Oklahoma Medicaid Eligibility Rules

Medicaid is a federal health care plan, administered by the states, which provides medical coverage for low-income and disabled Americans and long-term care for the elderly. In Oklahoma, the Medicaid program is known as SoonerCare. The Oklahoma Health Care Authority establishes Medicaid rates in the state, while the Department of Human Services takes applications and determines who qualifies for medical health care assistance.

Basic Qualifications

Those considered for Medicaid must be a citizen of the United States or a permanent resident who has legal alien status. The person requesting Medicaid assistance must also be a resident of Oklahoma. The applicant must have a valid Social Security number.

Eligibility Categories

SoonerCare provides medical assistance to certain children under the age of 19, pregnant women, the elderly--age 65 and older, families with children under the age of 18, and the disabled.
Individuals are considered categorically needy if their income and resources are at or below levels established for the type of assistance for which they qualify. Individuals are medically needy if their income and resources exceed established levels, but are not sufficient to meet the cost of medical care.
Adults with children under the age of 18 who receive assistance from the Temporary Assistance to Needy Families (TANF) program are automatically eligible; others may be eligible if they meet income and resource guidelines, according to the Oklahoma Department of Human Services.
The blind and other people who have a physical or mental impairment or disease that appears reasonably certain to continue at least 12 months and substantially impairs their ability to perform labor or services or to engage in a useful occupation are eligible if they meet income and resource guidelines, according to the department.
Children under 19 and pregnant women who meet income levels are eligible. The medical assistance for pregnant women must be related to their pregnancy.
Elderly people, 65 and older, who meet income and resource guidelines are eligible, even those who receive Medicare, provided their aid, income and resources do not meet the cost of medical needs.

Income Rules

A qualified applicant's income and, in some cases, financial resources must be less than the amounts specified by the Oklahoma Department of Human Services. For example, the maximum income for pregnant women and people under the age of 19 is $1,670. If there are two people in the family, the income level rises to $2,247 For a family of 3, it's $2,823; for four, $3,400; for five, $3,976, for six, $4,553; for seven $5,130; and for eight, $5,706. Another $577 is added to income level for each additional family member.
When determining financial resources for Medicaid eligibility, certain items are excluded. These include the value of a home (real or personal property) used as the primary residence; furnishings; and the value of one vehicle, if its current market value does not exceed $4,500. Resources are checked monthly to make sure they fall within the guidelines.