Oregon Medicaid Eligibility: Income Limits, Asset Rules & How to Apply

Oregon Medicaid — the Oregon Health Plan (OHP) — covers over 1.4 million Oregonians and offers something no other state program does quite the same way: the OHP Bridge Plan, a Basic Health Program that extends coverage to adults earning between 138% and 200% of the Federal Poverty Level — a gap most states leave entirely uncovered.

That alone makes Oregon one of the most expansive Medicaid states in the country.

OHP also covers people of all immigration statuses who meet income requirements (OHP Plus), offers zero premiums and zero copayments for most enrollees, and delivers care through Coordinated Care Organizations (CCOs) — community-governed managed care groups that integrate physical, dental, and behavioral health into a single plan.

Oregon has had no coverage gap for low-income adults since its ACA expansion in 2014.

This guide covers every OHP program, 2026 income limits, the Bridge Plan, asset rules, the 60-month look-back for long-term care, and how to apply. For a side-by-side comparison of Oregon’s limits vs. other states, see how Oregon’s income thresholds compare to every other state.

Oregon’s Medicaid Programs at a Glance

Oregon operates more distinct Medicaid pathways than most states.

Understanding which program applies to you is the first step to knowing whether you qualify.

OHP Plus is the standard Oregon Medicaid program — covering children, pregnant women, parents, adults up to 138% FPL, seniors, and people with disabilities.

It includes full medical, dental, mental health, and substance use treatment coverage with no premiums and no copayments. Enrollment is open year-round.

OHP Bridge is Oregon’s Basic Health Program, covering adults aged 19–64 with incomes between 138% and 200% FPL who do not have access to affordable employer coverage and are not eligible for Medicare.

Launched July 1, 2024, it covers approximately 100,000 Oregonians who previously fell between Medicaid and affordable Marketplace insurance. It delivers the same benefits as OHP Plus — through CCOs, with no premiums or copayments — but does not cover long-term care services and supports.

Nursing Home / Institutional Medicaid covers long-term nursing facility care, hospital stays, and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).

This is an entitlement — eligible applicants cannot be turned away for lack of capacity. Requires Nursing Facility Level of Care (NFLOC).

Home and Community Based Services (HCBS) Waivers fund in-home care, adult day services, and delivered meals to help seniors and disabled individuals remain at home rather than entering a nursing facility.

Unlike nursing home Medicaid, HCBS programs have limited slots and may have waiting lists.

Regular Medicaid (Aged, Blind, and Disabled — ABD) covers low-income elderly, blind, or disabled Oregonians who do not require nursing home-level care but need ongoing medical coverage.

Asset and income limits are less strict than long-term care programs, but still apply.

CHIP / OHP for Children extends coverage to children up to age 19 at higher income thresholds through OHP Plus. No asset test applies.

Oregon Medicaid Income Limits — 2026

All amounts are monthly gross income. The Federal Benefit Rate (FBR) referenced below is $967/month for 2026.

Key Notes on Oregon’s Income Rules

OHP Plus — No Immigration Status Barrier: Oregon covers people of all immigration statuses through OHP Plus if they meet income requirements.

Unlike most states where undocumented individuals are limited to emergency Medicaid only, Oregon offers full OHP Plus coverage regardless of immigration status.

OHP Bridge — Who Qualifies: Adults 19–64, income 138–200% FPL, no access to affordable employer coverage, not enrolled in Medicare.

OHP Bridge does not cover long-term care services and supports. AI/AN (American Indian/Alaska Native) members have the added option of Open Card (fee-for-service) coverage rather than a CCO.

Nursing Home / HCBS — Excess Income: Income above $2,901/month does not automatically disqualify you.

Excess must go toward the cost of care, after protecting: a Personal Needs Allowance of $183.90/month (higher for HCBS), Medicare premiums, and potentially a Needs Allowance for a non-applicant spouse. If you exceed $2,901, a Qualified Income Trust (QIT/Miller Trust) redirects the excess to restore eligibility.

Community Spouse Allowance: When one spouse enters a nursing facility, the other (the “community spouse”) may keep income up to $3,948/month as a Minimum Monthly Maintenance Needs Allowance (MMMNA), if their housing and utility costs exceed $793.13/month (effective July 1, 2025 – June 30, 2026).

