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State of Oklahoma Stoneware Dramatic (Adagrasib) Prior Authorization Form Member Name:___ Date of Birth:___ Member ID#:___Drug Information Pharmacy Billing (NDC:___) Start Date (or date of next dose):___ Dose:___Regimen:___Billing
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Visit the Oklahoma Soonercare website and click on the 'Apply Now' button.
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Create an account or log in if you already have one.
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Fill out the application with your personal information, including your income and family size.
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Submit any necessary supporting documents, such as pay stubs or proof of citizenship.
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Wait for a response from the Oklahoma Soonercare program regarding your application.

Who needs state of oklahoma soonercare?

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Those who are low-income and meet the eligibility requirements set by the Oklahoma Soonercare program.
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SoonerCare is Oklahoma's Medicaid program that provides health care coverage to eligible individuals and families.
Individuals and families who meet specific income and eligibility requirements must file for SoonerCare.
You can fill out the SoonerCare application online, by mail, or in person at your local DHS office. It requires personal information and documentation of income and assets.
The purpose of SoonerCare is to provide essential health care services and financial assistance to low-income residents of Oklahoma.
You must report personal identification information, income, household size, and any health insurance coverage.
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