Oklahoma Health Care Authority. Online Enrollment. Home View.
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1 Oklahoma Health Care Authority Online Enrollment Home View 1
2 General General Overview Applying on a home computer Home View 2
3 Online Enrollment Home View Application Application Walkthrough 3
4 Website Options Accessing online application or Maintaining and updating the application after eligibility determination Printing a paper application for the Health Insurance Marketplace Currently Internet Explorer 8 (or higher); and the latest versions of Google Chrome, Mozilla Firefox and Safari are acceptable browsers. Fictitious applicant data used throughout this document for demonstration purposes. 4
5 Home Page Web Application 5
6 Home Page Web Application 6
7 Home Page Web Application (cont.) 7
8 Information Needed Application Requirements Names, DOB, SSN, Contact Information, including a valid address Household Tax Information Gross Income: Earned & Unearned Expenses Health Insurance HP Pay 8
9 Home Page Apply for Benefits 9
10 Apply Now Rights and Responsibilities 10
11 Rights and Responsibilities (cont.) 11
12 Account Creation Creating an Account Creating an account is required to complete an application. 12
13 Account Creation Step 1: People & Contacts 13
14 Health Condition Assessment Step 1: People & Contacts (cont.) Pregnancy fields trigger additional Health Condition Assessment Questions 14
15 Step 1: People & Contacts (cont.) The selection of SoonerCare or help paying for health insurance is made automatically for children and pregnant women. 15
16 Step 1: People & Contacts (cont.) 16
17 Contact Information Step 1: People & Contacts (cont.) 17
18 Step 1: People & Contacts (cont.) Receive English or Spanish notices by letter or . The Authorized Representative section of this page allows a user to identify an authorized representative. 18
19 Authorized Representative Step 1: People & Contacts (cont.) Provide all of the required Authorized Representative information. 19
20 Step 1: People & Contacts (cont.) Address Standardization 20
21 Step 1: People & Contacts (cont.) Create a user ID and password. 21
22 Step 1: People & Contacts (cont.) Choose questions and answers that are not easily known by others. 22
23 Account Creation Step 1: People & Contacts (cont.) When the account is successfully created, the confirmation message displays. 23
24 Account Creation Step 1: Account Logon Log on using your User ID or Address and Password created on the previous page 24
25 Account Registration Step 1: Account Registration Enter the Registration code sent to the Address used to create your account. 25
26 Account Registration Step 1: Account Registration Enter the Registration code sent to the Address used to create your account and click Register. 26
27 Step 1: People and Contacts Click Continue to resume the application. 27
28 Step 1: People and Contacts Entering additional household members. 28
29 Household Step 1: People & Contacts (cont.) Household Members 29
30 Household Step 1: People & Contacts (cont.) Household Members 30
31 Household Questions Step 1: People & Contacts (cont.) Household Questions *There will be an Unemployment Benefits question for Insure Oklahoma applicants between the ages of 19 and 64. *There will be a Foster Care question for members in the household between the ages of 19 and 25. *There will be a full-time college student question for members in the household applying for Insure Oklahoma, between the ages of 19 and
32 Household Questions Step 1: People & Contacts (cont.) When Yes is selected for any of the questions, a household member must be selected. 32
33 Household Questions Step 1: People & Contacts (cont.) When a household member is between ages 19 and 22, applying for Insure Oklahoma and enrolled in an accredited Oklahoma college, you must select their college from the drop-down menu. If their college is not listed, select Other 33
34 Household Relationships Step 1: People & Contacts (cont.) Relationship information is collected by making a selection from the drop-down. 34
35 Spousal Relationships Step 1: People & Contacts (cont.) Relationship information is collected by making a selection from the drop-down. 35
36 Household Relationships Step 1: People & Contacts (cont.) Household Relationships 36
37 Household Relationships Step 1: People & Contacts (cont.) If the child s other parent is in the household, he or she should be selected from the drop-down. 37
38 Household Relationships Step 1: People & Contacts (cont.) 38
39 Sibling Relationships Step 1: People & Contacts (cont.) Add Sibling Relationships for children with no parents in the home 39
40 Sibling Relationships Step 1: People & Contacts (cont.) Select brothers and sisters 40
41 Review Step 1: People & Contacts (cont.) Review 41
42 Review Step 1: People & Contacts (cont.) Review 42
43 Review Step 1: People & Contacts (cont.) Review 43
44 Review Step 1: People & Contacts (cont.) Review 44
45 Review Step 1: People & Contacts (cont.) A pop-up message allows one more opportunity to review and update household members before moving on to Step 2. 45
46 Tax Household Step 2: Tax Household Make selections from the drop-downs. Additional fields may display depending on the Tax Filer Status. 46
