What Does Soonercare Cover For Pregnancy

Want Healthier Moms Expand Medicaid

How To: Enroll in SoonerCare Online – Step 1

As a state, Oklahoma cares a lot about children and families, but we sometimes forget that a mothers health is a critical piece of family health. When women are healthy, they have healthier pregnancies, healthier babies, and healthier families. But too many Oklahoma women die of child-birth related causes, and too many Oklahoma babies dont live to see their first birthday.

Fortunately, most infant and maternal mortality is preventable. Medicaid expansion in Oklahoma would provide reliable health care coverage to thousands of Oklahomans, and provide women with better access to care at all stages of their lives. Consistent health care means more women will have healthier babies, better physical and mental health, and less likely to die of preventable, birth-related causes.

Why Do I Need Prenatal Care

Prenatal care can help you have a healthy baby by:

  • Improving the chance your baby will be a healthy weight at birth
  • Having the best possible pregnancy and delivery
  • Giving your baby a healthy start in life

Prenatal care can help keep you and your baby healthy. Mothers who do not get prenatal care sometimes have babies who are more likely to have low birth weights or serious health problems than those mothers who do get prenatal care.

Health care providers can identify health problems early when they see mothers regularly during their pregnancy. Early treatment can help many problems and prevent others.

If you think you may be pregnant or know you are pregnant, contact a SoonerCare provider in your community for an appointment. If you are having any problems getting an appointment to start prenatal care, please call the SoonerCare Helpline at 987-7767 or TDD 757-5979.

What Does Soonercare Cover For Kids

SoonerCare covers a yearly examination and any requested follow-ups by your Eye Doctor or Optometrist. SoonerCare will also cover a pair of glasses. This includes both the lenses and the frames. The lenses are to be polycarbonate material. The frames are expected to last the patient 1 year, but if broken SoonerCare will cover an additional frame within that year. One Vision has a large selection of SoonerCare-eligible glasses. Our SoonerCare eyeglasses come in a wide variety of colors and styles.

Don’t Miss: How Soon Can I Know Am Pregnant

Dual Eligibile Medicare And Medicaid Plans In Oklahoma

The term dual eligible means that people are covered by both Medicare and Medicaid at the same time. In addition to qualifying for Medicaid, people usually qualify for Medicare Part A, Medicare Part B and a Medicare Savings Program that may pay for Medicare deductibles, coinsurance, and copayments.

The four kinds of Medicare Savings Programs are the Qualified Medicare Beneficiary Program, the Specified Low-Income Medicare Beneficiary Program, the Qualifying Individual Program and the Qualified Disabled and Working Individuals Program. To see if you qualify for any of these programs, contact a SoonerCare office.

How Much Does Medicaid Cover For Pregnancy

SoonerCare Member Memo

Dr. Vilma received her M.D. in Obstetrics, Gynecology, Infertility and Reproductive Endocrinology from Harvard. She is trained in managing pregnancy, pre-pregnancy health, and family planning.

Learn about our Editorial Policy.

Low income and unemployed pregnant women can qualify for Medicaid if they meet eligibility requirements. This United States federal government-sponsored insurance will cover the cost of a woman’s prenatal care, postpartum care, labor and delivery, and newborn and infant medical care.

Recommended Reading: Is It Easy To Get Pregnant On Birth Control

Login Procedure Who Already Have Account

If you have a Soonercare online account, you can access it at any time. Accessing your account online is easy and you will need your credentials. You can also use your account to check the status of your sooner care application, report changes or resubmit your soonercare application. To log into your account online, follow these simple steps:

Step 1 Go to the Soonercare login page: www.oklahoma.gov/Site/UserAccountLogin.aspx

Step 2 When you get to the login page, enter your user ID or email address followed by your password in the fields below and click Login. If the personal information you entered is correct, you will also be redirected to your account control panel.

NOTE: The Soonercare secure login portal is for participating Soonercare members only. If you are an OHCA provider, please refer to the step-by-step guide to access the OHCA providers online portal.


To be eligible for SoonerCare, a person must:

  • Lives in Oklahoma
  • be a US citizen or qualified alien
  • Meet income and financial resource patterns in specific categories.

