Oklahoma Health Care Authority (OHCA) administers Oklahoma’s Medicaid program, known as SoonerCare. OHCA is now implementing SoonerSelect, the new Medicaid value-based, managed care program in Oklahoma. Starting April 1, 2024, certain SoonerCare members will automatically begin receiving services through SoonerSelect.

The below three health plans were awarded the opportunity to serve Medicaid members under SoonerSelect. These health plans cover SoonerSelect members in all of Oklahoma’s 77 counties.

1. Oklahoma Complete Health (Centene)
2. Aetna Better Health of Oklahoma
3. Humana Healthy Horizons in Oklahoma

SoonerSelect Claims Processing Information

OHCA Pharmacy Requirement

To participate, plans require pharmacies to have a valid Oklahoma Medicaid ID and be listed on the roster managed by OHCA/SoonerSelect. If your pharmacy is not enrolled with Oklahoma Medicaid and wishes to participate, click here to go to the enrollment page. Select "New Contracts" under the "Contracts" header to begin the process.

OHCA Member Eligibility

Traditional SoonerCare is not ending. A majority of SoonerCare members will be moving to SoonerSelect. The table below provides a high-level overview of member eligibility. Please reference the SoonerSelect Health Program Member Quick Reference Guide.

Member Eligibility

For further details regarding excluded, mandatory, and voluntary populations, click here.

*SoonerSelect Children’s Specialty Program will be managed by Oklahoma Complete Health. It includes children in foster care, former foster children up to age 25, juvenile justice-involved children, and children receiving adoption assistance.

Clinical Exploratory Discussions

The AlignRx Clinical Services department is actively engaged with Oklahoma Complete Health, Aetna Better Health of Oklahoma, and Humana Healthy Horizons in Oklahoma to pursue payment for pharmacy-delivered clinical services, such as those listed below. The plans' immediate priority is the SoonerSelect April 1 launch, with the intent to re-engage regarding clinical services.

• Health risk screenings
• Social determinants of health (SDOH) screenings
• Immunization screenings and administration
• Medication synchronization
• Adherence packaging
• Home delivery

QUESTIONS? AlignRx Pharmacy Services: 844-ALIGNRX (844-254-4679), option 1