Oregon Health Plan / Medicaid for Senior Care in Oregon
What Oregon Health Plan Actually Covers for Senior Care
Navigating senior care can feel overwhelming, but the Oregon Health Plan (OHP), which is Oregon's Medicaid program, offers crucial support. It’s designed to help cover significant long-term care costs, both in facilities and at home. For care in a nursing home, OHP Nursing Home Medicaid covers everything from room and board to skilled nursing, personal care, doctor visits, and prescription medications. However, it won't pay for private rooms or non-medically necessary comfort items.
If your loved one wants to stay in the community, Oregon's Home and Community Based Services (HCBS) Waivers are key. These are like vouchers for services that help them remain at home, in an adult foster care home, or an assisted living residence. The Aged & Physically Disabled (APD) Waiver specifically helps people move from a nursing home back into the community, covering transitional costs like moving expenses, housing deposits, and essential household items. The Independent Choices Program (ICP) gives a budget to choose caregivers, including family members (but not spouses), for in-home care. Many daily living supports, like help with bathing, dressing, and meal prep, are now provided through the Community First Choice Option / K Plan. It's important to know that while these waivers are a lifeline, they generally do not cover room and board costs such as rent, mortgage, utilities, or groceries.
Do You Qualify?
Eligibility for OHP long-term care programs requires your loved one to be an Oregon resident, typically age 65 or older (or blind/disabled), and need a Nursing Facility Level of Care. For 2026, a single applicant's monthly income generally can't exceed $2,982. The asset limit for a single person is $2,000.
If your parent owns a house, it's usually not counted as an asset if their spouse, a minor child, or a disabled child lives there, or if they intend to return home. Otherwise, there's a home equity limit of $752,000 for 2026. For married couples where only one spouse is applying, the applicant still has the $2,000 asset limit, but the non-applicant spouse can keep a Community Spouse Resource Allowance (CSRA) between $32,532 and $162,660. While a pension counts as income, Oregon is an "income cap" state, meaning if income is too high, a Qualified Income Trust (QIT) can help. If assets are over the limit, you can "spend down" on approved items like home modifications or paying off debt. Be aware of the 60-month (5-year) look-back period for asset transfers.
Waitlists & How to Apply
Good news: Nursing Home Medicaid and Aged, Blind, and Disabled (ABD) Medicaid are entitlements, so if your loved one qualifies, benefits are guaranteed without a wait. However, Home and Community Based Services (HCBS) Waivers like the APD Waiver and Independent Choices Program have limited spots, so waitlists can happen.
Applying can be done in several ways: online at ONE.Oregon.gov, by calling OHP Customer Service at 1-800-699-9075 (TTY 711), or by contacting the Aging and Disability Resource Connection (ADRC) at 1-855-673-2372. You can also mail a paper application to OHP Customer Service, P.O. Box 14015, Salem, OR, 97309-5032, or fax it to 503-378-5628. Be ready with personal and financial information. The Oregon Department of Human Services aims to process applications within 45 days, or up to 90 days if disability is part of the qualification.
Last updated: March 2026. Sources: CMS, state Medicaid agency, Genworth 2024.