Eligibility, How to Apply and Contact Information
SoonerCare, Oklahoma's Medicaid program, provides health care to children under the age of 19, adults with children under the age of 18, pregnant women and people who are older than 65 or have blindness or another disability. The following programs are a part of SoonerCare: Aged, Blind and Disabled; Family Planning; Health Care for Children with Disabilities (TEFRA); and Health Screening, Diagnosis and Treatment (EPSDT).
Eligibility | How to Apply | Contact Information
Adults with children under age 18
- Recipients of the Temporary Assistance to Needy Families (TANF) program are automatically eligible for health benefits.
- Adults with children under the age of 18 who do not receive TANF may, in some circumstances, also be eligible for medical services. The income guidelines are presented in Appendix C-1 (.pdf, 8 pp, 316 KB) Schedule X. (Resources are not considered with this group.)
- Children under the age of 19 and pregnant women whose family incomes meet the income guidelines in Appendix C-1 (.pdf, 8 pp, 316 KB) Schedule I.A may be eligible for medical benefits. (Resources are not considered with this group.)
- Individuals who are 65 or older are eligible if they meet the financial criteria.
- To be eligible for medical benefits in Oklahoma, a disabled person must have a physical or mental impairment, disease or loss that appears reasonably certain to continue at least 12 months without significant improvement and that substantially impairs his/her ability to perform labor or services or to engage in a useful occupation. You will need to also apply for a disability determination with the Social Security Administration.
- In addition, people eligible for Medicare Part A may qualify to have medical benefits pay their Medicare premiums, co-payments and deductibles as a Qualified Medicare Beneficiary (QMB), a Qualified Disabled and Working Individual (QDWI) or a Specified Low Income Medicare Beneficiary (SLMB). (Get more information about these programs).
- The recipient's monthly income and resources must meet guidelines listed in Appendix C-1 (.pdf, 8 pp, 316 KB) (Schedule V-VII for help with Medicare premiums and Schedules VI and VIII for medical assistance).
- People who belong to the "aged, blind and disabled" group may also qualify for a State Supplemental Payment.
If you are not on medical benefits, contact your local OKDHS Human Services Center and file an application.
You will file one of two applications, depending on the group to which you belong. (See group descriptions above.)
Use SoonerCare Health Benefits Application - SC-1 (Link opens in new window) to apply for medical assistance for families with a member under 18, children under the age of 19 or pregnant women. This application can be mailed in or dropped off at your OKDHS Human Services Center. Under certain circumstances, you may not need to meet with a social services specialist.
Persons with disabilities, blindness or who are older than the age 65, must fill out form 08MP003 - Word (.doc, 5 pp, 168 KB) | PDF (.pdf, 4 pp, 247 KB) at the local OKDHS Human Services Center.
If you have questions about eligibility for these programs, please contact your OKDHS Human Services Center.