State Plan Personal Care is an Oklahoma Medicaid program that provides disabled and elderly residents with a personal care assistant to help them manage their Activities of Daily Living (ADLs) in their home or a family member’s home. Assistance with ADLs includes helping an eligible applicant dress, use the bathroom, eat, and so forth.
With this program, consumers are empowered to self-direct their personal care by choosing their care provider. State Plan Personal Care program participants can select home care agencies, neighbors, friends, and even some non-immediate family members to provide them with personal care. Under this program, certain family members are eligible to be paid caregivers; spouses and legal guardians are not eligible.
The Oklahoma State Plan Personal Care program is an entitlement program. This means that anyone who is eligible to receive services via this program is able to do so, as there are no enrollment caps.
Oklahoma Medicaid, also called SoonerCare, offers a similar program with Consumer Direction that covers a broader range of services called the ADvantage Waiver.
To be eligible for State Plan Personal Care, all applicants must be residents of Oklahoma. There are also health requirements. 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 on both the applicant’s monthly income and their countable assets. These limits change depending on the person’s constituent group. The following limits are relevant for seniors.
To receive assistance from the State Plan Personal Care program, individuals must be eligible for general Medicaid (as opposed to institutional Medicaid). Single seniors (65+) in 2023 are eligible if their monthly countable income is no greater than $1,215. For a married couple, their joint countable monthly income cannot exceed $1,643. Countable income allows for the deduction of some medical expenses, such as the cost of health insurance premiums.
Single applicants are limited to $9,090 worth of countable assets, and couples must have joint funds less than $13,630. The family home, provided it is lived in by at least one spouse, is considered exempt. There is no equity limit on the home like with other Medicaid programs. Other assets that are not counted include a vehicle, household items, personal goods, and burial plots.
Over the Financial Limits?
Persons over the income and / or asset limit(s) who cannot afford their cost of care should consider a home and community based Medicaid waiver or institutional (nursing home) Medicaid, as the income limit is higher.
On can also enlist the assistance of a Medicaid planning expert, who can help families execute a strategy to become Medicaid compliant. Learn more.
Benefits and Services
The State Plan Personal Care program pays for a personal assistant to help individuals with their activities of daily living and instrumental activities of daily living (IADLs). This includes assistance with the following:
- Meal preparation
- 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. Interested seniors can find more information on their webpage.
One can apply online or over the phone. An online application can be found here. Or the Medicaid Services Unit can be reached at 800-435-4711 to apply over the phone or get assistance with the online application.