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Prescriptions (Drugs)

Prescriptions that are covered may be filled at any pharmacy or drugstore that accepts SoonerCare.

Frequently Asked Questions

Adult members:

  • Are limited to six covered prescriptions per month (four generic and two brand-name). The pharmacy has to give you a generic drug when one is available. If you want a brand-name drug, you will have to ask your PCP to write a prescription for it. Your doctor may need to have some drugs approved by SoonerCare.
  • Do not have a monthly limit for birth control, some drugs for HIV/AIDS, some cancer drugs and some stop-smoking products.
  • You will have a co-payment.

Members younger than 21:

  • Have no limits or co-payments for medically necessary prescriptions.
  • Are covered for certain over-the counter (non-prescription) cold and fever products. Please call the SoonerCare Helpline if you have questions.

Always show your Oklahoma medical I.D. card to get your prescriptions. The pharmacy may not fill your prescription if you do not have your card.

If you are not sure a drug is covered, call your PCP or the Pharmacy Help Desk at (405) 522-6205 or (800) 522-0114.

Prior Authorizations

Some services need a Prior Authorization (PA). A PA is not the same as a referral. It means the services must be approved by SoonerCare before you receive them.

  • Your doctor must send medical records with the PA to show a medical need for the services.
  • You and the provider will get a letter from SoonerCare when the services are approved or denied.
  • A PA is not a promise of payment.
  • Please read your notice.

If you have questions, call the SoonerCare Helpline at 1-800-987-7767

Ready to quit smoking? Help is Here!

Smoking and tobacco can cause many major health problems. SoonerCare offers free stop-smoking benefits. Ask your health care provider about medicines or call the Oklahoma Tobacco Helpline for coaching.

Covered products include nicotine patches and gums and pills that combat cravings.

For the first 90 days, you can get stop-smoking products as a pharmacy benefit without prior authorization. Those products will not count toward the monthly limits for members age 21 and older.

For more information

Oklahoma Tobacco Helpline:
1-800-784-8669 (English)
1-800-793-1552 (Spanish)
1-877-777-6534 (TTY)