Qu Es Lo Que Est Cubierto

SoonerCare cubre muchos servicios de atención médica. Sin embargo, hay limitaciones que se aplican para asegurar que sólo se proporcionen los servicios médicamente necesarios. Algunos servicios son sólo para niños. Los beneficios y las coberturas aquí detalladas pueden cambiar. Por favor, consulte el capítulo 30 de las reglas de la OHCA para obtener la información más actualizada.

  • Servicios de gestión de casos

  • Quimioterapia y radioterapia

  • Terapia física y terapia ocupacional

  • Enfermería privada

  • Servicios para trastornos del lenguaje, auditivos y el habla

Los programas a continuación pueden proporcionar servicios adicionales o tener más restricciones a los servicios cubiertos anteriormente para los inscritos.

  • Servicios de tratamiento de cáncer de mama y de cuello uterino

  • Servicios de planificación familiar

  • Servicios en el Hogar y en la Comunidad autorizados bajo una exención

Don’t Miss: What Is The Best Pregnancy Tracker App

Healthy Women Have Healthier Pregnancies And Healthier Babies

Oklahoma ranked 47th for its infant mortality, and 34th for its maternal mortality last year. There are a few reasons why Oklahoma women and babies are at greater risk of dying from preventable, birth-related causes. Oklahoma has a high uninsured rate, including a high uninsured rate for women of childbearing age, and offers limited coverage to pregnant women and new moms through SoonerCare, the States Medicaid program. SoonerCare coverage of pregnant women and new moms is limited, based on income level requirements and in order to qualify, women must provide proof of pregnancy, then wait for an approval. This current structure also leaves many of the same women without health care when theyre not pregnant, which is a majority of their adult lives.

Without consistent health care coverage before pregnancy, many women cannot regularly see a doctor or treat ongoing illnesses. Because of this, women begin their pregnancies in poorer health, increasing the risk of complications for mom and baby. Giving birth to a child is physically and mentally demanding for the mother and the infant, so its important that women be healthy before pregnancy to have the best chance for a healthy pregnancy and birth. Expanding Medicaid enables more women to have continuous health care coverage so they can see a doctor more regularly, making for healthier pregnancies, healthier births, and healthier children who are also more likely to have insurance.

Welcome To Your New Medical Home

How to: Enroll in SoonerCare Online

Home is a gathering place where you can be yourself and feel safe. Variety Care provides a medical home for you and your family, regardless of income, health insurance or ability to pay. Our primary care providers offer annual exams and lab tests in addition to treatment for chronic conditions, like asthma, diabetes and depression. With on-site, low-cost pharmacies, dental care, vision and counseling services, were treating people as a whole and not just the symptoms.

Also Check: How To Tell When You Re Pregnant

Women In Medicaid Expansion States Are Healthier Before During And After Pregnancy

Infant and maternal mortality decreased in Medicaid expansion states, where more women have coverage before and during pregnancy. A leading cause of infant mortality in Oklahoma is complications related to low birth weight and prematurity. Regular doctor visits allow moms to address health concerns throughout the pregnancy, increasing the likelihood the baby will be born full term at a healthy weight. While most pregnant women in Oklahoma can access health care coverage, Medicaid expansion ensures more women who arent currently pregnant can go to the doctor regularly, maintaining better health. Women who begin their pregnancies in good health are less likely to experience these birth complications, making access to health care before pregnancy a critical piece of womens and childrens health care.

Access to good prenatal care is also crucial. Regular doctor visits during pregnancy increase the likelihood the baby will be born full term, allowing the baby additional time to gain weight. Weight gain is an important part of physical and cognitive development. It not only lessens the likelihood that the infant will need emergency care once born, but also increases the chances the infant will survive its first year.

Are Your Medications Doing Their Job

It can be hard to know if your medications are doing enough. It can be especially hard if you are taking lots of daily medications. SoonerCare has a free service that can help! Its called Medication Therapy Management , and you can participate if:

  • You are at least 18 years of age, and
  • You are not on Medicare, and
  • You take at least four daily medications, or
  • You had at least one hospital or emergency department admission in the last year .

