Americans who can’t afford health insurance may be eligible for coverage through Medicaid, the jointly funded national program that’s regulated by the federal government and administered by each state.
In Beaverton, the State Health Authority administers the Medicaid program known as the Oregon Health Plan. Almost one-quarter of the state’s residents are enrolled in the plan, including families with young children, pregnant women and approximately 170,000 seniors and blind or disabled adults. The OHP provides the following health care services to those who meet the program’s eligibility requirements:
- Medical care from doctors and specialists
- Physician assistant and nurse practitioner services
- Inpatient, outpatient and emergency hospital care
- X-rays, lab work and other diagnostic tests
- Prescription medications
- Long-term nursing home care
Qualifying for Oregon Health Plan Coverage Beaverton residents who are American citizens or legal immigrants and disabled or aged 65 and older can qualify for OHP coverage for long-term care if they:
- Have been assessed as needing the level of care normally provided in a nursing facility
- Have no more than $2,000 in countable assets per person
- Have a maximum monthly income of $2,313 for individuals or $4,626 for couples applying together
When determining eligibility, OHP counts applicants’ income from all sources, including wages, pensions, investment earnings, Social Security and VA benefits. While most assets count, some are automatically disregarded, such as personal effects, one vehicle, a principal home worth up to $585,000, household goods and irrevocable burial trusts.
Oregon Community First Choice Option The Oregon Community First Choice option, or
K Plan, offers an alternative to institutional nursing home care for OHP-eligible seniors and disabled adults. This entitlement program provides care services and supports in a person’s own home or a community-based setting, including adult foster homes, group homes and assisted living facilities. Eligible Beaverton residents receive case management and a range of other services, including:
- Transitional assistance to move back to the community from a nursing home
- Assistance completing daily living activities, such as eating, bathing and dressing
- Prepared meals and snacks
- Housekeeping and laundry services
- Durable medical equipment not covered by other programs
- Assistive technologies
- Medication management
- Skilled nursing services
- Community transportation
Seniors can apply for OHP medical coverage or the K Plan
online or in person at one of the two
Oregon Department of Human Services offices in Beaverton. Those who need assistance completing an application can call (503) 627-0362.
Aged and Physically Disabled Waiver The OHP Aged and Physically Disabled waiver helps seniors and disabled adults transition from a nursing facility back to the community. To receive waiver-covered services, applicants must be OHP-eligible and meet the requirements for long-term care coverage. Those approved for the APD program may receive services through the waiver and K Plan at the same time as long as they don’t overlap. Supports provided through the waiver may include case management and:
- Relocation costs to move back to the community, including housing security deposits, application fees, moving expenses and necessary furnishings
- Wellness education
The APD waiver isn’t an entitlement program of OHP. Participation is limited to about 44,000 individuals statewide, so approved seniors may be placed on a waiting list.
To apply for the APD waiver, Beaverton residents can contact
Washington County Disability, Aging and Veteran Services at (855) 673-2372
.