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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 317. Oklahoma Health Care Authority |
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Chapter 35. Medical Assistance for Adults and Children-Eligibility |
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Subchapter 5. Eligibility and Countable Income |
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Part 7. APPLICATION AND ELIGIBILITY DETERMINATION PROCEDURES |
SECTION 317:35-5-63. Agency responsible for determination of eligibility
Latest version.
- (a) Determination of eligibility by Oklahoma Health Care Authority (OHCA). OHCA is responsible for determining eligibility for the following eligibility groups:(1) children(2) newborns deemed eligible(3) pregnant women(4) pregnancy-related services under Title XXI(5) parents and caretaker relatives(6) former foster care children(7) Oklahoma Cares Breast and Cervical Cancer program(8) SoonerPlan Family Planning program.(9) Programs of All-Inclusive Care for the Elderly(b) Determination of eligibility by DHS. DHS is responsible for determining eligibility for the following eligibility groups:(1) TANF recipients(2) recipients of adoption assistance or kinship guardianship assistance(3) state custody(4) Refugee Medical Assistance(5) aged(6) blind(7) disabled(8) Tuberculosis(9) QMBP(10) QDWI(11) SLMB(12) QI-1(13) Long term care services(14) alien emergency services.(c) Determination of eligibility for programs offered through the Health Insurance Exchange. Effective October 1, 2013, OHCA assesses applicants who are found to be ineligible for SoonerCare for potential eligibility for affordable insurance programs offered through the Health Insurance Exchange. OHCA does not determine eligibility or ineligibility for those programs. OHCA facilitates the determination for those affordable insurance programs by forwarding applicants' electronic applications to the Health Insurance Exchange.