Oklahoma Medicaid for Seniors & Long-Term Care

Oklahoma administers long-term services and supports (LTSS) for seniors and adults with physical disabilities through a combination of Medicaid programs. The Oklahoma Department of Human Services (OKDHS) Aging Services Division coordinates LTSS alongside OHCA.

The ADvantage Waiver is Oklahoma's main HCBS waiver under Section 1915(c) of the Social Security Act. It is available to adults age 21 and older with physical disabilities, and to adults age 65 and older who qualify for nursing facility level of care. ADvantage provides personal care, homemaker services, adult day health, respite, environmental modifications, and medical equipment — allowing members to remain in their home or community rather than a nursing facility. Per OKDHS, ADvantage serves several thousand Oklahomans annually; there may be waiting lists, so contact OKDHS Aging Services for current availability.

The In-Home Supports Waiver is a separate HCBS waiver for adults with developmental disabilities and certain adults with physical disabilities, administered by OKDHS Developmental Disabilities Services (DDS) for the developmental disabilities population; the physical disabilities population contacts Aging Services. SoonerCare can also fund residential care for qualifying members in licensed Residential Care Facilities — settings less intensive than skilled nursing that provide personal care and limited health supervision.

SoonerCare covers nursing facility care for members who meet clinical level-of-care criteria and financial eligibility thresholds. Oklahoma Medicaid pays nursing facility rates directly to participating facilities. Residents contribute most of their income toward the cost of care, retaining a monthly Personal Needs Allowance set by OKDHS.

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income. For 2026, the CSRA allows the community spouse to keep between $32,532 and $162,660, updated annually by CMS.

The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

Oklahoma pursues estate recovery under 42 U.S.C. § 1396p for certain costs paid on behalf of members age 55 or older. The state seeks recovery for nursing facility services, HCBS waiver services, and related hospital and prescription costs paid by Medicaid. Recovery is deferred while a surviving spouse, minor child, or blind or disabled child is living, and hardship exemptions may be available in specific circumstances. OKDHS handles estate claims — contact the OKDHS estate recovery unit for information if you are administering the estate of a SoonerCare member.

Contact the Oklahoma DHS Aging Services Division at 1-405-521-2281 or find your local Area Agency on Aging through the Eldercare Locator at eldercare.acl.gov. OKDHS staff will conduct a functional assessment to determine level-of-care eligibility and guide you through the financial eligibility process. Oklahoma also has a Long-Term Care Ombudsman program for residents of nursing facilities and residential care homes — contact the ombudsman at 1-800-211-2116 for information on rights and advocacy assistance.