If you live in Oklahoma and need affordable health coverage, you may qualify for SoonerCare, which is Oklahoma's Medicaid program. Since Oklahoma expanded Medicaid in July 2021, more than 330,000 additional residents have gained coverage. Today, nearly one million Oklahomans receive health benefits through SoonerCare. This guide walks you through the eligibility requirements, income limits, and exact steps to apply.
Want to quickly check if you qualify for SoonerCare and other benefits? Use our free screener to find out in minutes.
Who Qualifies for SoonerCare (Oklahoma Medicaid)?
Oklahoma offers SoonerCare to several groups of residents, including:
- Adults ages 19 to 64 with income at or below 138% of the Federal Poverty Level (FPL)
- Children ages 0 to 18 with household income at or below 210% of the FPL
- Pregnant women with household income at or below 210% of the FPL (include expected babies in household size)
- Adults 65 and older or those who are blind or disabled (separate eligibility rules apply)
- Parents and caretaker relatives with dependent children in the home
To qualify for most SoonerCare categories, you must also:
- Be an Oklahoma resident
- Be a U.S. citizen or qualified immigrant
- Have a Social Security number (or have applied for one)
- Not be currently incarcerated
There is no asset test for most SoonerCare categories. Eligibility is based on your Modified Adjusted Gross Income (MAGI), which generally matches your adjusted gross income from your tax return.
Oklahoma Medicaid Income Limits (2025 to 2026)
The income limits below are effective from April 1, 2025 through March 31, 2026. These are based on monthly household income.
Adults Ages 19 to 64 (138% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,799 |
| 2 | $2,432 |
| 3 | $3,064 |
| 4 | $3,697 |
| 5 | $4,330 |
| 6 | $4,962 |
| 7 | $5,594 |
| 8 | $6,227 |
| Each additional | +$632 |
Children (Ages 0 to 18) and Pregnant Women (210% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $2,738 |
| 2 | $3,702 |
| 3 | $4,664 |
| 4 | $5,625 |
| 5 | $6,589 |
| 6 | $7,551 |
| 7 | $8,513 |
| 8 | $9,477 |
| Each additional | +$961 |
Think your income might be too high? Apply anyway. Some applicants qualify for SoonerCare with slightly higher incomes due to certain deductions. If you do not qualify for SoonerCare, you may be eligible for reduced cost health insurance through HealthCare.gov with premium tax credits.
Not sure where you fall? Check your eligibility with our free screener to see all the programs you may qualify for.
What Documents Do You Need to Apply?
Having the right documents ready will speed up your application. Gather the following before you start:
- Proof of identity such as a driver's license, state ID, passport, or birth certificate
- Social Security numbers for everyone in your household who is applying
- Proof of income including recent pay stubs, tax returns, W-2 forms, or a letter from your employer
- Proof of Oklahoma residency such as a utility bill, lease agreement, or bank statement with your address
- Proof of citizenship or immigration status such as a birth certificate, U.S. passport, or immigration documents
- Proof of pregnancy (if applicable) from your doctor or clinic
- Information about current health insurance if you have any existing coverage
If you do not have all of your documents ready, you can still submit your application. Oklahoma may be able to verify some information electronically.
How to Apply for SoonerCare: Step by Step
There are four ways to apply for SoonerCare in Oklahoma. Choose whichever method works best for you.
Option 1: Apply Online Through the MySoonerCare Portal
This is the fastest method for most applicants.
- Go to the MySoonerCare portal on the Oklahoma Health Care Authority website
- Create an account or log in if you already have one
- Select "Apply for SoonerCare"
- Fill out the application with your personal information, household details, and income
- Upload or submit any required documents
- Review your application and submit it
- Save or print your confirmation number for your records
Option 2: Apply Through HealthCare.gov
You can also apply through the federal marketplace, which will determine if you qualify for SoonerCare or for marketplace insurance with subsidies.
- Visit HealthCare.gov
- Click "Apply & Enroll"
- Create an account and complete the application
- If you qualify for Medicaid, your application will be forwarded to Oklahoma's SoonerCare program
- If you do not qualify for Medicaid, you will see marketplace plan options with any premium tax credits you are eligible for
Option 3: Apply by Phone
Call the SoonerCare Helpline at 1-800-987-7767. A representative can help you complete your application over the phone and answer any questions about eligibility.
You can also call the federal marketplace at 1-800-318-2596 for help applying through HealthCare.gov.
