SoonerPlan is Oklahoma’s family planning program for adults who don’t qualify for or aren’t enrolled in the state’s full Medicaid program, called SoonerCare. It covers birth control, related exams, lab tests, and sterilization procedures at no cost to eligible members. The program is open to both women and men between the ages of 19 and 64 who meet income requirements.
What SoonerPlan Covers
SoonerPlan is strictly a family planning benefit. It pays for birth control supplies and information, office visits and physical exams tied to family planning, and lab work including pregnancy tests, Pap smears, and screening for some sexually transmitted infections. For permanent birth control, the program covers tubal ligations for women and vasectomies for men who are 21 or older. It also covers the Gardasil (HPV) vaccine for both men and women through age 45.
What SoonerPlan does not cover is essentially everything else. It is not a general health insurance plan. Prenatal care, emergency room visits, prescriptions unrelated to birth control, dental care, vision care, and routine medical treatment for illness or injury all fall outside its scope. If you need broader coverage, you would need to apply for SoonerCare (Oklahoma’s Medicaid program) or find coverage through the Health Insurance Marketplace.
How SoonerPlan Differs From SoonerCare
SoonerCare is Oklahoma’s full Medicaid program, covering doctor visits, hospital stays, prescriptions, mental health services, and more. SoonerPlan exists specifically for people who aren’t enrolled in SoonerCare but still need access to birth control and reproductive health services. Think of it as a single, narrow benefit rather than comprehensive insurance. The income limits for SoonerPlan are considerably higher than for regular Medicaid, which means many people who earn too much for SoonerCare can still qualify.
Income and Eligibility Requirements
To qualify for SoonerPlan, you must be between 19 and 64 years old, live in Oklahoma, and have a household income below the program’s limits. Those limits are fairly generous compared to other Medicaid categories. Here are the current annual income caps by household size:
- 1 person: $33,672 per year ($2,806/month)
- 2 people: $45,672 per year ($3,806/month)
- 3 people: $57,648 per year ($4,804/month)
- 4 people: $69,624 per year ($5,802/month)
- 5 people: $81,624 per year ($6,802/month)
- 6 people: $93,600 per year ($7,800/month)
Larger households follow the same pattern, with the limit increasing by roughly $12,000 for each additional person. A single adult earning $30,000 a year, for example, would qualify. So would a family of four with a combined income under $69,624.
How to Apply
You can apply online through the Oklahoma Health Care Authority website. Before starting, gather the following: Social Security numbers and birthdates for everyone in your household, income information (including employer name and address for anyone who works), any current health insurance details, and identity or citizenship documentation. If anyone in the household is pregnant, you’ll also need the expected due date.
The online application lets you create a user account so you can save your progress and return later if you don’t finish in one sitting. If you run into questions during the process, the SoonerCare helpline is available at 800-987-7767.
Finding a Provider
SoonerPlan members need to see a provider who is contracted with the state’s network. The Oklahoma Health Care Authority maintains an online provider directory where you can search by plan type, provider name, specialty, and location. County health departments are a common option for family planning visits, but private clinics and physicians also participate.
One thing to keep in mind: being listed in the directory doesn’t guarantee availability. Some offices may not be accepting new SoonerCare or SoonerPlan patients, or may have age restrictions. It’s worth calling ahead before scheduling. Seeing an out-of-network provider could leave you with a bill the program won’t pay.