Note: You may sometimes see the term “enrollee” used along with the term “member.” This means a SoonerCare member eligible to choose a SoonerSelect plan.
What is SoonerSelect?
SoonerSelect is a health care delivery system used to coordinate health and dental care and to improve quality of care. The Oklahoma Health Care Authority (OHCA) will partner with health and dental plans to coordinate the care for most members. SoonerSelect provides Medicaid health benefits through contracted arrangements between state Medicaid agencies, health plans and dental plans.
Note: You may hear phrases such as contracted entities (CEs) or provider-led entities (PLEs) to describe health plans and dental plans.
The change 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 member satisfaction.
- Focus on preventive and primary care.
All health/dental plans will provide the same health care services currently offered by SoonerCare.
All health/dental plans will provide the same health care services currently offered by SoonerCare. Each plan may also offer extra benefits to help you and other members be healthier.
There are three SoonerSelect programs.
SoonerSelect Dental Program
AI/AN members can enroll in a dental plan. Dental plans will cover medically necessary preventive and restorative dental care. Additionally, medically necessary orthodontic services will be available for children under 21 years old.
SoonerSelect Health Program
AI/AN members can enroll in a health plan. Health plans will cover medically necessary prescriptions, health services and behavioral health services.
Children’s Specialty Program
The SoonerSelect Children’s Specialty Program (CSP will serve members involved in the juvenile justice system and those served by Oklahoma Human Services. This includes children in foster care and children receiving adoption assistance. The CSP provides medically necessary prescriptions, health care services and behavioral health services that focus on the unique health needs of the children it serves. It places special emphasis on early identification of needs and interventions.
How will AI/AN members be affected?
AI/AN members can join SoonerSelect but are not required to enroll. No action is required by an AI/AN member unless the member wants to join a SoonerSelect health/dental plan.
If you choose to enroll in SoonerSelect, you may opt-in to select a SoonerSelect plan for medical coverage by calling the Helpline at 800-987-7767, option 5.
Will my benefits change if I enroll in SoonerSelect?
All health and dental plans will provide SoonerSelect members with the same health care services currently offered by SoonerCare, but each plan may also offer extra benefits to help other members and you be healthier.
Why should I enroll in a plan?
In addition to your current benefits through SoonerCare, SoonerSelect dental and health plans can offer extra benefits to help improve your health. Some extra benefits include car seats for new parents, money for groceries, routine eye exams, and more. You can compare the extra benefits provided by each plan by clicking here.
You can enroll in a SoonerSelect health plan even if you did not enroll in a SoonerSelect dental plan.
As an AI/AN member, how and when do I opt-in?
You will have the chance to pick your dental and health plans during open enrollment. SoonerCare representatives can help you pick the plan that best suits your needs. You can enroll by calling the SoonerCare Helpline at 800-987-7767, option 5.
Dental open enrollment is from Dec. 1, 2024-Jan. 10, 2024. Health open enrollment is from Feb. 1-March 10, 2024. If you do not opt-in during open enrollment, you will not be allowed to join SoonerSelect until the next open enrollment period.
What happens if I don’t opt-in to SoonerSelect?
If you do not opt-in to SoonerSelect, you will remain on SoonerCare. You will not lose SoonerCare coverage if you choose not to join SoonerSelect.
Does it cost to join SoonerSelect?
There is no cost for enrolling in a SoonerSelect plan.
Will I have a co-pay?
No, AI/AN members are exempt from co-pays.
Can I disenroll at any time?
AI/AN members may disenroll from the SoonerSelect program at any time. If you choose to disenroll from SoonerSelect, you will not be allowed to join SoonerSelect until the next open enrollment period.
Will I be able to go to my Indian Health Care Provider (IHCP)?
AI/AN members can still receive services from a primary care Indian Health Care Provider. Each health and dental plan will have its own network of providers. The availability of specific providers may vary from plan to plan.
Each plan has a provider directory you can view by clicking here. You can select your Indian Health Care Provider as a PCP for your health plan if they are available in the provider directory.
