage or consult with a SoonerCare helpline representative prior to receiving services. Coverage, copays and limitations are subject to change. Updated December 19, 2022.