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How is Medicaid eligibility determined in Oklahoma?

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Quick Answer

In Oklahoma, applicants must meet citizenship, state residency, income and categorical qualifications to establish eligibility for SoonerCare, the state’s Medicaid program, according to the Oklahoma Healthcare Authority. Some of the categorical qualifiers include adults with children under 19, children under 19, pregnant women, and individuals over 65.

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The state also provides coverage to individuals who are blind or have disabilities and women under 65 who require treatment for cervical or breast cancer, reports the Oklahoma Healthcare Authority. Men and women over 19 who have family planning needs may qualify for SoonerPlan, which covers birth control for all members and includes vasectomies and tubal ligation for members over age 21. SoonerPlan also provides pregnancy tests for women and Gardasil for both sexes until they reach age 27.

The state develops income eligibility guidelines for each group using a percentage of the federal poverty level and family size, according to Medicaid.gov. As of 2015, Oklahoma had over 800,000 people enrolled in Medicaid.

Residents with questions about Medicare eligibility should contact their local Oklahoma Department of Human Services Human Service Center, according to the OKDHS website. The Human Services Center also accepts applications for coverage.

If an applicant does not qualify for Medicaid, the Joint Oklahoma Information Network offers assistance in finding government, nonprofit or private programs for which he may qualify. This network is a partnership of several state agencies requires applicants to complete a questionnaire that is separate from the Medicaid application.

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