Postpartum Coverage
Postpartum coverage provides health care services after a woman’s pregnancy ends. Extended postpartum can help lower the risk of pregnancy-related deaths and complications for the mother. It can also help with ongoing care for chronic conditions such as diabetes, high blood pressure, heart disease, substance use disorder and depression.
You can get 12 months of postpartum care if:
- You are in a Medicaid program that covers the birth of a child. This includes Medicaid for pregnant women.
- You were a SoonerCare member while pregnant sometime between Jan. 1 and Dec. 31, 2022, but you are no longer pregnant and were a SoonerCare member on Jan. 1, 2023.
- Your pregnancy ended 60 days before Jan. 1, 2023 (between Nov. 1-Dec. 31, 2022).
- You become pregnant on or after Jan. 1, 2023.
Postpartum care starts when your pregnancy ends. Your 12-month postpartum care period will end on the last day of the 12th month.
12 Months Continuous Eligibility
If you are in the SoonerCare for Pregnant Women program, you will get full Medicaid benefits for 12 months postpartum beginning Jan. 1, 2023. You can get full Medicaid benefits even if you have a life change, such as:
- A change in income.
- A change in your household. For example, you get married or divorced.
For the postpartum care benefit, life changes that would not qualify for continued Medicaid coverage include:
- If you move to a new state.
- If you ask to leave the Medicaid program.
What Do I Need to Do?
IMPORTANT: To get postpartum coverage for 12 months, you must tell SoonerCare when one of the following occurs:
- When you become pregnant.
- If your due date changes.
- When your pregnancy ends.
Please tell SoonerCare by:
- Updating your information at MySoonerCare.org or calling the SoonerCare Helpline at 800-987-7767.
- Speaking to your Oklahoma Human Services caseworker if Oklahoma Human Services determines your eligibility.
Your case will update to show the 12-month postpartum care period.
When you report you are pregnant or have been recently pregnant, and are SoonerCare eligible, postpartum coverage is available.
Remember to update your contact information. If you or someone in your family recently changed their address, email address or phone number, tell SoonerCare. We will use your address to send important documents and information. Please tell SoonerCare by:
- Updating your information at MySoonerCare.org or calling the SoonerCare Helpline at 800-987-7767.
- Speaking to your Oklahoma Human Services caseworker if Oklahoma Human Services determines your eligibility.
What Services are Covered Under Full Medicaid?
Members receiving SoonerCare for Pregnant Women can get full Medicaid benefits from doctors, OB/GYNs, health departments and rural health clinics.
For example:
- Lactation (breast milk) consultation services
- Labs and X-rays
- Hospitals, anesthesia and outpatient surgical centers
- Alternative treatment for pain management
- Prescriptions
- Dental services
- Medical equipment, such as wheelchairs wheelchairs (breast pumps are available through WIC)
- Mental and behavioral health care
Some services may need a referral, prior approval by your doctor, or a small copay.
What If I Have Questions?
If you have questions on coverage please call the SoonerCare helpline at 800-987-7767.
