On Medicaid and like your doctor? You might need to choose a health plan by March 10
As a primary care physician, I know firsthand the difference that having a doctor in your corner makes. A long-term partnership with a provider helps people lead healthier lives. It can help with preventing disease and diagnosing some conditions sooner, when they are easier to treat.
That’s why I am doing my part to make sure all Oklahomans know about the changes coming to SoonerCare on April 1.
More than 1 million Oklahomans, including nearly half of all children, receive health care coverage from SoonerCare. In 2022, Gov. Kevin Stitt signed a law making Oklahoma the 41st state to adopt managed Medicaid. With managed Medicaid, the state pays third-party companies to manage patients’ care. It holds those companies accountable for the cost and quality of care delivered to patients.
Oklahoma’s managed Medicaid program is called SoonerSelect, and it begins April 1. If you or a loved one is on SoonerCare, now is the time to be learning more about the changes.
Not everyone will switch to SoonerSelect. For example, those covered under the Aged, Blind and Disabled program will continue with their current coverage. These folks do not need to do anything.
More: More than 307,000 Oklahomans lost SoonerCare coverage in last nine months
Kids, pregnant women, young families and many adults are eligible, and must choose a health plan to manage their health care needs.
Eligible individuals began receiving letters in January, delivered to the mailing address on file with SoonerCare. They must make their decisions no later than March 10 if they would like to have their choice of health plan. Those who make no choice, or who miss the deadline, will have their insurance plan and primary care physician chosen for them. Once assigned, members may only change insurance plans within the first 90 days of coverage. Members may change primary care physicians at any time if the desired new physician is in network.
SoonerSelect health plans work in a way similar to employer-sponsored insurance plans and are offered by companies with experience in managed Medicaid in other states. Under SoonerSelect, there are three options: Oklahoma Complete Health, Aetna Better Health of Oklahoma, and Humana Healthy Horizons. SoonerSelect members will have the chance to choose a plan.
Each plan offers the same basic benefits that are similar to SoonerCare. The exciting part is the extra benefits that each plan offers. These “value-added benefits” let SoonerSelect members add to their health care coverage other things that might matter to them. For example, there are financial rewards for seeing your primary care doctor, better vision services, programs for new parents, telehealth and access to a broad network of health care providers. The goal is to make health care better for everyone.
What to do if you need help choosing a plan under SoonerSelect
Choosing the right plan might seem tricky, but help is available. Choice counselors can help determine the best plan for families and individuals. For help picking a plan, go to http://tinyurl.com/292xwt77 or call the SoonerCare Helpline at 800-987-7767 and select Option 5.
After choosing a plan, members should make an appointment with their primary care doctor. People who regularly see a primary care doctor for care have better health and lower health care costs.
As a lifelong Oklahoman, I share in our commitment to the continued good health of all who live here. With an increased focus on preventive and primary care, mental health care and maternity and newborn care, the changes coming with SoonerSelect are a big deal in how we care for our community.
I’m asking all eligible Oklahomans to embrace this change and let SoonerSelect help us realize a healthier future.
Dr. Rachel Franklin is a family medicine physician and the associate chief physician executive for Care Delivery Models at OU Health.
This article originally appeared on Oklahoman: SoonerCare changing April 1; Oklahomans need to select health plan
