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What Is Covered by Oklahoma Soonercare?

Below is a list of services that are covered by Oklahoma Soonercare. Please go to the Soonercare coverage chart for a more comprehensive list, as well as the limitations of coverage for adults who are Soonercare members:

  • Ambulance
  • Ambulatory Surgery Center services
  • Behavioral health and substance abuse services (outpatient)
  • Case management services
  • Chemotherapy and radiation therapy
  • Child Health
  • Clinic services including renal dialysis services
  • Dental services (limited for adults)
  • Dentures for adults residing in nursing facilities
  • Durable Medical Equipment and supplies
  • Family planning services and supplies
  • Federally Qualified Health Center (FQHC) services
  • Hemophilia
  • Home health services
  • Inpatient hospital services
  • Inpatient hospital services in an institution for mental disease for people who are 65 years of age or older*
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)*
  • Laboratory and X-ray services
  • Medical supplies and equipment, including diabetic supplies
  • Mental Health and Substance Abuse Services
  • Nurse midwife services
  • Nursing facility services*
  • Nutritional Services
  • Outpatient hospital services
  • Pregnancy services (breastfeeding, etc.)
  • Personal care services
  • Physician services, including preventive services
  • Podiatry services
  • Prescription drugs and insulin
  • Prenatal, delivery and postpartum services (maternity services)
  • Quitting Smoking & Tobacco
  • Rural health clinic services
  • Transplants that are prior authorized
  • Transportation to obtain covered medical care (SoonerRide)
  • Tuberculosis services
  • Ultrasound benefits

 

* Not covered under SoonerCare CHOICE

 

Additional services for children

 

  • Hearing aids
  • Immunizations
  • Incontinence Supplies for certain children ages 4-20
  • Incontinence Supplies (Spanish)
  • Inpatient hospital services for patients in institutions for mental disease
  • Optometric or optical services, including eyeglasses
  • Orthodontics
  • Other medically necessary services
  • Physical and occupational therapy
  • Private duty nursing
  • Speech, hearing and language disorder services

 

The following programs may provide additional services or more restrictions to the services covered above for enrollees.

 

  • Breast and Cervical Cancer Treatment Services (Oklahoma Cares)
  • Family Planning services (SoonerPlan)
  • Home and community-based services authorized under a waiver (In-Home Care)

 

--Source: www.okcha.org