Oklahoma Medicaid, called SoonerCare, provides health coverage for over 1 million low-income residents, including doctor visits, hospital stays, and prescriptions at little or no cost.
In 2025, income limits will be updated with federal poverty levels to keep up with inflation, helping children, pregnant women, adults, seniors, and people with disabilities.
Quick Eligibility Snapshot
Here’s a fast look at key groups and their FPL percentages for 2025 (includes 5% disregard where applicable).
Key Groups and FPL Levels 2025
| Group | Max FPL (2025) | Notes |
| Children (0–18) | 205% | Full preventive care; no asset test |
| Adults (Expansion) | 138% | MAGI rules for 19–64; no children required |
| Pregnant Women | 205% | Counts baby as +1; 12 months postpartum coverage |
| Parents/Caretakers | 41% | Tied to child in home; very low income threshold |
| Aged, Blind & Disabled | SSI-based ($967/month individual) | Asset limits apply |
| Long-Term Care | 300% SSI ($2,901/month individual) | Nursing home & HCBS waivers; spousal rules |
| Medicare Savings | 100–135% FPL | QMB, SLMB, QI-1 help pay Medicare premiums |
MAGI vs Non-MAGI Eligibility
MAGI (Modified Adjusted Gross Income) uses tax rules for kids, pregnant women, parents, and expansion adults, no asset test, based on AGI plus untaxed Social Security.
Non-MAGI covers elderly (65+), blind, disabled, long-term care, and Medicare Savings, it checks monthly income plus assets, with medical needs like nursing level care. Special paths include spend-down (use excess on bills) and waivers like ADvantage for home care.
Oklahoma Medicaid Income Limits for 2025 (Full Breakdown)
Limits update April 1 with FPL changes. Oklahoma uses FPL percentages for MAGI and SSI rates for non-MAGI. Family size counts you, spouse, kids under 19, +1 for pregnancy.
Tax household (MAGI) includes tax dependents; Medicaid household (non-MAGI) adds shared-cost folks. For 2025, FPL is $1,305 monthly ($15,660 yearly) for one, +$459 ($5,508) per extra. The 5% disregard boosts MAGI limits.
Children (0–18)
Oklahoma covers children 0-18 up to 205% FPL through SoonerCare and CHIP, focusing on preventive care like checkups and vaccines. No asset test; seamless with CHIP at higher incomes.
Children 0–18 (205% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $2,677 | $32,124 |
| 2 | $3,619 | $43,428 |
| 3 | $4,561 | $54,732 |
| 4 | $5,503 | $66,036 |
Pregnant Women
Pregnant women qualify up to 205% FPL, counting the unborn baby as +1, with coverage for prenatal care, labor, delivery, and 12 months postpartum. It’s medically needy if over, with spend-down.
Pregnant Women (205% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 2 (Mom + Baby) | $2,677 | $32,124 |
| 3 | $3,619 | $43,428 |
| 4 | $4,561 | $54,732 |
SoonerCare vs CHIP Perinatal: SoonerCare full for mom up to 205%; CHIP fetal only up to 200% if ineligible.
Adult Expansion (138% FPL)
Oklahoma’s expansion covers adults 19-64 up to 138% FPL, no kids required for doctor visits, meds, and mental health. Verification uses MAGI, no assets.
Adult Expansion (138% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,799 | $21,588 |
| 2 | $2,432 | $29,184 |
| 3 | $3,065 | $36,780 |
| 4 | $3,698 | $44,376 |
Low-income adults get full benefits; disabilities bump to non-MAGI with extras.
Parents & Caretaker Relatives
Parents or caretakers qualify up to 41% FPL if caring for a child under 19, linking to family support with low thresholds and retroactive coverage up to 3 months.
Parents / Caretakers (41% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $535 | $6,420 |
| 2 | $723 | $8,676 |
| 3 | $911 | $10,932 |
| 4 | $1,099 | $13,188 |
Caretakers get family planning and checkups; renewals yearly.
Aged, Blind & Disabled (Non-MAGI)
ABD Medicaid uses non-MAGI with SSI limits: $967 monthly for individuals ($1,450 couples), automatic for SSI recipients, with asset test. Deductions for work/medical expenses help.
Aged, Blind & Disabled (SSI-Based)
| Group | Monthly Income Limit | Annual Income Limit |
| Individual | $967 | $11,604 |
| Couple | $1,450 | $17,400 |
LTC transitions to waivers; spousal protection allows $3,000/month for non-applicant.