MTM visits are done by phone. You will talk with a pharmacist about:

  • Maximizing your prescription limit.
  • How to know your medications are working.
  • Medication safety and side effects.
  • Problems you may have with your medications.
  • Medications that should not be taken together.
  • Any questions you may have about your medications.

After your free MTM visit, we will mail you some information about your medications. We will also work with your health care provider to make sure your medications line up with healthy outcomes. We want to help you get the most out of your medications and improve your health!

For more information about MTM, please call the SoonerCare pharmacy helpdesk at 800-522-0114, option 4.

You May Like: When Should You See Doctor When Pregnant

Know Eligibility Criteria Of The Portal

  • People entitled to relay assistance for families in need
  • must pass income and resource tests to be eligible and have a medical need
  • Pregnant women and/or children under 18 whose household income is at or below 185% of the federal poverty level
  • Pregnant women with 133% or less of the federal poverty level receive a full range of SoonerCare Choice services
  • Financial eligibility is determined at the local Department of Social Services office
  • may be categorically eligible if people are over 65, blind or disabled
  • All individuals who receive Supplemental Security Income benefits from the Social Security Administration are eligible to submit a separate soonercare application for Medicaid benefits to the county DHS office.
  • People who exceed income limits can receive help under a donation procedure if they are categorically linked

Process Of Soonercare Sign In

SoonerCare Member Memo

To use the SoonerCare Login Portal, you must create an account, including a username and password, with which you will log into the system. Creating a new account on the Soonercare login portal is very simple. Follow the steps below to SoonerCare Sign In.

If you dont have a user account, but you do have your personal identification number , you can now create an account with your PIN. If you dont already have a user account or PIN, create a new account now. Please read the terms and conditions carefully, to apply for SoonerCare Benefits, you must select I Agree to complete the soonercare application.

  • The first step in the SoonerCare Sign In is to tell them about everyone who lives in the house.
  • Start with an adult if one lives in the house.
  • He is the point of contact for the file.
  • The contact person must be at least 15 years old. When finished, select Next to continue. If you need further assistance, call 987-7767.

Read Also: Can You Color Your Hair While Pregnant

Costos Compartidos De Medicare Y Responsabilidad De Terceros

SoonerCare sólo paga los deducibles y una parte del co-seguro cuando alguno de los servicios mencionados anteriormente están cubiertos por Medicare. OHCA también paga la prima mensual de la Parte B de Medicare para los miembros de SoonerCare mayores de 65 años y para ciertas personas ciegas o discapacitadas. Si una persona elegible tiene otro seguro médico, se debe enviar una factura a esa compañía de seguros antes de que se facture a SoonerCare.

Will Soonercare Cover Replacement Glasses

Next, Soonercare will cover replacement glasses under certain circumstances. Here are the guidelines from the Oklahoma Health Care Authority:

Eye glasses, lenses and frames, are covered for children. Prior Authorization is required for additional eye glasses for children beyond 2 pairs in a 12 month period. It should be unusual for a childs vision to change so frequently that greater than two pairs of eye glasses are needed within a 12 month timeframe. However, if this should occur, the documentation should clearly demonstrate changes in the members vision necessitating the new prescription. PA will provide if the services are reasonable and medically necessary.

Here is a list of indications for additional eye glasses:

  • Change in Vision:
    • Documentation should indicate a change in correction of 0.5 diopters or greater in either sphere or cylinder power in either eye since last examination OR
    • A shift in axis of greater than 10 degrees in either eye since last examination OR
    • A change in the members head size warranting a new pair of eyeglasses OR
    • The member has an allergic reaction to the eyeglasses materials OR
    • A comprehensive or intermediate vision examination shows that a change in eyeglasses is medically necessary.

    2. Irreparable Lenses/or Frames

    3. Lost or Stolen Eye Glasses

    Also Check: Should I Get The Whooping Cough Vaccine While Pregnant

    Tulsa Eye Doctors In Network With Soonercare

    Also, most of the Eye Doctors in Tulsa and Broken Arrow accept SoonerCare. After all, with over 70% of Tulsa kids enrolled in the program, it makes sense that SoonerCare would be the first vision insurance most Eye Doctors would apply to get in network with, and therefore be able to take more patients.

