Who OHCA pays Medicare premiums for
OHCA's definitions rule (OAC 317:35-1-2) describes two "buy-in" arrangements, in which OHCA pays your Medicare premium for you:
| Premium | OHCA pays it for |
|---|---|
| Part B premium | Categorically needy SoonerCare members eligible for Part B, including people who get TANF or Oklahoma's State Supplemental Payment for the aged, blind or disabled, and QMB Plus, SLMB and QI-1 members |
| Part A premium | QMB Plus members enrolled in Part A who don't qualify for Part A without a premium, and QDWI members |
Most people don't pay a Part A premium because they or a spouse worked long enough. If you do owe one, QMB Plus requires you to enroll in Part A so OHCA can pay it.
Which Oklahoma program fits you
- QMB Plus: Part A and B premiums, deductibles and coinsurance. 2026 income limit $1,350 a month for one person.
- SLMB: Part B premium. Limit $1,616.
- QI-1: Part B premium, if you don't qualify for full SoonerCare. Limit $1,816.
All three have a resource limit of $9,950 for one person in OKDHS Appendix C-1. See what QMB is in Oklahoma and Oklahoma's income limits.
How to get SoonerCare to pay your premiums
- Apply with OKDHS. Call (405) 522-5050, visit a Human Services Center or apply online at OKDHSLive.org. If you already have SoonerCare and just got Medicare, tell OKDHS.
- Finish the interview. OKDHS interviews every applicant, in person or by phone, and mails a decision within 30 to 60 days.
- Check your Social Security check. Once the buy-in starts, the Part B premium stops being taken out.
- Renew every year. QMB Plus, SLMB and QI-1 have 12-month certification periods.
Step-by-step details are in how to apply for a Medicare Savings Program.
Related questions
Can I have SoonerCare and Medicare?
How the two work together.
SoonerCare and Medicare Advantage
Plan choices for dual-eligible Oklahomans.
SoonerCare and Medicare guide
The full guide for dual-eligible members.
To review Medicare plans from the companies they work with, you can request a call from a licensed insurance agent.
Sources
- OHCA — OAC 317:35-1-2, Definitions (Part A and Part B buy-in)
- OHCA — OAC 317:35-7-60, Certification for SoonerCare
- Oklahoma Health Care Authority — SoonerCare Supplemental
- Oklahoma Health Care Authority — About SoonerCare
- Oklahoma Human Services — Help With Medicare Part A and B Premiums
- OKDHS — Appendix C-1 (7/1/2026)
- Medicare.gov — Help with drug costs (Extra Help)
More questions in this guide
- Can I have SoonerCare and Medicare at the same time?
- Can I have SoonerCare and a Medicare Advantage plan?
- Does Medicare or SoonerCare pay for a nursing home in Oklahoma?
- What is a D-SNP in Oklahoma?
- What is the ADvantage waiver in Oklahoma?
Part of the guide: SoonerCare and Medicare: a guide for Oklahoma dual eligibles · All questions
Frequently asked questions
How much does that save me?
The standard Part B premium is $202.90 a month in 2026, so the buy-in saves most people that amount every month. If you owe a Part A premium and qualify for QMB Plus, the savings are larger. The 2027 premiums are not published yet.
When does SoonerCare start paying?
OHCA's rule says the Part B buy-in starts the first day of the month after OKDHS approves you, or in the month your State Supplemental Payment starts if you get one. Until then, Social Security keeps deducting the premium from your check.
Is this the same as a Medicare Savings Program?
Yes. OHCA calls its Medicare Savings Programs SoonerCare Supplemental. QMB Plus, SLMB and QI-1 are the Oklahoma names, and OKDHS decides eligibility for all of them.
Does SoonerCare pay my Part D premium too?
Not directly. If SoonerCare pays your Part B premium, you get Extra Help automatically, and Extra Help pays all or part of your Part D plan premium.
Medicare in your Oklahoma county
Plans, local agents and help, county by county: Oklahoma · Tulsa · Cleveland · Canadian · Comanche · Rogers · Wagoner · Payne · Pottawatomie · Creek · Muskogee · Garfield · Grady · Washington · Logan · Bryan · Le Flore · Carter · Cherokee · McClain · All 77 counties →
