Oregon Medicaid & Elder Care
Oregon's Medicaid, known as the Oregon Health Plan, offers robust home and community-based services and assisted living support for seniors, though strict income and asset limits require careful planning.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardOregon Monthly Costs
Oregon's long-term care costs are significantly higher than the national average, with nursing home private rooms exceeding national rates by 70% in 2025.
Waiver Programs
Oregon Aged & Physically Disabled (APD) Waiver
Also called: Aged and Physically Disabled Waiver
This waiver assists elderly (65+) or physically disabled (18-64) Oregon residents in transitioning from a nursing home back to a community setting, such as their home, an assisted living residence, or an adult foster care home. It provides essential case management, housing support, and transition services.
- check_circle Case Management
- check_circle Community Transition Services
- check_circle Housing Support Services
- check_circle Assistance with application fees for housing
- check_circle Security deposits
- check_circle Initial utility deposits
- check_circle Purchase of household items
insights Program Snapshot
- Functional criterion
- Nursing Facility Level of Care (NFLOC)
- Administered by
- Oregon Department of Human Services (operates), Oregon Health Authority (oversees)
- Target Population
- Seniors (65+) and physically disabled adults (18-64)
- Recertification
- Annual (assumed)
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,000 | $4,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Oregon's Medicaid Estate Recovery Program is aggressive, expanding the definition of the estate and potentially placing liens on homes. However, it includes hardship provisions and does not apply to OPI-M beneficiaries.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or transfers for less than fair market value made within 60 months prior to application can trigger a penalty period of Medicaid ineligibility.
- warning Excess Income: Failing to establish a Miller Trust (Qualified Income Trust) if monthly income exceeds the state's income cap will result in financial ineligibility.
- warning Joint Accounts: All assets of a married couple are considered jointly owned, regardless of whose name is on the account, and are counted towards the applicant's asset eligibility.
First Steps for Families
Locate your ADRC
Contact your local Oregon Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
How to Apply for Oregon Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification demonstrating the need for a Nursing Facility Level of Care (or equivalent functional need for specific programs).
Gather Records
Collect comprehensive financial statements for the past 60 months, income verification, and identity documents.
Setup Miller Trust
If your monthly income exceeds Oregon's Medicaid income cap, establish a Qualified Income Trust (Miller Trust) to become income-eligible.
Submit Application
Apply for the Oregon Health Plan (Medicaid) online at ONE.Oregon.gov, in-person at a local Oregon Department of Human Services (ODHS) office, or via phone at 1-800-699-9075.
Interviews & Verification
Participate in required caseworker evaluations and provide any additional documentation requested by the state Medicaid agency to verify eligibility.
Approval & Care
Upon final eligibility determination, benefits will be activated, and long-term care services can commence.
Documents You'll Need
Financial Verification
- 60 months of bank statements
- Stock/bond certificates
- Retirement account information
- Proof of all assets
Income Verification
- Social Security award letters
- Pension statements
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments
- Proof of age
- Proof of U.S. citizenship or qualified non-citizen status
Property/Residency
- Home deed
- Vehicle registration
- Proof of Oregon residency
- Utility bills
Frequently Asked Questions About Oregon Medicaid
Does Oregon Medicaid pay for assisted living?
Yes, Oregon Medicaid, known as the Oregon Health Plan, can help pay for services in assisted living facilities through programs like the Community First Choice plan and the K Plan. These programs cover the cost of services, such as personal care, but typically do not cover room and board expenses. Eligibility requires meeting specific financial and functional criteria, including a Nursing Facility Level of Care.
What is the Oregon Medicaid income limit for seniors in 2026?
For 2026, the monthly income limit for a single senior applying for Nursing Home Medicaid or Home and Community-Based Services (HCBS) waivers in Oregon is $2,982. For married couples where both apply, the combined income limit is $5,964. Oregon is an income-cap state, meaning if income exceeds this amount, a Qualified Income Trust (Miller Trust) is generally required to achieve eligibility.
How long is the HCBS waiver waitlist in Oregon?
Oregon's Home and Community-Based Services (HCBS) waivers, such as the Aged & Physically Disabled (APD) Waiver and the K Plan, are not entitlements, and the number of participants is limited. While waitlists may exist for these programs, specific current waitlist counts or estimated wait times are not consistently published by the state. The Community First Choice program, however, is an entitlement and does not have a waitlist.
Will Medicaid take my parent's house in Oregon?
Oregon's Medicaid Estate Recovery Program (MERP) may seek to recover costs for long-term care services from a deceased Medicaid recipient's estate, which can include their home. The state has an expanded definition of 'estate' and may place a lien on the home. However, recovery is typically delayed if a surviving spouse or certain dependents reside in the home, and hardship provisions exist. The primary home is generally an exempt asset during the applicant's lifetime if equity is below $752,000.
Can I be paid to care for my parent through Oregon Medicaid?
Yes, Oregon Medicaid offers programs that allow family members, including adult children, to be paid as caregivers. The Independent Choices Program (ICP) is a self-directed option where eligible individuals receive a cash benefit to hire their own caregivers, which can include family. Additionally, other HCBS programs like the K Plan may support consumer-directed care models where a qualified family member can be compensated for providing personal care services.
Medicaid vs Medicare for long-term care in Oregon?
Medicare is federal health insurance primarily for those 65+ and generally covers only short-term, skilled nursing care or rehabilitation after a hospital stay, not ongoing custodial long-term care. Oregon Medicaid (Oregon Health Plan), conversely, is a joint state-federal program for low-income individuals that *does* cover extensive long-term care services, including nursing home care, assisted living services, and in-home care, provided eligibility requirements are met.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE OREGON
Last updated: April 24, 2026. Sources: Oregon Department of Human Services, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.