Long Term Services and Supports
Long Term Care
Long term care offers additional benefits to members who are enrolled in SoonerCare. Care can be in a facility, in the home or a housing setting, or self-directed. These are some of the services under SoonerCare:
Nursing Home Care
This if for persons that cannot take care of their needs in the home or in the community. There are many nursing care homes in the SoonerCare network that can help. The nursing home or your local OHS county office can help you apply for this service.
Helps eligible persons ages 65 and older and persons with physical disabilities ages 21 and over. This program helps members safely live in their homes. This program may also provide help in an assisted living home that is approved by Medicaid. To apply, call 800-435-4711 or go to your local DHS county office.
This is another option for some adults so they can stay in their home or other home-like setting. The program serves SoonerCare adults ages 19 years and older. These are persons who have a medically fragile condition and meet hospital and/or skilled nursing level of care.
A program for adults with disabilities and/or long-term illnesses that are ages 19 and older. It helps a person move into their own home in the community. It also gives the needed support and services to stay in the home.
Allows the person to handle all parts of their care. This means you can decide who provides your care and how services are provided. This gives you the right to recruit, hire, train, and direct those that supply any services.
Program of All-Inclusive Care for the Elderly (PACE) is a waiver that provides medical services and supports everyday living needs for certain elderly individuals. Most of these individuals are eligible for benefits under both Medicare and Medicaid. Care is provided by a team of skilled staff to those in the program.
Long Term Care FAQs
SoonerCare helps pay for nursing home care for some individuals. It does not pay for nursing home care for everyone. To find out if you can get help with paying for your nursing home care, apply at your local county Oklahoma Human Services. The caseworker can help you fill out your application. You will need to complete the Request for Benefits form (08MP001E) to apply for SoonerCare. Download a copy of the form or call your local OHC county office and ask for an application.
For applications that are approved, most will start the month you apply. You may be eligible for SoonerCare for up to three months before the month you apply. If you have any unpaid medical bills, you should let your caseworker know. SoonerCare will review your bills. You may have bills that SoonerCare can help pay for during the dates you have SoonerCare.
To qualify for long term care, you must meet requirements for both income and medical status. There are limits that SoonerCare looks for to qualify. Your caseworker looks at your age, health, marital status, daily living status, and income which include resources. To find out if you qualify for any long term care services, contact your local OHS county office.
It can take up to 45 days after the caseworker receives your request.
It can be different depending on the program. For the ADvantage, Living Choice and Medically Fragile Waiver programs, it is a nurse. The nurse will ask questions using the Uniform Comprehensive Assessment Tool (UCAT). The questions asked are about the person’s health and social activity. For nursing home care, it is the nursing home that determines for services. They use the Preadmission Screen and Resident Review (PASRR). This determines the best care setting and type of services for each resident.
A nursing home is not the same as an assisted living community. A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home. Nursing homes provide 24-hour care within a home-like setting. This includes meals, snacks, personal care, help bathing, dressing, and other types of care.
Assisted living communities are set up to feel like a person’s own home. Residents usually live in their own apartment or suite with their own bathroom and mini kitchen. In assisted living, the resident can carry out actions of daily living such as bathing, dressing, and using the restroom with some help. They mainly offer social support to those that can live on their own.
You may have to pay part of your income to the nursing home for your care.