Oregon Medicaid Long-Term Care

Last updated: August 21, 2026 Jurisdiction: Oregon

OHP is Oregon's Medicaid program

Oregon calls its Medicaid program the Oregon Health Plan, or OHP. ODHS states that Medicaid can pay for long-term care for people who meet the applicable eligibility requirements, with services available in a person's home or in a facility (ODHS Long-term Care Options).

Long-term-care services are not one single benefit with one universal financial test. Oregon's own comparison chart identifies a long-term-care-services path under OSIPM and distinguishes it from MAGI eligibility; the chart directs staff to consider income, resources, transfer-of-assets rules, home equity, and the community-spouse provisions where applicable (ODHS OSIPM and MAGI Comparison Chart).

For the core OSIPM long-term-care pathway, the state's rule uses a 300%-of-SSI countable-income standard unless the person has established the qualifying trust described in the rule. The state's January 2026 transmittal identifies that long-term-care countable-income standard as $2,982 per month (OAR 461-155-0250; ODHS 2026 standards transmittal).

Two types of eligibility evidence are needed

Financial eligibility alone does not answer whether Oregon will authorize long-term-care services. ODHS says it examines how much help an applicant needs with activities of daily living and calls the resulting determination a service priority level. The levels run from 1 through 18, with level 1 representing much higher needs than level 18 (ODHS ADL and service-priority guidance).

For nursing-facility care, ODHS explains that a person who no longer meets Medicare skilled criteria or has exhausted Medicare's 100-day skilled period but still needs nursing-facility care is at Intermediate Care Facility, or ICF, level of care. Medicaid may help with ICF-level nursing-facility care when Medicaid criteria are met (ODHS Nursing Facility Information and Options).

For home and community settings, Oregon's APD system works with CMS on two waivers that were approved through 2026: the 1915(c) Aged and Physically Disabled Waiver and the 1915(b)(4) Case Management and Agency with Freedom of Choice Waiver. Oregon also describes the K Plan as a Medicaid state-plan option supporting people who need regular help and want to remain at home or in a community setting (ODHS APD waivers and K Plan).

Practical sequence: Ask ODHS about both the financial OHP decision and the ADL/service-priority determination. Oregon says funding is limited, but the located public page does not publish a statewide APD long-term-care waitlist or enrollment-cap figure (ODHS ADL guidance; ODHS waiver page).

Questions to bring to the application

A family should identify the intended setting, current ADL support needs, income sources, resources, home ownership, recent transfers, and whether a spouse remains in the community. Those facts determine which Oregon rules apply. This page is general education, not a determination of OHP eligibility.

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OHP is Oregon's Medicaid program

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