Learn about SoonerSelect
Most SoonerCare members get their health care services covered in a new way – through health and dental plans. A health or dental plan is an organization that provides health care services through a network (group) of doctors, dentists, pharmacists, mental health professionals and other service providers. All health and dental plans provide the same health care services currently offered by SoonerCare, but some may provide extra services to help improve your health. To learn about the basic benefits and services that SoonerSelect health plans offer, visit SoonerCare Benefits (oklahoma.gov).
Health Plans
You can choose between three health plans: Aetna Better Health of Oklahoma, Humana Healthy Horizons of Oklahoma and Oklahoma Complete Health.
Each health plan has a provider network. In most cases, you must get care from a provider in your plan’s provider network, such as a primary care provider (PCP). Your PCP could be a doctor, nurse practitioner or physician assistant, but you can choose one as long as they are in your plan’s network. A PCP cares for your health, coordinates your needs, and refers you to specialists when needed. If you already have a PCP that you would like to keep seeing, you should pick a plan that includes your PCP in their network.
Dental Plans
You can choose between two dental plans: DentaQuest or Liberty Dental. Your dental plan covers medically necessary cleanings, preventive and restorative care, and medically necessary orthodontic services for children under age 21.
Each dental plan also has a provider network. In most cases, you must get care from a dental provider in your plan’s provider network, such as a primary care dentist (PCD). A PCD is a dental care professional. They care for your dental health, coordinate dental needs, and refer you to specialists when you need them. If you already have a dentist or other provider you would like to keep seeing, we’ll work with you to pick a plan that allows you to keep your current provider.
Children’s Specialty Program
There is also a Children’s Specialty Program that covers SoonerSelect children and youth served by Oklahoma Human Services’ Child Welfare Services. This includes children in foster care and former foster care children, those receiving adoption assistance, and those involved in the juvenile justice system. Oklahoma Complete Health serves these members.
American Indian/Alaskan Native Members
If you are a federally recognized tribal member or qualify for services through Indian Health Services (IHS), you may decide to join a SoonerSelect plan. If you choose not to opt in, you’ll remain on your current SoonerCare plan.
Resources
- Member FAQ
- Provider FAQ
- AI/AN Member FAQ:
English | Spanish - Fact Sheet - English
- Fact Sheet - Spanish
- SoonerSelect Stakeholder Toolkit
- SoonerSelect Quality
- Directed Payments SB 1337 Legislative Report
- Managed Care Guardrails
- Capitation Rates
- IHCP Addendum
- Network Adequacy Standards
SoonerSelect is a health care delivery system to facilitate member care, costs and quality. Oklahoma will partner with health and dental plans to coordinate the care for most members. SoonerSelect allows for the delivery of Medicaid health benefits and more services through contracted arrangements between state Medicaid agencies and contracted entities (CEs).
(Note: You may hear members use phrases such as managed care organizations (MCOs) or provider-led entities (PLEs) to describe the CEs. The term contracted entity is in the legislation for SoonerSelect and includes all the possible types of contracted organizations. It is OHCA’s preferred term.)
The transition in health care delivery will allow OHCA to:
- Improve health outcomes for Oklahomans
- Move toward a system where we pay providers based on the quality of care they provide to Oklahomans rather than just by service
- Improve SoonerCare member satisfaction
- Focus on preventive and primary care
- Better estimate the cost of providing quality care and plan accordingly
All health plans will provide members the same health care services currently offered by SoonerCare. However, each plan may offer extra benefits to help improve the health of its members.
Examples of added value benefits similar programs in other states include:
- Program for new and expecting mothers with customized support and care.
- Expanded nutritional counseling for members with chronic conditions.
- Home meal delivery during post-hospitalization, acute in-patient stay, and postpartum.
The following SoonerCare populations will be enrolled in SoonerSelect:
- Children, including foster children
- Low-income parents
- Pregnant women
- Adults aged 19-64
American Indian/Alaska Native members can opt-in to a SoonerSelect plan.
At least 60 days before the start date, OHCA will ask transitioning members to pick one dental plan and one health plan. Members can compare the extra benefits each health plan provides and choose the right one for them.
There are three plan types in the SoonerSelect program.
Dental Plans
All SoonerSelect members will enroll in a dental plan. Dental plans will cover medically necessary preventive and restorative dental care. Additionally, orthodontic services will be available for children under 21.
Health Plans
Most SoonerSelect members will be enrolled in a health plan. Health plans covers all medically necessary health and behavioral health services, except dental services.
Children’s Specialty Plan
SoonerSelect members involved in the juvenile justice system and those served by Oklahoma Human Services, including children in foster care and receiving adoption assistance will enroll in a children’s specialty plan instead of the health plan. The children’s specialty plan will receive medically necessary health and behavioral health services, except dental services. The children’s specialty plan will have a strong focus on the unique health and behavioral health needs of the children it serves. It places special emphasis on early identification of needs and interventions.
All plans must offer at least the services already available to SoonerCare members. Some plans may offer additional services.
All health plans will provide SoonerSelect enrollees with the same health care services currently offered by SoonerCare. Additionally, there are no changes to eligibility requirements.
Health plans can offer extra benefits to help improve the health of SoonerSelect members. Members will be able to compare extra benefits provided by each plan and pick the right one for them.
Each CE will have its own contracts with providers so the availability of specific providers may vary from CE to CE. If members have a doctor or other provider they want to want to keep seeing, they should pick a health plan they accept. During enrollment, when members are picking their plans, each plan will have a provider directory on its website that members can review.
Members will have the opportunity to pick their dental and medical health plans. Enrollment for a dental plan will begin in October 2023. Enrollment for medical plans will begin in November. SoonerCare representatives can help members pick the plan that best suits their needs. Members can enroll by logging in to MySoonerCare.org or call the SoonerCare Helpline at 800-987-7767.
In the first half of 2024. Members can expect more information as we get closer.
Right now, only the dental contracts have been awarded: DentaQuest and Liberty Dental. You can find more information at Oklahoma.gov/OHCA/SoonerSelect.
OHCA will award medical contracts at the end of May.
Yes. Members should make sure their case and contact information (address, phone number and email address) are up to date so when the time comes, they can receive critical information about SoonerSelect.
Like SoonerCare, SoonerSelect is paid for with Medicaid funds. Members are not responsible for plan premiums. Cost sharing and copays will still apply.
Insure Oklahoma is separate from SoonerSelect, and members eligible for Insure Oklahoma are not eligible for SoonerSelect.
