1. Pregnancy-related care for undocumented individuals and non-citizens
Soon-To-Be-Sooners
Pregnancy-related care for undocumented individuals
and non-citizens

2. Soon-To-Be-Sooners (STBS)
The Oklahoma Health Care Authority (OHCA) is strongly committed to providing optimal health care as well as making improvements that may contribute toward positive birth outcomes in our state. We are pleased to announce that pregnancy-related health care services have been expanded for the benefit of babies who will be born citizens of Oklahoma and the United States through the “Soon-To-Be-Sooners” (STBS) program.

3. Program & Policy Overview
Program begins April 1, 2008
Provides limited benefits for pregnancy-related care
Available for undocumented or non-citizens who are pregnant
Benefits for mother end at delivery

4. Program & Policy Overview continued…
Pregnant women may apply for benefits through OKDHS or out station centers
Applications may be downloaded at
Members receive an OHCA medical ID card
Members are not eligible for Managed Care; excluded from SoonerCare Choice
Not eligible for STBS if found to have other insurance (TPL)

5. Covered Services
Benefits and covered services are those that impact the well-being of the pregnancy. For example:
Office visits that impact the pregnancy
Labs and some diagnostics related to the pregnancy
Hospital services for the birth
Hospital care for the newborn

6. Covered Services continued…
Prescriptions for pregnancy related conditions as medically necessary
No prior authorization needed for prenatal vitamins
Prior Authorization needed for all other Rx’s
Genetic Counseling
Lactation Consultant services
Maternal and infant health social work services
Patient Advice Line

7. Non-Covered Services Dental services SoonerRide Vision (eye care)
Services for conditions that do not impact pregnancy outcome
Medical services for the mother after the birth of the baby
Exception--A postpartum visit is covered when provided as a component of the CPT billing code 59400

8. Checking Eligibility
Providers will be able to check eligibility on this population as they would any other SoonerCare member
Eligibility Verification System (EVS)
OHCA’s Medicaid Secured Website

9. Client Eligibility Verification (OHCA Secured Website)

10. New Members
Upon eligibility of the program the mother will receive a “Welcome” letter to explain the program and who to call if she has any questions

11. Newborn Member
Newborns are U.S. citizens and are eligible for the full scope of SoonerCare program benefits
Newborns will receive up to 12 months eligibility

12. Contact Information
For policy questions and billing inquiries:
OHCA Provider Services
(toll free)