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