Children: Limits may extend up to 300% FPL for certain age groups under OHP Plus. Verify with OHA for your child’s specific age bracket.

Pregnant Women: Coverage extends 12 full months postpartum regardless of income changes after delivery — a significant protection for new mothers.

Federal Poverty Level Reference — 2026

Your FPL percentage determines which OHP program you qualify for. Use the federal poverty level calculator to find the exact threshold for your household size.

OHP Bridge — Oregon’s Unique Coverage Extension

OHP Bridge is the most distinctive feature of Oregon’s Medicaid system — and something that sets Oregon apart from most other states.

Before July 2024, adults earning between 138% and 200% FPL faced a difficult choice: they earned too much for Medicaid but couldn’t afford Marketplace insurance even with subsidies.

This group — often called the “coverage churn” population — frequently cycled in and out of coverage as their income shifted.

OHP Bridge solves this by functioning as a Basic Health Program under Section 1331 of the ACA.

Oregon is only the third state to establish a BHP, after Minnesota and New York. The result:

• Same coverage as OHP Plus: medical, dental, behavioral health, substance use treatment, transportation to appointments
• No premiums, no copayments, no deductibles
• Delivered through CCOs, so members can keep their existing doctors when transitioning between OHP Plus and Bridge
• Covers approximately 100,000 Oregonians — including ~55,000 who transitioned from OHP Plus and ~35,000 from Marketplace plans

OHP Bridge does not cover: Long-term care services and supports. If you need nursing home or in-home care, you must qualify under Nursing Home Medicaid or HCBS Waivers, not Bridge.

How Oregon Delivers Care — Coordinated Care Organizations (CCOs)

Most OHP members receive care through a Coordinated Care Organization (CCO) — a community-governed managed care plan that integrates physical health, dental, mental health, and substance use treatment into a single plan.

Oregon’s CCO model is nationally recognized as an innovative approach to Medicaid delivery.

Rather than operating through a traditional fee-for-service system, CCOs are accountable for outcomes across a defined geographic population and have flexibility to invest in social determinants of health — housing, food security, and transportation — that traditional insurance cannot cover.

When you enroll in OHP, you’ll choose a CCO in your area, or be assigned one if you don’t choose.

New members are enrolled in a CCO within a few days of enrollment, reducing the time spent on Open Card (fee-for-service) coverage where provider choices are more limited.

Asset Rules for Long-Term Care Programs

Oregon’s asset rules apply only to Nursing Home Medicaid, HCBS Waivers, and ABD Regular Medicaid.

OHP Plus, OHP Bridge, CHIP, and pregnancy coverage have no asset test.

Home equity: The primary home is exempt while the applicant or spouse resides there or intends to return. Oregon’s home equity cap is $730,000.

Exempt (Non-Countable) Assets

• Primary home (within the $730,000 cap)
• One vehicle
• Household goods and personal effects
• Irrevocable Funeral Trusts
• Medicaid Compliant Annuities
• Life insurance with face value $1,500 or less

Oregon’s 60-Month Medicaid Look-Back Period

Oregon enforces a 60-month (5-year) look-back for Nursing Home Medicaid and HCBS Waivers — but not for ABD Regular Medicaid.

When you apply for long-term care Medicaid, Oregon reviews all asset transfers from the 5 years before your application date.

Transfers below fair market value — including gifts to family members, below-market property sales, or certain trust transfers — trigger a penalty period of Medicaid ineligibility calculated by dividing the transferred amount by Oregon’s average monthly nursing home cost.

Transfers that do not trigger a penalty:

• Transfers to a spouse
• Transfers to a blind or disabled child
• Transfers of the home to a caregiver child who lived in the home for at least 2 years before institutionalization and whose care delayed the need for nursing home placement
• Transfers to a sibling with an equity interest in the home who lived there at least 1 year before institutionalization

Given the penalties involved, never transfer assets without consulting a Certified Medicaid Planner if long-term care Medicaid may be needed within 5 years.