Long-Term Care (300% of SSI – Nursing Home & Waivers)
Long-term care qualifies up to 300% SSI ($2,901 monthly individual) with a $2,000 asset limit ($3,000 couple). Spend-down uses excess on bills; spousal impoverishment protects $157,920 assets for non-applicant.
Long-Term Care (300% SSI)
| Group | Monthly Income Limit | Annual Income Limit |
| Individual | $2,901 | $34,812 |
| Couple | $4,351 | $52,212 |
Eligibility verification needs medical proof; allowable expenses deduct from income.
Medicare Savings Programs (QMB, SLMB, QI-1)
QMB up to 100% FPL ($1,305 monthly individual) pays Medicare Part A/B premiums; SLMB 120% ($1,566); QI-1 135% ($1,761). Assets $2,000/$3,000 for QMB.
QMB (100% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,305 | $15,660 |
| 2 | $1,763 | $21,156 |
| 3 | $2,221 | $26,652 |
| 4 | $2,680 | $32,160 |
SLMB (120% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,566 | $18,792 |
| 2 | $2,116 | $25,392 |
| 3 | $2,666 | $31,992 |
| 4 | $3,216 | $38,592 |
QI-1 (135% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,761 | $21,132 |
| 2 | $2,380 | $28,560 |
| 3 | $2,999 | $35,988 |
| 4 | $3,617 | $43,404 |
Benefits include deductibles; retroactive up to 3 months.
Oklahoma Medicaid Asset Limits (Non-MAGI Only)
Non-MAGI groups like elderly/disabled have asset limits: $2,000 individual, $3,000 couple. Exempt: Home, one car ($4,500 value), household goods, burial funds ($1,500). MAGI skips assets. Oklahoma Medicaid asset limits protect essentials, spousal rules allow $157,920 for non-applicant in LTC.
What Counts as Income in 2025
Countable income: Wages, SSI, pensions, interest, unemployment, child support (MAGI includes). Non-countable: Gifts, loans, Native payments, home equity. MAGI uses AGI + untaxed benefits; non-MAGI subtracts medical costs. 5% disregard helps MAGI, e.g., $20,000 yearly for one = $1,667 monthly, disregard to $1,583 (under 138% $1,732).
How to Apply for Oklahoma Medicaid (SoonerCare)
1. Online: OKDHSLive.org screen, upload, 45 days.
2. Phone: 800-987-7767, bilingual.
3. In-Person: Local DHS office.
4. Mail: Form from oklahoma.gov/ohca to county.
5. Newborn: Auto 12 months, report birth. Shutdown backlog adds 1-2 weeks; presumptive for pregnancy is 5 days.
Required Documents
Income: Pay stubs (4 weeks), tax returns, W-2s.
ID: License, birth certificate.
Residency: Bill.
Pregnancy: Note.
Disability: SSA letter.
Self-employed: Profit/loss.
Common Reasons People Are Denied
Over income from unreported extras. Wrong docs or missing verification.
Household miscount (forget spouse). Duplicate benefits without adjustment. Citizenship gaps, emergency for undocumented.
Frequently Asked Questions (FAQ)
What is the income limit for a family of 3 in Oklahoma?
Family of 3 qualifies up to 205% FPL for children ($4,561 monthly, $54,732 yearly). Adults expansion at 138% ($3,065, $36,780), check your group.
Does Oklahoma check bank accounts?
Yes for non-MAGI like seniors/disabled, $2,000 individual limit. MAGI groups skip assets.
What is the income limit for pregnant women?
Up to 205% FPL ($2,677 monthly for mom + baby, $32,124 yearly). Counts baby as +1; 12 months postpartum.
How often do income limits update?
Yearly April 1 with FPL changes. 2025 numbers hold through March 2026, recheck if life shifts.
Can adults without children get Medicaid?
Yes, expansion up to 138% FPL ($1,799 monthly for one). No kids needed, just income and residency.
Final Thoughts
Oklahoma Medicaid income limits vary by category, FPL charts show paths for kids at 205% to seniors on SSI. MAGI vs non-MAGI rules shape it, with assets only for non-MAGI. Income checks determine eligibility, apply or check the official site for help. Key takeaways: 5% disregard aids MAGI, spend-down for over-limit. Your health’s priority, get started today.
