Oregon Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Oregon.
7.6 million Medicaid long-term care recipients nationwide
Oregon Health Authority - Division of Medical Assistance Programs
Processing Time
30-45 days for standard Medicaid; waiver services typically available within 30 days of Medicaid approval through Coordinated Care Organizations (CCOs). Oregon has relatively streamlined enrollment.
Oregon Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Oregon, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Oregon follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Oregon Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $9,833/month average (semi-private), $10,789/month (private) (the average monthly nursing home cost in Oregon).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Oregon
Nursing Home Care
Medicaid pays 100% of nursing home costs in Oregon once eligibility is established. The average monthly cost is $9,833/month average (semi-private), $10,789/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
IADL/ADL Waiver and Medicaid Covered Services in Residential Care: Oregon Medicaid covers services for individuals living in licensed residential care facilities (assisted living). Through the IADL/ADL waiver and state plan services, Medicaid pays for attendant care, medication administration, and care coordination. Room and board costs are not covered—residents pay housing costs (typically $700-1,500/month for Medicaid beds) from their monthly income.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Oregon offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Oregon Project Independence (OPI)
State-funded (not a Medicaid waiver) program for adults age 60+ who don't meet nursing facility level of care but need assistance to remain independent. Provides case management, adult day services, home-delivered meals, homemaker/chore services, personal care, minor home modifications, and assistive devices. No asset test. Serves as preventive program before individuals need more intensive services.
Program Details →IADL/ADL Medicaid Waiver
Serves adults age 18+ who meet nursing facility level of care. Provides attendant care services (help with instrumental and basic activities of daily living), relief care (respite), specialized supplies, and environmental modifications. Over 12,000 participants statewide.
Program Details →Community First Choice (CFC)
Oregon's state plan option (not technically a waiver) providing personal care services to individuals meeting institutional level of care. Integrated into Oregon's coordinated care model through CCOs (Coordinated Care Organizations).
Program Details →How to Apply for Medicaid in Oregon
Oregon Medicaid applications typically take 30-45 days for standard Medicaid; waiver services typically available within 30 days of Medicaid approval through Coordinated Care Organizations (CCOs). Oregon has relatively streamlined enrollment.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Oregon through:
- Online at ONE.Oregon.gov (Oregon's integrated eligibility system)
- Phone: 1-800-699-9075 (Oregon Health Plan customer service)
- Download application and mail to: Oregon Health Authority, P.O. Box 14520, Salem, OR 97309-5044
- In-person at local Department of Human Services office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Oregon from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Oregon-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreCoordinated Care Organizations (CCOs)
Oregon's innovative managed care model coordinating physical health, behavioral health, and dental care. Most Medicaid beneficiaries enrolled in one of 15 regional CCOs.
Learn MoreOregon ABLE Savings Program
Tax-advantaged savings accounts for individuals with disabilities. Assets in ABLE accounts don't count toward Medicaid asset limits up to $100,000.
Learn MoreNeed Help with Oregon Medicaid?
Contact Oregon Health Authority - Division of Medical Assistance Programs for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-800-699-9075Application Helpline
1-800-699-9075