Medical/Functional Requirements for Long-Term Care

To qualify for Nursing Home Medicaid or HCBS Waivers, applicants must demonstrate Nursing Facility Level of Care (NFLOC) through documented limitations in:

ADLs (Activities of Daily Living): Mobility, bathing, dressing, eating, toileting.

IADLs (Instrumental ADLs): Cooking, shopping, managing finances, medication management.

Cognitive/behavioral issues: Alzheimer’s, dementia, or other cognitive conditions — though diagnosis alone does not guarantee NFLOC; functional limitations must be documented.

For ABD Regular Medicaid, you need proof of disability or blindness per SSA criteria — NFLOC is not required.

Estate Recovery

Oregon’s Medicaid Estate Recovery Program may seek reimbursement for long-term care costs from a beneficiary’s estate after death, most commonly targeting the primary home if not protected through a surviving spouse, qualifying disabled child, or caregiver child exemption.

Early planning — well before a care need arises — is the most effective way to protect your home.

Consult a Certified Medicaid Planner to explore available strategies.

Options If You Exceed the Limits

Qualified Income Trusts (QITs): If your income exceeds $2,901/month, a QIT redirects excess into an irrevocable trust, restoring long-term care eligibility while protecting your Personal Needs Allowance and spousal allowance.

Oregon Medicaid must be named as the trust beneficiary.

Irrevocable Funeral Trusts (IFTs): Pre-paid burial and funeral expenses are exempt from asset limits — a legitimate way to reduce countable assets.

Spend Down: Convert countable assets into exempt ones — home repairs, a vehicle purchase, paying off debt — or pay down medical expenses to bring assets within limits.

Medicaid Compliant Annuities: Convert excess assets into an income stream, reducing countable assets while the income is directed toward care costs.

Federal Policy Changes Coming to Oregon Medicaid

Work Requirements (January 2027): Will apply to OHP Bridge and OHP Plus adults 19–64 who are not seniors, disabled, pregnant, or otherwise exempt.

The Medicaid work requirement framework follows similar logic to how SNAP work requirements apply to food assistance — with comparable exemptions for disability, pregnancy, and caregiving. A full breakdown of what the legislation changes: how the One Big Beautiful Bill affects Medicaid and SNAP benefits.

Reduced Retroactive Coverage (January 2027): Medicaid will cover only 2 months prior to application (down from 90 days).

Apply promptly if you think you qualify — delayed applications will mean higher out-of-pocket medical debt.

More Frequent Eligibility Renewals (December 2026): Renewals shift from annual to every 6 months for most enrollees.

Missing a renewal deadline risks a coverage gap.

New Cost-Sharing (October 2028): Non-exempt enrollees may face up to $35 per specialist visit.

Primary care and preventive services remain free. Seniors, children, pregnant women, and nursing facility residents are exempt.

Oregon OHP and SNAP: Two Programs That Work Together

Many Oregon families qualify for both OHP and SNAP simultaneously — and applying for one often makes qualifying for the other easier.

Oregon SNAP (the Oregon Trail Card program) uses 200% FPL Broad-Based Categorical Eligibility — the most permissive threshold allowed federally. If your household qualifies for OHP Plus, you very likely qualify for SNAP as well.

Conversely, SNAP enrollment can help qualify children in your household for WIC automatically.

Useful links for Oregon residents:

• Oregon SNAP monthly benefits and income limits
• Step-by-step guide to applying for SNAP in Oregon
• Oregon WIC income guidelines and eligibility
• Whether seniors receiving Social Security can also get food stamps

How to Apply for Oregon Medicaid (OHP)

Online: Apply at Oregon’s ONE eligibility portal — one.oregon.gov. This single application covers OHP, SNAP, and other ODHS benefits simultaneously.

By Phone: Call OHP Customer Service at 1-800-699-9075 (TTY 711). Available for application assistance and program questions.

By Mail: Download a paper application from oregon.gov/oha, complete it, and mail to: OHP Customer Service, P.O. Box 14015, Salem, OR 97309-5032.

In Person: Visit your nearest ODHS office or contact an OHP Assister — a trained navigator who can guide you through enrollment at no cost.

Long-Term Care: Call 1-800-282-8096 or contact your local Aging and Disability Resource Connection (ADRC) at 1-855-673-2372 to initiate the NFLOC assessment before submitting your application.

