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  • Oklahoma Medicaid Application Form

Get Oklahoma Medicaid Application Form

/ Pharmacy Prior Authorization Form Confidential Information Patient DOB Patient Name Patient ID Number Physician Name Phone Specialty Fax DEA # Physician Address City State Zip Drug Requested: 2/0.5mg.

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Contact support

For assistance with the Online SoonerCare Application or other questions or concerns about SoonerCare, please call the SoonerCare Helpline at 800-987-7767.

You may apply at your local county DHS office or download the PS-1 - Request for Services application from the DHS website. The DHS workers will assist you in gathering the needed information such as your income, assets, family size and, if available, recent medical information.

SoonerCare is Oklahoma's Medicaid program, and the Oklahoma Health Care Authority (OHCA) is the state agency that administers it. The health care needs of Oklahomans can be many and complex. SoonerCare offers various health benefit packages to accommodate our members in the most fiscally responsible way.

Expansion Adults (effective: 4/1/2023) Size of HouseholdMonthly IncomeAnnual Income1$1,677$20,1242$2,269$27,2283$2,860$34,3204$3,450$41,4004 more rows

Federal Law Requires Proof of Citizenship and Identity If you are applying for SoonerCare for the first time, you must provide one-time proof of your U.S. citizenship and identity. This flyer explains how to send in that proof. Newborn children (under age one) of SoonerCare members do not have to show proof.

Apply for Medicaid in Oklahoma Eligibility: The aged, blind, and disabled. Also, parents with income up to 42% of poverty, pregnant women with income up to 138% of poverty level, and children under age 19 with income up to 205% of poverty.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232