Medicaid is America’s national health coverage program designed to provide basic health care to low-income children, pregnant women, adults with disabilities and seniors. The elderly and disabled make up 17% of Medicaid enrollees in Oregon, and nearly 75% of seniors and people with disabilities meet the financial criteria for free Medicaid coverage in the state.
The Oregon Medicaid program is called the Oregon Health Plan. To qualify for long-term care coverage, seniors must have an income at or below 300% of the federal poverty level and own no more than $2,000 in assets ($3,000 per couple). The current monthly income limit for OHP is $2,313 for single seniors and $4,626 for couples applying together.
If only one spouse is seeking OHP coverage, the non-applicant spouse is allowed to keep up to $126,420 of the couple’s jointly owned assets. Some assets are also exempt from Medicaid limits, including the principal residence of the applicant valued at $585,000 or less, one vehicle, an irrevocable burial trust worth $1,500 or less and personal effects, such as clothing, household items and collectibles.
Oregon K Plan
As a Medicaid-expansion state, Oregon extends medically necessary, community-based support services to Medicaid enrollees through the K Plan under the Community First Choice Option or the Affordable Care Act. The K Plan helps seniors age in place within their communities while living at home or in an assisted living facility rather than being placed in a nursing home.
To qualify for services through the K Plan, seniors must be assessed as needing the level of care normally provided in a nursing home and be able to safely remain in the community. If approved, seniors are provided with a range of medically necessary services based on their individual needs, such as:
- Homemaker and personal care services
- Skilled nursing and medication management
- Transportation to and from medical appointments
- Help with meal preparation and/or home meal delivery
- Access to adult day health services
- Durable medical equipment
- Minor home modifications to improve safety and accessibility
- A personal emergency response system
- Ongoing case management
- Help with activities of daily living
Because the K Plan is a Medicaid entitlement program, there are no statewide enrollment limits or waiting lists for services.
For more information about OHP enrollment and the Oregon K Plan, contact the
Oregon Department of Human Services at (503) 945-5600 or the
Hollywood Senior Center at (503) 288-8303.