Oklahoma Personal Care Program (Medicaid State Plan)

Page Reviewed / Updated - Feb. 2016

Program Description

The Oklahoma Personal Care program provides disabled and elderly residents with the funds to retain a personal care assistant to help them manage their activities of daily living (ADLs) in their home or a family members home. Assistance with ADLs includes helping an eligible applicant dress, use the bathroom, eat, and so forth. This is a Medicaid program that is also referred to by the name of State Plan Personal Care. The program is based on the Medicaid Cash and Counseling model in which the consumer is empowered to self-direct their personal care by choosing whom is hired. Personal Care Program participants are able to select home care agencies, neighbors, friends, and even some non-immediate family members to provide them with personal care. To clarify, under this program certain family members are eligible to be paid caregivers; spouses and legal guardians are not eligible.

Oklahoma Medicaid, also called SoonerCare, offers a similar program with Consumer Direction that covers a broader range of services called the ADvantage Waiver.

Eligibility Guidelines

In order to be eligible for this program, all applicants must be residents of Oklahoma. There are also health and financial requirements to be eligible for the Personal Care Program. Applicants must require assistance to complete their activities of daily living. However, their disabilities cannot be so severe that they require skilled nursing level assistance or the level of care provided in an Intermediate Care Facility.

Financially, applicants must qualify for Medicaid. Oklahoma’s Medicaid is “means tested” which is to say, there are limits one both the applicant’s monthly income and their countable assets. These limits change depending on the person’s constituent group. For example, children, pregnant women and aged, blind or disabled persons all have different numerical limits.

Oklahoma Medicaid 2016 Income Limit for Seniors
To receive assistance from the Personal Care Program, individuals must be eligible for general Medicaid (as opposed to institutional Medicaid). Seniors in 2016 are eligible if their monthly income is no greater than 300% of the Federal Benefit Rate or $2,199 (annually $26,388). However, there is some flexibility to this limit if the applicant is married and his or her spouse is not applying for Medicaid. Under these circumstances, joint income can be allocated to the spouse who is not applying to provide a living stipend. This can help to lower an applicant's income to a Medicaid compliant level.

Oklahoma Medicaid 2016 Assets Limit for Seniors
Single applicants are limited to $2,000 worth of countable assets. In the split-spouse situation described above, the non-applicant spouse is allowed up to $119,220 in countable assets. There is also some flexibility with this limit, as many items are considered exempt. For example, the family home, provided it is lived in by at least one spouse, and valued under $552,000, is considered exempt. Their vehicle, provided it is a utility vehicle, as opposed to a collector's car or an investment, is also exempt. Burial plots are also considered exempt assets.

There are various other assets that can be considered exempt. Persons over the income or asset limits who cannot afford their cost of care should consider working with a Medicaid planning expert who can assist them in converting their finances so that they become Medicaid compliant. Learn more.


Benefits and Services

The Personal Care Program will pay for a personal assistant to help individuals with their activities of daily living, such as bathing, grooming, eating, and toileting. In addition, instrumental activities of daily living (IADLs) are considered eligible. These include assistance with meal preparation, laundry, housekeeping, and shopping for groceries and other essentials.


How to Apply / Learn More

This program is managed at the county level by the Oklahoma Department of Human Services office.  One can find more information on their webpage or by calling their toll-free number at 1-800-435-4711.