SoonerCare is Oklahoma’s Medicaid program. This program helps pay some or all medical bills for many people who can't afford them. The Oklahoma Health Care Authority (OHCA) is the state agency that administers the program. The Oklahoma Department of Human Services (OKDHS) determines financial eligibility for the program. What is SoonerCare?
We want you to be happy with SoonerCare. We are here to help you if you have questions or problems. Talking about a problem or filing a complaint or an appeal on a denied service will not affect your membership or benefits.
How to file a complaint
Call the SoonerCare Helpline. If you have problems with SoonerCare or its providers, we want to know. The SoonerCare Helpline will make a full report of your problem. We will work with you to try to fix it.
Fraud is when a person or group tries to get a benefit that doesn’t belong to them. An example would be money or a medical service. Basically, if someone other than the true member uses a SoonerCare card to get services, that person is committing fraud.
The Oklahoma Health Care Authority sends out an Explanation of Benefits each month to selected members. This helps us identify services that were charged to members who did not get them.
Smoking and tobacco can cause many major health problems. SoonerCare offers free stop smobenefits. Ask your health care provider about medicines or call the Oklahoma Tobacco Helpline for coaching. Products covered include nicotine patches and gum and pills that combat cravings.
For the first 90 days, you can get stop smoking products as a pharmacy benefit without prior authorization. Those products will not count toward the monthly limits for members age 21 and older.
After 90 days of treatment, prior authorization is needed.