SoonerCare fast facts, 01/2013

              January 2013
SoonerCare Fast Facts
Data was compiled as of the report date. Numbers frequently change due to certifications occurring after the data is extracted and other factors. This report is based on data within the
system prior to the report date. A majority of the data is a “point in time” representation of the specific report month and is not cumulative. Unless stated otherwise, CHILD is defined
as an individual under the age of 21. The data is valid as of the report date and is subject to change.
CHIP Breakdown of Total Enrollment
Members qualifying for SoonerCare (Medicaid) eligibility under
the CHIP program are under age 19 and have income between
the maximum for standard eligibility and the expanded 185% of
Federal Poverty Level (FPL) income guidelines.
The Insure Oklahoma is a program to assist qualifying small business own-ers,
employees & their spouses (Employer-Sponsored Insurance—ESI) with
health insurance premiums and some individual Oklahomans (Individual
Plan—IP) with limited health coverage. www.insureoklahoma.org
Note that all subsequent figures are groups within the above total enrollment num-bers
(except Insure Oklahoma). SoonerPlan members are not entitled to the full
scope of benefits; only family planning services are covered.
Delivery System Breakdown of Total Enrollment
SoonerPlan, 49,313,
6%
SoonerCare Choice,
533,998, 69%
SoonerCare
Traditional (Fee-For-
Service), 196,254,
25%
Other Enrollment Facts
Total Enrollment including Insure Oklahoma—
Unduplicated enrollees State Fiscal Year-to-Date (July through
report month including Insure Oklahoma) —
Other Breakdowns of Total Enrollment
Oklahoma SoonerCare (Medicaid) members residing in a long-term
care facility —
Oklahoma persons enrolled in both Medicare and Medicaid
(Dual Enrollees) —
Qualifying Group Age Group Enrollment % of Total
Aged/Blind/Disabled Child 19,577 2.51%
Aged/Blind/Disabled Adult 132,548 17.00%
Children/Parents Child 480,026 61.58%
Children/Parents Adult 75,616 9.70%
Other Child 54 0.01%
Other Adult 21,161 2.71%
826 0.11%
SoonerPlan (Family Planning) 49,313 6.33%
TEFRA 444 0.06%
Total Enrollment 779,565 Adults 274,389 35%
Children 505,176 65%
Oklahoma Cares (Breast & Cervical Cancer)
TOTAL ENROLLMENT —
OKLAHOMA SOONERCARE (MEDICAID)
Race is self-reported by members at the time of enrollment. The multiple race members have selected two or more races. Hispanic is
an ethnicity not a race. Hispanics can be of any race and are accounted for in a race category above.
Age Breakdown of Total Enrollment
488,882 232,813 57,870
Children Age
18 and Under,
63%
Adults Age
19 to 64,
30%
Adults Age
65 and Over,
7%
Small Businesses
Enrolled in ESI
Employees w/
ESI
Individual Plan
(IP) Members
Children Adults Percent
Pregnant
Women
American Indian 62,128 25,001 11% 2,982
Asian or Pacific Islander 8,396 4,241 2% 623
Black or African American 64,528 36,962 13% 2,469
Caucasian 324,797 198,573 67% 18,137
Multiple Race 45,327 9,612 7% 1,590
Hispanic Ethnicity 101,179 17,980 15% 4,907
Race Breakdown of Total Enrollment
OTHER Gro up includ es—DDSD St at e-PKU-Q1-Q2 -Refug ee--SLMB-So o n t o b e So o ners (STBS) and TB p at ient s .
The Total Enrollment figure makes up 450,045 cases . A case is used to group members of the same family living in the
same household.
For more informat ion go to www.okhca.org under Individuals then to Programs . Insure Oklahoma members are NOT
included in the figures above.
2/11/2013
4,789 16,705 13,791
15,667
108,379
952,696
New Enrollees
Oklahoma SoonerCare members
that have not been enrolled in the
past 6 months.
Adults 9,564
Children 12,436
Total 22,000
810,061
Age Breakdown % of FPL CHIP Enrollees
INSURE OK DEPENDENTS (ESI & IP) 521
PRENATAL 2,620
INFANT 150% to 185% 1,920
01-05 133% to 185% 15,093
06-12 100% to 185% 37,340
13-18 100% to 185% 25,084
Total 82,578
Data is currently unavailable.