SoonerSelect is Oklahoma’s Medicaid managed care program, which replaced the state’s previous fee-for-service model with private insurance companies that coordinate and deliver healthcare to most SoonerCare (Medicaid) members. Instead of the state paying doctors directly for each visit, Oklahoma now contracts with health plans that manage members’ medical, dental, pharmacy, and behavioral health benefits. The program launched in phases, with the Children’s Specialty Program beginning April 1, 2024.
How SoonerSelect Works
Under SoonerSelect, eligible Oklahomans are assigned to (or choose) a private health plan that acts as a go-between for the state and healthcare providers. Your health plan handles your benefits, helps you find doctors, and coordinates your care. You still have SoonerCare coverage, but a specific insurance company manages the details.
Three insurance companies provide medical coverage:
- Aetna Better Health of Oklahoma
- Humana Healthy Horizons in Oklahoma
- Oklahoma Complete Health
For dental coverage, two separate companies handle benefits:
- DentaQuest
- Liberty Dental Plan
You’ll have both a medical plan and a dental plan. Any provider you see, including specialists and pharmacies, needs to be contracted with your specific plan.
Who Must Enroll
Most SoonerCare members are required to join SoonerSelect. The mandatory groups include expansion adults, parents and caretaker relatives, pregnant women, newborns, former foster children, children in juvenile justice, foster care children, children receiving adoption assistance, and children generally.
American Indian and Alaska Native members are the main exception. They can voluntarily opt in to SoonerSelect but are not required to enroll.
Who Is Excluded
Several groups remain outside of SoonerSelect entirely and continue receiving services through traditional SoonerCare. These include people who have both Medicare and Medicaid (dual-eligible individuals), anyone enrolled in a home and community-based waiver program, people eligible for Medicaid based on age, blindness, or disability, and those in nursing facilities or similar levels of care. People receiving Medicaid coverage only for emergency services, breast or cervical cancer treatment, tuberculosis-related services, or family planning through SoonerPlan are also excluded.
The Children’s Specialty Program
SoonerSelect includes a specialized track called the Children’s Specialty Program (CSP), designed for children in particularly vulnerable situations. Starting April 1, 2024, three groups were automatically enrolled: children in the custody of Oklahoma Human Services (including American Indian and Alaska Native children), juvenile justice-involved children, and foster children in tribal custody who opted in to SoonerSelect.
Two additional groups can choose the CSP or pick a different SoonerSelect health plan. If they don’t actively choose, they default into CSP. These are children and youth receiving adoption assistance and former foster care members up to age 25.
Finding a Provider in Your Plan
Your doctor, specialist, and pharmacy all need to be contracted with your specific SoonerSelect plan. The Oklahoma Health Care Authority offers an online provider directory where you can search by plan, provider name, facility, specialty, and location. Each of the three health plans (Aetna, Humana, and Oklahoma Complete Health) also maintains its own provider directory.
When scheduling an appointment, it’s worth confirming directly with the provider’s office that they’re currently seeing SoonerSelect members under your plan. If you’re having trouble finding a provider, your plan’s member services line can help.
Value-Added Benefits Beyond Standard Coverage
One of the more notable features of SoonerSelect is that the health plans offer extra benefits beyond what traditional Medicaid covers. These vary by plan and sometimes by member eligibility, but they go well beyond typical medical care.
Pregnant members who complete prenatal visit requirements or care management programs can receive a portable crib or car seat. Members in care management may get a YMCA membership. Food-insecure members can receive up to four fresh produce farm boxes per year, and members discharged from the hospital with certain chronic conditions can get up to 21 meals per week for 12 weeks.
Plans also offer financial incentives for staying on top of your health. Members can earn gift cards and prepaid Visa cards for completing activities like annual wellness visits, screenings, and vaccinations. Some plans provide a free smartphone with a wireless plan so members can access telehealth services and health plan resources.
The benefits extend into education and daily life as well. Members 16 and older can access job skills training, GED tutoring, and exam fee vouchers, while K-12 students may receive online tutoring and ACT/SAT prep. Up to $350 per year is available for housing expenses like rent, mortgage, utilities, or moving costs. Some plans cover up to $250 per year for pest control and asthma trigger mitigation in the home. Transportation benefits include up to 15 round trips per year for non-medical purposes like grocery shopping, food bank visits, and job interviews.
Not every benefit is available through every plan, and some require participation in care management or meeting specific health criteria. Contacting your plan directly is the most reliable way to find out which extras apply to you.