Library: Policy

317:55-3-3. Voluntary enrollment and disenrollment

Revised 9-12-22

(a) Per 56 O.S. ' 4002.3, AI/AN populations that are eligible for SoonerCare will have the option to: 

(1) Voluntarily enroll in the MCP through an opt-in process;

(2) Enroll in an MCO or DBM at each open enrollment period, regardless of initial selection or past disenrollment from the MCP;

(3) Receive services from an IHCP;

(4) Choose the IHCP as the enrollee's PCMH provider or DH provider, if the provider has the capacity to provide such services;

(5) Obtain services covered under the contract from out-of-network IHCPs when the enrollee is otherwise eligible to receive the IHCP's services;

(6) Self-refer for services provided by IHCPs to AI/AN enrollees;

(7) Obtain services covered under the contract from out-of-network IHCPs when the AI/AN enrollee is otherwise eligible to receive the IHCP's services; and

(8) Disenroll from any MCO or DBM at any time without cause.

(b) Children receiving prevention services from child welfare services have the option to enroll in the MCO contract to provide health care services under the Specialty Children's Plan.