    Stbs Services May Include:

    SoonerCare Enrollment Training
    • Routine office visits that benefit the unborn child

    • Medications that benefit the unborn child

    • Ultrasounds that benefit the unborn child

    • Lab services that benefit the unborn child

    • Some specialty services when those services benefit the unborn child

    • Hospital services that benefit the unborn child

    • Mental health services that benefit the unborn child

    • Substance use disorder services that benefit the unborn child

    • Services associated with miscarriage or a non-viable pregnancy, such as a molar pregnancy, ectopic pregnancy, or fetal death in utero

    Miscarriages and non-viable pregnancies do sometimes occur. In these difficult circumstances, STBS covers services that may be necessary for the compassionate or palliative care of the unborn child, as well as those services necessary to support and resolve all outcomes of pregnancy.

    You May Like: What Does Folic Acid Do For Pregnancy

    How To Reset Identification Number

    If you forgot your User ID, dont worry, you can easily recover it by following these steps:

    • Go to your browser.
    • Visit the official website at www.oklahoma.gov
    • After clicking on it, you will be redirected to a new page.
    • Enter the requested account information. They will use the values provided to identify your account.
    • If they find a match, an email will be sent to your registered email address.
    • You will be asked to enter your User Type, Trading Partner ID and PIN.
    • In the end, you need to click the submit button.

    As mentioned above, you will receive an email at the email address provided with a new identification number. If you still have problems after that, please contact customer service.

    What Does Medicaid Cover In Oklahoma

    Under federal law, all states are required to provide the following mandatory Medicaid benefits:

    • Inpatient hospital services
    • 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
    • Family Planning services
    • Home and community-based services authorized under a waiver

    You May Like: Can You Still Get Pregnant With Pcos

    Find Out If You Qualify For Soonercare

    Being pregnant is challenging and life changing. Paying for your medical bills shouldnt be another hurdle you face. If you do not have health insurance or worry that you will not be able to afford prenatal care, you might be eligible for Oklahomas Medicaid program, SoonerCare. The best part is that Variety Care accepts SoonerCare at each of its locations across the Oklahoma City metro, Norman and southwestern Oklahoma.

    Some of the services covered by SoonerCare include:

    • Specialty visits
    • Delivery services
    • Labs & diagnostics related to pregnancy
    • Maternal & infant health social work
    • Lactation consultation services

    Prenatal Vitamins Are The Building Blocks Of A Healthy Pregnancy

    Oklahoma Health Care Authority

    SoonerCare makes taking PNVs easy by covering most of them at no cost for female members of childbearing age. They also do not count against your monthly prescription limit.

    PNVs vary in the kinds and amounts of vitamins and minerals they contain. Ask your health care provider which PNV is best for you. For additional information, please visit OHCA Pregnancy Services and FAQ: Nutrition During Pregnancy.

    Here are some of the most important vitamins and minerals during and after your pregnancy:

    Quit by using your SoonerCare benefits! SoonerCare covers all FDA approved medications to help you quit tobacco. These do not count against the six-prescription per month limit.

    Talk to your SoonerCare provider about which options are best for you:

    -Nicotine Patch

    Also Check: What Can I Take To Stop Feeling Nauseous While Pregnant

    Which Medicare Plan Is Best In Oklahoma

    Its extremely important to remember that no plan is created equal. Yes, there might be standardized Medicare supplement plans, but the prices are almost always different.

    The way to determine which Medicare plan is best in Oklahoma is to shop your options. By fully shopping your options youll be able to find the best plan that fits you. Below are some considerations for finding which Medicare plan is best in Oklahoma.

    • Use the Part D plan finder to enter your drugs to identify the tiers and associated copays.
    • Compare the networks of primary doctors and specialists to ensure your doctor is in network
    • Understand the additional benefits you may qualify for such as dental, vision, hearing, and wellness.

    Once you have gone through that exercise in full, youll be better suited to determine which Medicare plan is best in Oklahoma for you.

    Related Posts

    Recent Stories