What you need to know about the new SoonerSelect Health plans
OKLAHOMA CITY (KFOR) – Many SoonerCare members in Oklahoma will be changing to the new SoonerSelect Health plans the first of this month.
According to SoonerSelect, members can now begin using their new coverage and value-added benefits that promote health and wellness both inside and outside of the doctor’s office.
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The goal of the Oklahoma Health Care Authority is to have SoonerSelect members feel comfortable and confident with their benefits and new health plan.
Below is a list of what members can expect before heading to their next appointment.
WHO ARE THE SOONERSELECT HEALTH PLANS?
SoonerSelect health plans include Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health.
WHAT MEMBERS ARE ELIGIBLE FOR SOONERSELECT HEALTH?
SoonerSelect health plans cover:
Non-disabled children, including children in foster care
Low-income parents
Pregnant women
Non-disabled adults ages 19-64
Eligible American Indian/Alaska Native (AI/AN) members have the choice to opt into enrollment in the SoonerSelect program. Current SoonerCare members were able to select a plan during the open enrollment period. Only new AI/AN members will be able to opt-in between April 1 and the next open enrollment period.
HOW DO MEMBERS ENROLL OR CHANGE THEIR HEALTH PLAN?
Members had an opportunity to pick a health plan during open enrollment. If a member did not make an active choice, OHCA assigned them a health plan.
Members may change their health plan through June 30, 2024.
Providers cannot change a SoonerSelect health plan for a member.
For enrollment questions, contact OHCA at 800-987-7767, option 5, or log into MySoonerCare.org.
HOW DO MEMBERS FIND THEIR HEALTH PLAN INFORMATION?
Members can log into their member portal at MySoonerCare.org to view their plan. Each plan’s provider directories, member handbooks and benefit guides can be found on the OHCA SoonerSelect website at oklahoma.gov/ohca/soonerselect/health-plans.html.
WHAT SHOULD MEMBERS TAKE TO THEIR APPOINTMENTS?
SoonerSelect members will need to make sure they have their health plan ID card before going to their appointments. Health plans will mail SoonerSelect health plan ID cards to each member. If the member has not received their health plan ID card by April 1, 2024, members should log onto MySoonerCare.org to see their plan information or contact their health plan for an electronic ID card.
Aetna Better Health of Oklahoma: 844-365-4385, AetnaBetterHealth.com/Oklahoma
Humana Healthy Horizons: 855-223-9868, Humana.com/Medicaid/Oklahoma
Oklahoma Complete Health: 833-752-1664, OklahomaCompleteHealth.com
HOW DO MEMBERS LEARN MORE ABOUT THEIR BENEFITS AND COVERAGE?
All SoonerSelect health plans offer the same services currently covered by SoonerCare. Members should review their plan’s benefit guide as well as the value-added benefits covered by their respective health plan. Members should contact the plans directly if they have any questions.
HOW DO MEMBERS FIND IN-NETWORK PROVIDERS?
Each health plan has its own provider network. Members can search the provider directories here: oklahoma.gov/ohca/soonerselect/health-plans.html.
WHAT IF A MEMBER’S PROVIDER IS NOT IN-NETWORK?
Members may continue to receive services that require prior authorization under SoonerCare until July 1, 2024, even if the provider is not in their health plan’s network. After July 1, 2024, a member may receive care from an out-of-network provider if an in-network provider cannot provide the service or the health plan determines an out-of-network provider is required. If a member’s provider is not in-network, the member should contact their health plan to learn more about available in-network providers.
HOW DO MEMBERS VIEW OR CHANGE THEIR PRIMARY CARE PROVIDER (PCP)?
To view, assign, or change PCPs, members should contact their health plan.
Aetna Better Health of Oklahoma: 844-365-4385, AetnaBetterHealth.com/Oklahoma
Humana Healthy Horizons: 855-223-9868, Humana.com/Medicaid/Oklahoma
Oklahoma Complete Health: 833-752-1664, OklahomaCompleteHealth.com
HOW DO MEMBERS UPDATE THEIR ADDRESS & INFORMATION WITH OHCA?
Members should make sure their contact information, such as address, phone number and email, are up to date with OHCA. Incorrect information may result in missing important information about SoonerSelect.
Members can update their information directly with OHCA by logging onto MySoonerCare.org or calling the SoonerCare helpline at 800-987-7767.
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MORE QUESTIONS?
For unanswered questions members can contact SoonerCare helpline at 800-987-7767 or visit the OHCA SoonerSelect website.
For health plan-specific questions, contact the health plans directly or review their Member Handbooks.
SoonerCare providers can find information and help here or by calling the Provider helpline at (405) 522-6205 or (800) 522-0114.
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