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COVID-19
We know you have lots of questions about COVID-19. We’re here to support you with answers. Just check these resources to learn more:
General questions
SoonerCare is a government program that provides no-cost or low-cost health care for millions of Americans. Adults and children who qualify meet certain state guidelines. Eligibility is based on your total family income and household size. Once you apply, the Oklahoma Health Care Authority reviews your enrollment in SoonerCare. If you’re approved for SoonerCare, you can choose us or another SoonerSelect health plan as your plan.
Questions about eligibility? You can contact SoonerCare directly for help at 1-800-987-7767.
SoonerCare
Learn more about what’s covered
Find out if you qualify
People who may qualify for SoonerCare services include:
- Adults with children under 19
- Children under 19
- Pregnant women
- Adults, not eligible for Medicare, ages 19 to 64
- People 65 and older
- People who are blind or have disabilities
- Women under 65 in need of breast or cervical cancer treatment
- Men and women 19 and older with family planning needs (SoonerPlan)
- People who were enrolled in SoonerCare and aged out of foster care (at 18 years old) in another state, on or after January 1, 2023
If you’re approved for SoonerCare, you can choose us as your SoonerSelect health plan.
We want you to be happy with the care you get. So if you’re ever unhappy with your health plan or a provider, you can file a grievance. Or you can file an appeal if we deny, delay or change a service. If you don’t agree with the decision on your appeal, you can ask for a state fair hearing.
Tell us. You have the right to report anyone you believe is committing fraud or abuse.
Member Services
You’ll find your health plan summary and benefits info in your member handbook or on your Member Portal or Aetna Better Health app.
We’re here for you at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.
You can also use the Contact us page to get in touch. Or log in to your Member Portal or Aetna Better Health app.
You have some options if you lose your member ID card. First, log in to your Member Portal or Aetna Better Health app. There, you can:
- Ask us to mail you a new ID card
- Find the electronic version of your ID card — as long as you have your smartphone, you’ll always have your ID card with you for health care visits
Or call us at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.
My health care providers
Your PCP is a medical provider who will manage your health care. They’re the doctor, nurse, physician assistant or clinic that provides your main health care. They’ll help you get all the covered services you need.
You can change your PCP through your Member Portal or Aetna Better Health app. You can also call Member Services at 1-844-365-4385 (TTY: 711). This is the number on your ID card.
You can also learn more about choosing a PCP.
Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
Specialists are providers who treat specific conditions. Your PCP might refer you to a specialist in our network. Or they may recommend you see one. Need help finding a specialist? You can call us at 1-844-365-4385 (TTY: 711).
You can use our online search tool to find providers for the health care services you need.
Call the provider’s office and let them know you have Aetna Better Health. This means you shouldn’t get a bill. If you keep getting bills, just call us at 1-844-365-4385 (TTY: 711).
Coverage and care
Whether it’s day or night, your PCP or on-call provider can tell you what to do. If they’re not in the office, leave a message. They’ll return your call. Your provider must see you within 24 hours if you need urgent care.
If you're having an emergency, call 911 or go to the closest hospital.
You’ll only need emergency care if you think your health is in serious danger. Emergencies may include:
- Severe pain
- Serious injury
- Sudden illness
- Illness that is quickly getting much worse
- Heavy bleeding that doesn’t stop, especially if you’re pregnant
If it’s not an emergency, but you need medical advice, call us at 1-844-365-4385 (TTY: 711). Then, choose the option for the 24-Hour Nurse Line. A nurse can help you decide if you need to go to the ER or urgent care.
Check out some of these articles to learn more about getting the right care at the right time:
If you have no way to get to the hospital during an emergency, call 911. We cover ambulance rides on the ground in a medical emergency.
Need a ride to your doctor visits? You can get help with rides to medical services we cover. We cover rides for your nonemergency medical needs. You can get a ride for visits to your:
- Provider
- Dental provider
- Pharmacy
- Behavioral health appointments
If you’re away from home and have an emergency, go to the closest hospital or call 911. The hospital doesn’t have to be in our network for coverage and care.
You can use the provider search tool to find a hospital. Or you can call us at 1-844-365-4385 (TTY: 711) for help.
Pregnant women need special care. You’ll want to see a provider within three weeks of a positive pregnancy test (home or lab). We can help with pregnancy care. Just call us as soon as you can at 1-844-365-4385 (TTY: 711).
You can also visit our health and wellness library to learn more about pregnancy, women’s health and other topics to help keep you healthy.
