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OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:25-7-13. Enrollment ineligibility

[Revised 09-01-21]

Members in certain categories are excluded from participation in the SoonerCare Choice program. All other members may be enrolled in the SoonerCare Choice program and subject to the provisions of this Subchapter. Members excluded from participation in SoonerCare Choice include:

(1) Individuals receiving services in a long-term care facility, in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), or through a Home and Community Based Waiver;

(2) Individuals in the former foster care children's group [see Oklahoma Administrative Code (OAC) 317:35-5-2];

(3) Individuals in benefit programs with limited scope, such as Tuberculosis, Family Planning, or pregnancy only;

(4) Non-qualified or ineligible aliens;

(5) Children in subsidized adoptions;

(6) Individuals who are dually-eligible for SoonerCare and Medicare; and/or

(7) Individuals who have other creditable coverage.

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.

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Oklahoma Health Care Authority

4345 N Lincoln Blvd

Oklahoma City, OK 73105

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The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.