Oklahoma Complete Health is a Medicaid managed care program designed to provide comprehensive healthcare services to eligible individuals and families in Oklahoma. As a managed care organization, Oklahoma Complete Health aims to improve the health and well-being of its members by providing access to a wide range of medical services, including primary care, specialty care, hospital care, and prescription medications.
The program is administered by the Oklahoma Health Care Authority (OHCA) and is available to individuals who meet certain eligibility requirements, such as low-income families, children, pregnant women, and individuals with disabilities. Oklahoma Complete Health offers a range of benefits, including doctor visits, hospital stays, prescriptions, and other medical services, with the goal of providing high-quality, cost-effective care to its members.
Key Points
- Oklahoma Complete Health is a Medicaid managed care program for eligible individuals and families in Oklahoma.
- The program provides comprehensive healthcare services, including primary care, specialty care, hospital care, and prescription medications.
- Eligibility requirements include low-income families, children, pregnant women, and individuals with disabilities.
- Oklahoma Complete Health offers a range of benefits, including doctor visits, hospital stays, and prescriptions.
- The program aims to improve the health and well-being of its members by providing access to high-quality, cost-effective care.
Program Benefits and Services
Oklahoma Complete Health offers a comprehensive range of benefits and services to its members, including:
- Primary care services, such as routine check-ups and health screenings
- Specialty care services, such as cardiology, dermatology, and orthopedics
- Hospital care, including inpatient and outpatient services
- Prescription medications, including generic and brand-name drugs
- Maternity care, including prenatal and postpartum services
- Mental health and substance abuse services, including counseling and therapy
- Dental and vision care, including routine check-ups and procedures
These benefits and services are designed to provide Oklahoma Complete Health members with access to the care they need to maintain their physical and mental health, and to improve their overall quality of life.
Eligibility and Enrollment
To be eligible for Oklahoma Complete Health, individuals must meet certain requirements, such as:
- Being a resident of Oklahoma
- Meeting income and resource guidelines, which vary depending on family size and other factors
- Being a U.S. citizen, national, or qualified alien
- Not being eligible for other Medicaid programs, such as SoonerCare or Medicare
Individuals who are eligible for Oklahoma Complete Health can enroll in the program through the Oklahoma Health Care Authority (OHCA) or through a certified application counselor. The enrollment process typically involves completing an application, providing required documentation, and selecting a primary care provider.
| Category | Eligibility Requirements |
|---|---|
| Income | Varies depending on family size and other factors |
| Resources | Varies depending on family size and other factors |
| Citizenship | U.S. citizen, national, or qualified alien |
| Residency | Must be a resident of Oklahoma |
Program Administration and Funding
Oklahoma Complete Health is administered by the Oklahoma Health Care Authority (OHCA), which is responsible for overseeing the program and ensuring that it meets federal and state requirements. The program is funded through a combination of federal and state funds, as well as through premiums and cost-sharing from members.
The OHCA works with a range of stakeholders, including healthcare providers, community organizations, and advocacy groups, to ensure that Oklahoma Complete Health meets the needs of its members and provides high-quality, cost-effective care. The program's administration and funding are designed to support the delivery of comprehensive healthcare services to eligible individuals and families in Oklahoma.
Program Evaluation and Quality Improvement
Oklahoma Complete Health is subject to regular evaluation and quality improvement initiatives, which are designed to ensure that the program meets its goals and objectives. These initiatives may include:
- Member satisfaction surveys, which provide feedback on the quality of care and services
- Quality metrics, which track performance on measures such as access to care, health outcomes, and patient safety
- Provider evaluation, which assesses the quality of care provided by healthcare providers participating in the program
- Program evaluation, which assesses the overall effectiveness of the program and identifies areas for improvement
These evaluation and quality improvement initiatives are designed to support the ongoing improvement of Oklahoma Complete Health, and to ensure that the program provides high-quality, cost-effective care to its members.
What is Oklahoma Complete Health?
+Oklahoma Complete Health is a Medicaid managed care program designed to provide comprehensive healthcare services to eligible individuals and families in Oklahoma.
Who is eligible for Oklahoma Complete Health?
+Individuals who meet certain eligibility requirements, such as low-income families, children, pregnant women, and individuals with disabilities, may be eligible for Oklahoma Complete Health.
What benefits and services does Oklahoma Complete Health provide?
+Oklahoma Complete Health provides a comprehensive range of benefits and services, including primary care, specialty care, hospital care, prescription medications, and more.
How do I enroll in Oklahoma Complete Health?
+Individuals who are eligible for Oklahoma Complete Health can enroll in the program through the Oklahoma Health Care Authority (OHCA) or through a certified application counselor.
How is Oklahoma Complete Health funded?
+Oklahoma Complete Health is funded through a combination of federal and state funds, as well as through premiums and cost-sharing from members.