You’ll want to make sure your baby has medical coverage. If you don’t have insurance when your baby is born, enroll them in SoonerCare. You can do so by contacting the Oklahoma Health Care Authority.
If you have questions or need help, just call us at 1-844-365-4385 (TTY: 711).
When you have a condition, you’ll work with your health care provider to set up a treatment plan. The plan will likely include certain steps, like:
- Taking medication
- Making lifestyle changes, like eating and exercise
- Finding emotional support
Some conditions can benefit from disease management, like:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Heart failure
- Coronary artery disease (CAD)
- Depression
Do you have one of these conditions? If yes, you may be able to get help from a care manager. You can learn more on our page about disease management. Or call us at 1-844-365-4385 (TTY: 711).
Pharmacy
A PDL is a list of covered medications. In Oklahoma, the list comes from Oklahoma Health Care Authority. These medications treat a variety of conditions. You can learn more on our Pharmacy benefits page.
You can ask your provider to:
- Give you a similar medication that is preferred on the list
- Get prior authorization (PA) to cover this medication if they think it’s necessary to treat your medical condition
First, your provider will contact us. Then, our pharmacy staff will review the info your provider gave us. Finally, we’ll make a decision.
You don’t need a referral to see in-network providers for routine and preventive health care services.
You do need PA for some health care services and supplies before you get them. The Oklahoma Health Care Authority Drug Utilization Board uses nationally recognized guidelines to make PA decisions about care your provider suggests.
Your provider must check to see if your service requires PA before they provide it. You can learn more about PA.
The Oklahoma Health Care Authority Drug Utilization Board sets quantity limits for different reasons. Some medications have a maximum limit or dose for safety reasons. The Oklahoma Health Care Authority Drug Utilization Board sets the limits based on proven standards of care, such as the U.S. Food and Drug Administration (FDA) guidelines. In some cases, we make exceptions. Have your provider contact us. We’ll review the info from your provider and make a decision. You can learn more about pharmacy benefits.
These types of medications aren’t covered on the PDL:
- Cosmetic
- Hair growth
- Infertility or erectile dysfunction
- Experimental or investigational
- Weight loss/weight gain
- Nutritional supplements
- Cough and cold medications
Your health
Staying active is one of the best things you can do for your health. It can:
- Give you more energy
- Help you feel better
- Prevent some health problems that go along with aging
Some physical activity is better than none at all. But check with your doctor before you start — just to be sure it’s safe. Want to learn more about staying active?
You can learn more about health goals, info and coaching.
You’re not alone. During the COVID-19 pandemic, many people have felt more stress and anxiety than ever. They need more help than usual coping with everyday pressures. Things like job loss, child care issues and other challenges are very real.
Did you know that stress can affect your health? It’s common during times of stress to pick up some unhealthy habits. Don’t be too hard on yourself. It’s not always easy, but you can learn ways to:
- Eat healthy
- Exercise regularly
- Start other healthy habits
Learn more about healthy habits:
- Healthy living resources
- 4 ways to take care of physical and mental well-being during unsettled times
- Staying mentally healthy in tough times
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. Or you can find this info on your Member Portal or Aetna Better Health app.
It may not be easy, but you can stop using nicotine — whether it’s smoking, vaping, chewing or another form. Let’s quit together.
Oklahoma Tobacco Settlement Endowment Trust (TSET)
TSET is a state trust that aims to prevent cancer and cardiovascular disease. These are leading causes of death in Oklahoma. The trust awards grants to:
- Schools
- Communities
- State agencies
- Other partners
Through these grants, TSET:
- Funds research and other opportunities
- Addresses our state’s most pressing public health issues
- Works to improve the health of people who live in Oklahoma
- Creates healthier places for all Oklahomans to live, work, learn and play
Find more support
You can also learn more about quitting from the:
- Oklahoma Tobacco Helpline: 1-800-QUIT-NOW (1-800-784-8669)
- American Cancer Society’s guide to quitting smoking
- Great American Smokeout® event
- Centers for Disease Control and Prevention
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
Learn more about substance use and mental health issues from the:
- Alcoholics Anonymous® website
- Substance Abuse and Mental Health Services Administration (SAMHSA) website
And be sure to check out even more mental and behavioral health resources.
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
If you’re having a mental health crisis, get help right away. You can call the Oklahoma Mental Health Lifeline by dialing 988. They also offer their free, confidential counseling through chat and text.
And be sure to check out even more mental and behavioral health resources.
Questions?
Just call Member Services at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.