Option 4: Apply in Person
Visit your local Oklahoma Department of Human Services (DHS) office. This option is especially helpful for:
- People who are 65 or older
- People who are blind or have a disability
- Anyone who needs hands-on help with the application process
You can find your nearest DHS office at okdhs.org/countyoffices.
What Happens After You Apply?
After you submit your SoonerCare application, here is what to expect:
- Processing time: Oklahoma typically processes applications within 45 days (90 days for disability-related applications)
- Verification: The state may contact you to verify information or request additional documents. Respond promptly to avoid delays.
- Decision notice: You will receive a written notice by mail telling you whether you have been approved or denied
- If approved: Your SoonerCare coverage will begin, and you will receive a SoonerCare member ID card. Coverage may be backdated up to 3 months before your application date if you were eligible during that time.
- If denied: The notice will explain why and how to appeal. You have the right to request a fair hearing if you disagree with the decision.
SoonerCare Benefits: What Does Oklahoma Medicaid Cover?
Once approved, SoonerCare covers a wide range of medical services, including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance abuse treatment
- Lab tests and X-rays
- Preventive care and screenings
- Dental care (for children; limited for adults)
- Vision care (for children; limited for adults)
- Home health services
- Transportation to medical appointments (SoonerRide)
- Family planning services
For pregnant women, SoonerCare also covers prenatal care, delivery, and postpartum care for up to 12 months after giving birth.
Special Programs to Know About
Insure Oklahoma (Employer-Sponsored Insurance)
If your income is too high for SoonerCare but you work for a small business (with fewer than 250 employees), you may qualify for Insure Oklahoma. This program helps pay for employer-sponsored insurance premiums. Income limits are higher, ranging up to approximately 200% to 250% of the FPL depending on the plan.
SoonerPlan (Family Planning)
Adults ages 19 to 64 who do not qualify for full SoonerCare benefits may qualify for SoonerPlan, which covers family planning services including contraception, screenings, and related office visits.
Soon-To-Be-Sooners (STBS)
This program provides prenatal care to pregnant women who do not qualify for full-scope SoonerCare benefits. It covers pregnancy-related services to ensure healthy outcomes for mothers and babies.
Keeping Your SoonerCare Coverage
Once you are enrolled, you must renew your SoonerCare coverage each year. Oklahoma will send you a renewal notice before your coverage period ends. You can renew:
- Online through the MySoonerCare portal
- By phone at 1-800-987-7767
- By returning the renewal form by mail
Important: Report any changes in income, household size, address, or other circumstances within 10 days. Failing to report changes or respond to renewal notices can result in losing your coverage.
Frequently Asked Questions
Can I apply for SoonerCare at any time of year?
Yes. Unlike marketplace health insurance, Medicaid does not have an open enrollment period. You can apply for SoonerCare at any time during the year.
How long does it take to get approved for SoonerCare?
Most applications are processed within 45 days. If your application involves a disability determination, it may take up to 90 days. You can check your application status through the MySoonerCare portal or by calling 1-800-987-7767.
Can I get SoonerCare if I am undocumented?
Undocumented immigrants generally do not qualify for full SoonerCare benefits. However, emergency Medicaid may cover emergency medical conditions regardless of immigration status. Pregnant women may also qualify for certain prenatal coverage regardless of status.
What if I am denied SoonerCare?
If your application is denied, you will receive a notice explaining the reason. You have the right to appeal the decision by requesting a fair hearing. The notice will include instructions on how to file an appeal and the deadline for doing so.
Can I have both SoonerCare and other insurance?
Yes. If you have other health insurance (such as through an employer), SoonerCare can serve as secondary coverage and may help cover costs that your primary insurance does not pay.
Does SoonerCare cover dental and vision for adults?
SoonerCare provides limited dental benefits for adults, including emergency extractions and dentures in some cases. Vision benefits for adults are also limited. Children receive comprehensive dental and vision coverage through the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit.
Next Steps
Getting started with your SoonerCare application does not have to be complicated. Here is a quick summary of your options:
- Check your eligibility with our free benefits screener to see if you qualify for SoonerCare and other programs
- Apply online at the MySoonerCare portal or HealthCare.gov
- Call for help at 1-800-987-7767 (SoonerCare Helpline)
- Visit in person at your local DHS office
For a complete overview of all benefits available in your state, visit our Oklahoma Benefits Overview page.
Remember, there is no cost to apply, and you can submit your application at any time. Even if you are not sure you qualify, it is worth applying because you might be eligible for more help than you think.
