Skip to main content

OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:30-5-552 Coverage by category

(a) Adults. SoonerCare does not cover adults [twenty-one (21) years of age and over] for paid family caregivers.

(b) Children. SoonerCare does cover children [under twenty-one (21) years of age] if:

(1) The member is eligible for SoonerCare; and

(2) The Oklahoma Health Care Authority (OHCA), in its discretion, deems the services medically necessary. Medical necessity is determined in accordance with Oklahoma Administrative Code (OAC) 317:30-5-560.1.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.