SoonerCare Work Requirements Begin in 2027 as OHCA Warns Members

SoonerCare Work Requirements Begin in 2027 as OHCA Warns Members to Prepare

The Oklahoma Health Care Authority has begun notifying Medicaid members who could be affected by new SoonerCare work requirements scheduled to take effect January 1, 2027.

OHCA says members who receive a yellow letter should read it carefully and watch for additional notices. The new federal requirements generally apply to adults ages 19 through 64 who do not qualify for an exemption and could affect whether some Oklahomans remain eligible for Medicaid coverage.

Members subject to the requirement will generally need to complete 80 hours per month of qualifying activities or demonstrate that they meet a minimum monthly income standard.

SoonerCare Work Requirements Include Employment, Education and Community Service

Under the new federal law, qualifying activities can include employment, community service, participation in a work program or educational programs.

However, not every SoonerCare member between ages 19 and 64 will be required to meet the 80-hour standard.

OHCA says some members will qualify for exceptions, and the agency will first use information it already has on file to determine whether a person satisfies the requirement or meets an exemption.

Members can use the OHCA Work Requirements screener to learn more about the changes and determine whether they may qualify for an exception.

The requirements do not begin until January 1, 2027, but OHCA is contacting potentially affected members now so they have time to understand the rules and prepare.

Yellow Letter Does Not Automatically Mean SoonerCare Coverage Will End

OHCA is emphasizing that receiving a yellow letter does not mean a member is immediately losing Medicaid coverage.

Instead, the letter indicates that the person may need to take action in 2027 to remain eligible.

OHCA will initially review information already available to the agency. If that information shows the member meets the federal requirement or qualifies for an exception, additional documentation may not be necessary.

If OHCA cannot make that determination with existing records, the agency says it will send another notice explaining what information or documentation the member needs to provide.

Members are being encouraged to make sure their mailing address, phone number and email address are current so they do not miss those notices.

SoonerCare members can review and update their information through MySoonerCare.

OHCA Urges Members to Prepare Before January 2027

The immediate message from state officials is for members to pay attention to their mail and begin reviewing the new rules rather than waiting until the requirements take effect.

Anyone who receives a yellow letter should keep it and watch for additional communication from OHCA. Members who may need qualifying hours can also begin exploring employment, education, community service or approved work programs.

The changes could be significant for Oklahoma because SoonerCare is the state’s Medicaid program, providing health coverage to eligible Oklahomans through the Oklahoma Health Care Authority.

OHCA is also asking health care providers, employers and community organizations to help notify members about the upcoming requirements. The agency has created posters, outreach materials and a stakeholder toolkit that organizations can use to explain the changes.

Additional information about Medicaid eligibility and the upcoming federal changes is available directly from the Oklahoma Health Care Authority.

For members receiving the yellow notice, the key date is January 1, 2027. Until then, OHCA says members should keep their contact information current, review whether they may qualify for an exception and respond to any future requests for documentation.

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