Anyone familiar with how Soonercare / Medicaid in OKLAHOMA works with an MAPD?

[enyce]

Hey folks,

So I'm new to Oklahoma and a little confused with how the state coordinates with MAPD's.

Back in New Jersey there are SNP plans that are specifically for this situation. (Care+Caid)

But in Tulsa, OK , There are no SNP plans... Curious on understanding how does the state coordinate covering copayments (if any) for the HMO members....

Called the state and UHC but they have surprisingly been of little help understanding this.

Wouldn't want to enroll someone and get a complaint months later with claims of misinformation.

 

[GoPokes]

There is a SNP plan in OKC area for 2018. First time for it. Not yet available in Tulsa area. I have some dual members in tulsa area on zero premium mapd plans I think. It works okay. The main thing Id tell you to be aware of in the tulsa area with mapd is community care and the warren clinic, st francis, st johns network. If they go to doctors in that network, they wont take any mapd plans other than community care, and we cant sell community care. They do all sales internally. If they go outside that network, all/most of the other mapd plans work pretty well.