Medicaid, the nationwide health coverage program funded by state and federal governments, provides basic health services to 24% of Oregon’s 4.1 million residents. Each year, Oregon spends about $8.4 billion on Medicaid services, with 41% of those expenditures going toward services for the elderly and disabled.
In Oregon, Medicaid is known as the Oregon Health Plan and is administered by the state through the Oregon Health Authority. Seniors aged 65 and older who earn $2,313 a month or less ($4,626 for couples) and own $2,000 or less ($3,000 per couple) in countable assets may qualify for free coverage under the OHP.
Note that some assets are exempt under Medicaid rules, including a non-revocable burial trust valued at up to $1,500 and a home owned by the applicant valued at up to $585,000 that the applicant uses as their principal residence.
Income Cap Trusts
Oregon seniors with incomes that exceed Medicaid limits may be able to qualify for OHP coverage by establishing an Income Cap Trust. Also known as a Miller Trust or Qualified Income Trust, this irrevocable legal agreement places the applicants’ excess income into a trust account that designates the state of Oregon as the beneficiary.
Because the senior no longer has access to the excess income, their declared monthly income is lower, allowing them to meet Medicaid income limits. Upon death, the funds in the ICT are used to first reimburse the state for Medicaid services; any remaining funds are added to the senior’s estate.
Oregon K Plan
Medicaid-covered seniors who meet the criteria for nursing home placement and who prefer to reside in an assisted living residence may qualify for help through the K Plan. Also sometimes referred to as the Community First Choice Option, this Medicaid-expansion program helps seniors age in place in their homes or an assisted living facility by providing medically necessary support services.
If approved for the K Plan, seniors may be assigned one or more of the following services based on their specific care needs:
- Skilled nursing
- Support to transition from a nursing home to an assisted living facility
- Help with activities of daily living such as bathing, dressing and grooming
- Access to a personal emergency response system
- Home meal delivery
- Transportation
- Medical equipment and supplies
- Homemaker
- Adult day health programming
Because the K Plan is not a Medicaid waiver, there is no statewide participation limit, and every eligible senior receives services.
To learn more about the OHP, ICTs and the K Plan in Oregon, contact the
OHP at (800) 669-9075 or the
Aging and Disability Resource Connection of Oregon at (855) 673-2372.