Most SoonerCare members will get their health care services covered in a new way this year – through health and dental plans called SoonerSelect. This new health care delivery system coordinates health and dental care and will improve quality of care, according to the Oklahoma Health Care Authority (OHCA).
SoonerCare (Oklahoma Medicaid) is a health coverage program jointly funded by the federal and state government. This program helps pay some or all medical bills for many people who can’t afford them. The Oklahoma Health Care Authority (OHCA) is the state agency that administers the program and determines financial eligibility for the program.
The same health care services offered by SoonerCare will be available through all health/dental plans under SoonerSelect. There are no changes to eligibility requirements. Health/dental plans can offer extra benefits to help improve the health of SoonerSelect members, and members can compare those benefits to choose the plan they prefer. Those extra benefits can include club and camp scholarships, nutrition support and food security. There is no extra cost for enrolling in a SoonerSelect plan.
“The transition to SoonerSelect marks a significant shift in the way many Oklahomans think about their health care,” said Ellen Buettner, chief executive officer of the Oklahoma Health Care Authority. “Members will receive extra benefits that promote wellness inside and outside the doctor’s office, empowering individuals to lead healthy and productive lives.”
The change in health care delivery will allow OHCA to:
- Improve health outcomes for Oklahomans
- Move toward a system where providers are paid based on the quality of care they provide to Oklahomans rather than just by service
- Improve member satisfaction
- Focus on preventive and primary care
How it works
SoonerCare members moving to SoonerSelect will have the opportunity to choose their SoonerSelect health plans beginning Feb. 1. In addition to traditional SoonerCare benefits, each plan offers extra value-added benefits. Members can connect with choice counselors and review benefit guides to select the best plan to fit their needs.
Members must select a health plan by March 10; otherwise, OHCA will enroll them in a plan on their behalf. Members have 90 days from the date of enrollment to change their plan.
Members moving to SoonerSelect include children, low-income parents, pregnant women and Expansion adults ages 19-64. Eligible American Indian/Alaskan Native (AI/AN) members have the opportunity to opt into SoonerSelect. If AI/AN members do not opt into SoonerSelect, they will remain in their current SoonerCare program and will continue receiving services in the same way.
OHCA has contracted with three entities to administer SoonerSelect health benefits:
Oklahoma Complete Health will also serve the children’s specialty program, which covers all Medicaid services, other than dental, for children in foster care, former foster care children, juvenile justice involved children and children receiving adoption assistance.
All health plans will provide the same health care services currently offered by SoonerCare, including medically necessary prescriptions, health services and behavioral health services. Each plan also offers extra value-added benefits to improve health outcomes for members, including:
- Monetary incentives for attending well-child and annual primary care visits.
- Enhanced vision services for adults such as eye exams and funds for contacts or eyeglasses.
- Home-based asthma interventions such as deep cleaning carpets and hypoallergenic bedding.
- Nutrition support including meals or money to address food insecurity.
- Healthy weight incentives including memberships to local community organizations and gyms.
- Legal assistance, including criminal record expungement.
SoonerSelect incentivizes health outcomes while maintaining oversight and authority over Oklahoma’s Medicaid program and program funding. OHCA remains committed to enhancing the health and well-being of SoonerCare members and will maintain rigorous accountability measures to hold SoonerSelect partners to the highest standards.
“OHCA’s commitment to whole-person wellness for SoonerCare members remains unwavering, and OHCA will promote the highest standard in health care delivery through SoonerSelect,” Buettner said. “We’re excited about the positive effect this will have on the health of our state and change the way future generations will use SoonerCare.”
The implementation date for SoonerSelect health plans is scheduled for April 1, 2024. SoonerSelect dental plan implementation is Feb. 1, 2024.