Learn about SoonerSelect
Most SoonerCare members will get their health care services covered in a new way next year – through health and dental plans. A health or dental plan is an organization that provides health care services through a network (group) of doctors, dentists, pharmacists, mental health professionals and other service providers. Some plans provide extra services like programs to help you quit smoking and get healthier.
Health and dental plans have a provider network. In most cases, you must get care from a provider in your plan’s provider network, such as a primary care provider (PCP) or a primary care dentist (PCD).
Your PCP could be a doctor, nurse practitioner or physician assistant, but you will be able to choose as long as they are in your plan’s network They care for your health, coordinate your needs, and refer you to specialists when needed.
A PCD is a dental care professional. They care for your dental health, coordinate dental needs, and refer you to specialists when you need them. If you already have a doctor or other health care provider that you would like to keep seeing, we will work with you to pick a plan that allows you to keep your current provider.
You will be able to pick between three health plans: Aetna Better Health of Oklahoma, Humana Healthy Horizons of Oklahoma and Oklahoma Complete Health.
You can pick between two dental plans: DentaQuest or LIBERTY Dental. Your dental plan will provide medically necessary cleanings, preventive and restorative care, and will provide medically necessary orthodontic services for children under 21.
If you are a federally recognized tribal member or qualify for services through Indian Health Service (IHS), you may decide to join a plan or remain on your current SoonerCare plan.
There is also a Children’s Specialty Program that will serve children involved in the juvenile justice system and including children in foster care and children receiving adoption assistance. Oklahoma Complete Health will serve these members.
Your SoonerCare dental services will be covered through a dental plan starting Feb. 1, 2024. The rest of your health care needs will be covered by health plans starting on April 1, 2024. Be sure to watch for mail and emails this fall for instructions on how to pick a dental and health plan for you and your family.
To learn about the basic benefits and services that all health plans offer, go to SoonerCare Benefits (oklahoma.gov).
Resources
- Member FAQ
- Provider FAQ
- Fact Sheet - English
- Fact Sheet - Spanish
- SoonerSelect Stakeholder Toolkit
- Watch Previous SoonerSelect Town Hall Meetings
- SoonerSelect Quality
- Directed Payments SB 1337 Legislative Report
- ODMHSAS Managed Care Guardrails
- Capitation Rates
- IHCP Addendum
- Network Adequacy Standards
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.
Dental Plans
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.
Health Plans
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.
