The Oklahoma Health Care Authority will transition to a new health care model called SoonerSelect following Gov. Kevin Stitt’s signing of two delivery system reform bills.
SoonerSelect will allow OHCA to better incentivize health outcomes while maintaining oversight and authority over Oklahoma’s Medicaid program and the program funding. The agency is committed to improving the health and lives of SoonerCare members and will hold its SoonerSelect partners to high standards through strong accountability measures.
The following SoonerCare populations will be impacted:.
Children, including foster children
Adults aged 19-64
American Indian/Alaska Native members are voluntary and will have the option to opt-in to a SoonerSelect plan. Tribal Health Care Updates
Prior to the start date, these members will be asked to choose from one of the dental plans and one of the medical plans.
Members will be able to compare the extra benefits provided by each health plan and choose the right one for them. Those who do not choose a plan will have one assigned to them. Members will have opportunities to switch their plan. The SoonerSelect plans are listed below.
To be announced later
All health plans will provide select Medicaid members the same health care services currently offered by SoonerCare but may offer extra benefits to help improve the health of its members.
Please keep your address up to date with SoonerCare to make sure you receive upcoming important information. You may do so at MySoonerCare.org.
Frequently Asked Questions for Members
SoonerSelect is a health care delivery system to facilitate member care, costs and quality. Oklahoma will partner with health and dental plans to coordinate the care for most members. SoonerSelect allows for the delivery of Medicaid health benefits and more services through contracted arrangements between state Medicaid agencies and contracted entities (CEs).
(Note: You may hear members use phrases such as managed care organizations (MCOs) or provider-led entities (PLEs) to describe the CEs. The term contracted entity is in the legislation for SoonerSelect and includes all the possible types of contracted organizations. It is OHCA’s preferred term.)
The transition in health care delivery will allow OHCA to:
- Improve health outcomes for Oklahomans
- Move toward a system where we pay providers based on the quality of care they provide to Oklahomans rather than just by service
- Improve SoonerCare member satisfaction
- Focus on preventive and primary care
- Better estimate the cost of providing quality care and plan accordingly
All health plans will provide members the same health care services currently offered by SoonerCare. However, each plan may offer extra benefits to help improve the health of its members.
Examples of added value benefits similar programs in other states include:
- Program for new and expecting mothers with customized support and care.
- Expanded nutritional counseling for members with chronic conditions.
- Home meal delivery during post-hospitalization, acute in-patient stay, and postpartum.
The following SoonerCare populations will be enrolled in SoonerSelect:
- Children, including foster children
- Low-income parents
- Pregnant women
- Adults aged 19-64
American Indian/Alaska Native members can opt-in to a SoonerSelect plan.
At least 60 days before the start date, OHCA will ask transitioning members to pick one dental plan and one health plan. Members can compare the extra benefits each health plan provides and choose the right one for them.
There are three plan types in the SoonerSelect program.
All SoonerSelect members will enroll in a dental plan. Dental plans will cover medically necessary preventive and restorative dental care. Additionally, orthodontic services will be available for children under 21.
Most SoonerSelect members will be enrolled in a health plan. Health plans covers all medically necessary health and behavioral health services, except dental services.
Children’s Specialty Plan
SoonerSelect members involved in the juvenile justice system and those served by Oklahoma Human Services, including children in foster care and receiving adoption assistance will enroll in a children’s specialty plan instead of the health plan. The children’s specialty plan will receive medically necessary health and behavioral health services, except dental services. The children’s specialty plan will have a strong focus on the unique health and behavioral health needs of the children it serves. It places special emphasis on early identification of needs and interventions.
All plans must offer at least the services already available to SoonerCare members. Some plans may offer additional services.
All health plans will provide SoonerSelect enrollees with the same health care services currently offered by SoonerCare. Additionally, there are no changes to eligibility requirements.
Health plans can offer extra benefits to help improve the health of SoonerSelect members. Members will be able to compare extra benefits provided by each plan and pick the right one for them.
Each CE will have its own contracts with providers so the availability of specific providers may vary from CE to CE. If members have a doctor or other provider they want to want to keep seeing, they should pick a health plan they accept. During enrollment, when members are picking their plans, each plan will have a provider directory on its website that members can review.
Members will have the opportunity to pick their dental and medical health plans. Enrollment for a dental plan will begin in October 2023. Enrollment for medical plans will begin in November. SoonerCare representatives can help members pick the plan that best suits their needs. Members can enroll by logging in to MySoonerCare.org or call the SoonerCare Helpline at 800-987-7767.
In the first half of 2024. Members can expect more information as we get closer.
Right now, only the dental contracts have been awarded: DentaQuest and Liberty Dental. You can find more information at Oklahoma.gov/OHCA/SoonerSelect.
OHCA will award medical contracts at the end of May.
Yes. Members should make sure their case and contact information (address, phone number and email address) are up to date so when the time comes, they can receive critical information about SoonerSelect.
Like SoonerCare, SoonerSelect is paid for with Medicaid funds. Members are not responsible for plan premiums. Cost sharing and copays will still apply.
Insure Oklahoma is separate from SoonerSelect, and members eligible for Insure Oklahoma are not eligible for SoonerSelect.