For the full step-by-step application process: everything you need to know about applying for Medicaid in Oregon.

Documents You’ll Need

• Oregon residency proof (utility bill, lease, or official mail)
• U.S. citizenship or qualifying immigration status documentation
• Income proof: pay stubs, SSA award letters, pension statements, self-employment records
• SSNs for all household members
• For LTC/ABD: bank statements, property records, 60 months of asset transfer history
• For disability programs: SSA disability documentation or physician letter
• For pregnancy: physician verification

Processing Times

• Standard applications: Up to 45 days
• Disability-based applications: Up to 90 days
• Expedited/presumptive eligibility: Pregnant women may receive immediate presumptive eligibility for outpatient care — coverage starts the same day you apply at an enrolled provider

Frequently Asked Questions

What is OHP Bridge and who qualifies?

OHP Bridge is Oregon’s Basic Health Program covering adults 19–64 with incomes between 138% and 200% FPL who don’t have access to affordable employer coverage and aren’t on Medicare.

Launched July 1, 2024, it covers about 100,000 Oregonians with the same benefits as OHP Plus — medical, dental, behavioral health — at no premiums, no copayments, and no deductibles. It does not cover long-term care services.

What are the 2026 Oregon Medicaid income limits?

Adults 19–64 through OHP Plus: $1,799/month (single). OHP Bridge adults: up to $2,429/month (200% FPL, single). Nursing Home/HCBS: $2,901/month (single). ABD Regular Medicaid: $967/month (single). Children and pregnant women: up to $2,787/month (213% FPL for one person).

For full limits by household size, see how Oregon’s thresholds compare to other states’ Medicaid income limits.

Does Oregon Medicaid cover undocumented immigrants?

Yes — Oregon provides full OHP Plus benefits to people of all immigration statuses if they meet income requirements.

This is one of the most expansive immigration coverage policies among US states and applies to adults, children, and seniors regardless of documentation status.

What is Oregon’s Medicaid look-back period?

Oregon enforces a 60-month (5-year) look-back for Nursing Home Medicaid and HCBS Waivers.

Asset transfers below fair market value within this window may trigger a penalty period of ineligibility. No look-back applies to ABD Regular Medicaid, OHP Plus, or OHP Bridge.

What is a Coordinated Care Organization (CCO)?

A CCO is Oregon’s community-governed managed care model for OHP delivery.

Your CCO integrates physical, dental, and behavioral health services into a single plan with a single point of contact. Most new OHP members are enrolled in a CCO within days of approval. You can choose your CCO or be assigned one. CCOs vary by region — verify which CCOs serve your county through OHA.

Can I get both OHP and SNAP in Oregon?

Yes — many Oregon households qualify for both simultaneously.

OHP Plus and SNAP eligibility overlap significantly, and qualifying for one often simplifies the process for the other. Oregon also uses SNAP enrollment to auto-qualify children for WIC. See what Oregon SNAP benefits cover and whether your household qualifies for income limits and eligibility details.

What if my income is too high for OHP Plus but I can’t afford Marketplace insurance?

You may qualify for OHP Bridge — covering adults up to 200% FPL at no cost with the same benefits as OHP Plus.

If your income exceeds 200% FPL, you may qualify for subsidized Marketplace coverage. Apply through one.oregon.gov and the system will route you to the right program.

Does Oregon Medicaid cover dental and mental health?

Yes — OHP Plus and OHP Bridge both include dental care and behavioral health (mental health and substance use treatment) as part of their core benefit package, delivered through your CCO.

This is a broader benefits package than most state Medicaid programs.

How long does Oregon Medicaid take to process?

Standard applications: up to 45 days. Disability-based applications: up to 90 days.

Pregnant women may receive same-day presumptive eligibility for outpatient care from enrolled providers. For more on documents, timelines, and what to expect: the full Oregon Medicaid application guide.

Last updated: 2026 | Sources: Oregon Health Authority (OHA), Oregon Department of Human Services (ODHS), CMS.gov, USDA FPL guidelines. Verify current figures at one.oregon.gov or by calling OHP Customer Service at 1-800-699-9075. This guide is for informational purposes only — eligibility is determined by the Oregon Health Plan.