47 Tax Household Step 2: Tax Household (cont.) Household members display based on the filing status. Check the individuals that will be claimed. 47
48 Employment Step 3: Household Income Step 3 collects household income and begins by collecting employment information for anyone in the household who is working. 48
49 Employment Step 3: Household Income (cont.) Add the employment details for the individual listed. 49
50 Employment Step 3: Household Income (cont.) If an Insure Oklahoma applicant has an EEN, click on the Yes radio button and click on the Enter EEN button. 50
51 Employment Step 3: Household Income (cont.) Enter Employee Enrollment Number 51
52 Employment Step 3: Household Income (cont.) The Employer s data will automatically populate. 52
53 Employment Step 3: Household Income (cont.) Add Taxable Income *Insure Oklahoma applicants will include number of hours worked per week, and whether or not the employer offers health insurance. 53
54 Employment Step 3: Household Income (cont.) If you don t have an EEN, add the employment details for the individual listed. 54
55 Employment Step 3: Household Income (cont.) Validate Employer Information 55
56 Other Income Step 3: Household Income (cont.) Step 3 also collects income that is not received through employment. 56
57 Other Income Step 3: Household Income (cont.) 57
58 Other Income Step 3: Household Income (cont.) Select the other source of income then enter the amount and how often it is received. 58
59 Other Income Step 3: Household Income (cont.) Additional sources of income continues down the page. 59
60 Expenses Step 4 Expenses Expenses
61 Expenses Step 4: Expenses (cont.) Enter the details for the deductible expense for each person 61
62 Expenses Step 4: Expenses (cont.) Additional Deductible Expenses 62
63 Health Insurance Step 5: Health Insurance Tell us about any commercial health insurance. 63
64 Health Insurance Step 5: Health Insurance (cont.) Selecting Yes on the previous page generates this details page. Enter all of the required information. 64
65 Health Insurance Step 5: Health Insurance (cont.) Details Page Continues 65
66 Medicare Step 5: Health Insurance (cont.) Medicare is another source of health insurance that is asked about. 66
67 Medicare Step 5: Health Insurance (cont.) Selecting Yes to the Medicare question generates a list of household members. Select the member with Medicare coverage No additional information is collected. 67
68 Review Step 6: Review Review information provided: People & Contacts 68
69 Review Step 6: Review (cont.) 69
70 Review Step 6: Review (cont.) Household Questions and Household Relationships 70
71 Review Step 6: Review (cont.) Sibling Relationships and Contacts 71
72 Review Step 6: Review (cont.) Tax Household and Household Income 72
73 Review Step 6: Review (cont.) Other Income and Expenses 73
74 Review Step 6: Review (cont.) Health Insurance and Medicare Coverage 74
75 Processing 75
76 Citizenship & Identity Step 7: Citizenship & Identity Citizenship & Identity 76
77 Citizenship & Identity Step 7: Citizenship & Identity (cont.) Identity for a child under 16 77
78 Submit Application Step 8: Submit Submit Application 78
79 Submit Application Step 8: Submit 79
80 PCP Selection Provider Selection 80
81 Provider Detail Provider Selection (cont.) 81
82 PCP Selection Provider Selection 82
83 Provider Detail Provider Selection (cont.) 83
84 Provider Directions Provider Selection (cont.) Directions 84
85 PCP Selection Provider Selection (cont.) 85
86 PCP Selection Provider Selection (cont.) 86
87 Submit Application My Benefits Application Results My Benefits page displays 87
88 Submit Application My Benefits (cont.) 88
89 Submit Application My Benefits (cont.) 89
90 Pay Premium Convenience Pay 90
91 Pay Premium Convenience Pay 91
92 Pay Premium Convenience Pay 92
93 Pay Premium Convenience Pay 93
94 Pay Premium Convenience Pay 94
95 Pay Premium Convenience Pay 95
96 Pay Premium Convenience Pay 96
97 Benefits Summary My Benefits 97
98 Benefits Summary My Benefits 98
99 Benefits Summary My Benefits 99
100 Submit Application Document Uploading Uploading a Document 100
101 Submit Application Document Uploading (cont.) Uploading a Document 101
102 Submit Application Document Uploading (cont.) Uploading a Document 102
103 Submit Application Document Uploading (cont.) Upload Successful 103
104 Health Condition Assessment My Benefits Page (cont.) Application Results 104
105 Health Condition Assessment Health Condition Assessment Health Condition Assessment Questions 105
106 Health Condition Assessment Health Condition Assessment (cont.) Health Condition Assessment Questions 106
107 Other Programs My Benefits Page (cont.) Application Results 107
108 Manage Account Returning to the Application 108
109 Log On to your Account Returning to the Application (cont.) 109
110 Application Returning to the Application (cont.) 110
111 My Benefits My Benefits Page 111
112 My Benefits My Benefits Page 112
113 Get ID Card My Benefits Page (cont.) 113
114 Get ID Card Print ID Card 114
115 Print ID Card Print ID Card 115
116 End Benefits My Benefits (cont.) 116
117 End Benefits My Benefits (cont.)
118 View Letters My Benefits (cont.) 118
119 View Letters Letters 119
120 View Letters Letters (cont.) 120
121 View Letters Letters (cont.) 121
122 Contact Us 122
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