OKLAHOMA CITY — The Oklahoma Health Care Authority is providing additional clarification regarding the significant changes coming to the state’s Medicaid program.
June 30, Oklahomans voted to expand SoonerCare eligibility to adults ages 19-64 whose income is 138 percent of the federal poverty level or lower through Medicaid expansion. This change equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four.
Benefits under expansion will be the same as SoonerCare benefits today. Those who are eligible under the expanded guidelines can apply for SoonerCare on June 1, and benefits for those who qualify will begin July 1.
October 1, OHCA will transition to a managed care service delivery model called SoonerSelect. SoonerSelect will be implemented in partnership with four medical plan organizations and three dental plan organizations.
Members will select whichever plan they prefer for their coverage. Medical and dental providers must contract with at least one of the plans to continue serving SoonerCare members.
The following SoonerCare populations will be asked to choose from one of the health plans: children, including children in foster care; low-income parents; pregnant women; and the adult expansion population. American Indian/Alaska Native members are considered voluntary and will have the option to opt-in to a managed care plan. The SoonerSelect medical plans are BCBSOK, Humana Healthy Horizons in Oklahoma, Oklahoma Complete Health and UnitedHealthcare. The three dental plans are DentaQuest, LIBERTY Dental and MCNA Dental.
“It is important for the public to know SoonerSelect is not the same as Medicaid expansion,” OHCA CEO Kevin Corbett said. “Medicaid expansion will provide approximately 200,000 more Oklahomans with health care coverage, which will improve our health outcomes in Oklahoma. Those currently enrolled in SoonerCare will move into managed care in the fall, which will provide them the same health care services they currently receive with the understanding that each plan may offer extra benefits to help improve the health of those members.”
Managed care keeps Oklahoma dollars in Oklahoma. Managed care organizations pay Oklahoma health care providers to deliver care and they are required to hire local, Oklahoma-based teams to manage the care of Medicaid members. This will create hundreds of high-paying, quality jobs in Oklahoma, boosting the state’s economy.
“Oklahoma is one of only ten states that has not moved to managed care for their Medicaid population. Under Oklahoma’s current fee-for-service system, Oklahoma ranks among the worst in the nation in health outcomes and we’re not getting any better,” said Corbett. “Moving to managed care in Oklahoma is important, so we can improve health outcomes and reduce costs.”