Oklahoma Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Oklahoma.
7.6 million Medicaid long-term care recipients nationwide
Oklahoma Health Care Authority (OHCA)
Processing Time
30-45 days for standard Medicaid; ADvantage Waiver applications take 60-90 days due to level-of-care assessments. Waiting lists may exist depending on regional capacity.
Oklahoma Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Oklahoma, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Oklahoma follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Oklahoma Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $6,267/month average (semi-private), $6,878/month (private) (the average monthly nursing home cost in Oklahoma).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Oklahoma
Nursing Home Care
Medicaid pays 100% of nursing home costs in Oklahoma once eligibility is established. The average monthly cost is $6,267/month average (semi-private), $6,878/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
ADvantage Waiver - Assisted Living Coverage: Oklahoma's ADvantage Waiver includes services for individuals residing in assisted living facilities. Participants can receive Medicaid-covered personal care, medication administration, and care coordination while living in licensed assisted living centers. Room and board costs are not covered by Medicaid—residents must pay housing costs from their monthly income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Oklahoma offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
ADvantage Waiver
Oklahoma's primary waiver serving individuals age 65+ or age 21-64 with physical disabilities who meet nursing facility level of care. Provides adult day health, case management, environmental modifications and assistive technology, home-delivered meals, personal care/homemaker services, personal emergency response systems, prevocational services, respite care, specialized medical supplies/equipment, and transportation. Approximately 20,000 participants statewide—one of Oklahoma's largest waiver programs.
Program Details →In-Home Supports Waiver (IHSW)
Serves adults age 18+ with intellectual disabilities who meet intermediate care facility level of care. Some elderly individuals with lifelong developmental disabilities qualify.
Program Details →How to Apply for Medicaid in Oklahoma
Oklahoma Medicaid applications typically take 30-45 days for standard Medicaid; ADvantage Waiver applications take 60-90 days due to level-of-care assessments. Waiting lists may exist depending on regional capacity.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Oklahoma through:
- Online at okdhs.org/onlineservices
- Phone: 1-800-522-0310 (OHCA) or 1-877-476-6632 (SoonerCare helpline)
- Download application at okdhs.org and mail to local DHS office
- In-person at Oklahoma Department of Human Services office (77 county offices)
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Oklahoma from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Oklahoma-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Medicare Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreSoonerCare (Oklahoma Medicaid)
Oklahoma's Medicaid program name. Recent expansion (2021) extended coverage to adults up to 138% FPL.
Learn MoreHome and Community-Based Services for Seniors (HCBS-S)
State-funded program for seniors age 65+ who don't meet nursing facility level of care but need some assistance. Provides limited services to help seniors remain at home.
Learn MoreNeed Help with Oklahoma Medicaid?
Contact Oklahoma Health Care Authority (OHCA) for specific questions about eligibility, application status, or covered services.