Medicaid Long-Term Care Guide in Oregon
Long-term care eligibility, benefits, and how to apply through the Oregon Department of Human Services (ODHS).
What makes Oregon Medicaid different
Medicaid in Oregon is also called the Oregon Health Plan (OHP). The program through which the elderly receive medical care is the Oregon Supplemental Income Program-Medical (OSIPM). Jointly funded by the state and federal government, it is administered by the state under federally set parameters. In addition to nursing home care, assisted living, and adult foster care, OR Medicaid pays for many non-medical support services that help frail seniors remain living at home.
Administered by the Oregon Department of Human Services (ODHS).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Benefits are provided in Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services (HCBS)
Not an entitlement; the number of program participants is limited and waiting lists may exist. Services are intended to delay the need for nursing home care and may be provided at home, adult day care, adult foster care, or in assisted living.
Level of care: Nursing Home
Regular Medicaid / Aged, Blind, and Disabled
An entitlement; if eligibility requirements are met, services can be received. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care benefits, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Oregon Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged, Blind, and Disabled
*All of a beneficiary's monthly income, aside from a Personal Needs Allowance of $81.28 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
Explore Oregon Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Oregon.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Oregon
How the main LTC programs available in Oregon compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $17–21/hr | Hourly wage | No | Yes | Often |
| Structured Family Caregiving (SFC) | Not in Oregon | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Oregon Medicaid programs
K Plan (HCBS Waiver)
1915(c) DD Waiver
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Oregon
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in OregonHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: OHA · oregon.gov/oha/hsd
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Oregon
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Oregon. The process typically takes 45–90 days from application to first paycheck.
Apply in Oregon: OHA · oregon.gov/oha/hsd
Medicaid Eligibility Screener — Oregon
Answer 7 quick questions — we'll check the financial and care requirements for Oregon and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly all income is counted towards Medicaid's income limit, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In OR, the VA Aid & Attendance Pension, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). If a non-applicant spouse's income is under this amount, income can be transferred from the applicant spouse.
- The non-applicant spouse can further increase their Spousal Income Allowance if housing and utility costs exceed a 'shelter standard' of $793.13 / month (eff. 7/1/25 – 6/30/26). The maximum allowance is $4,066.50 / month in 2026.
- For Regular Medicaid, both spouses' income is counted. There is no MMMNA for a non-applicant spouse.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside.
- In Oregon, IRAs / 401Ks are counted as assets.
- Exempt (non-countable) assets include personal belongings, household furnishings, an automobile, irrevocable burial trusts, term life insurance, and generally one's primary home.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660 (2026). If the non-applicant's half is under $32,532, up to $32,532 can be retained.
- There is no CSRA for Regular Medicaid.
- The home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Oregon's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Oregon has a 60-month Medicaid Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications.
- Medicaid checks all asset transfers, including those by one's spouse, to ensure none were gifted or sold under fair market value.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The Look-Back Period does not apply to Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule violates Medicaid's Look-Back Period.
- MMMNA: $2,643.75 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- The non-applicant spouse can increase their allowance if housing/utility costs exceed $793.13 / month, up to a maximum of $4,066.50 / month in 2026.
- The CSRA allows the non-applicant spouse to retain 50% of assets up to $162,660 (min $32,532) in 2026.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Qualified Income Trusts (QITs) — Also called Miller Trusts or Income Cap Trusts in Oregon. Allows persons over the income limit to become income-eligible for Nursing Home Medicaid or a Waiver. 'Excess' income is deposited into an irrevocable trust managed by a trustee. Funds can only be used for specific purposes (e.g., long-term care services and medical expenses). Upon the participant's death, remaining funds must be paid to the state of Oregon.
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, roll-in showers, stair lifts), vehicle modifications (wheelchair lifts, adaptive controls), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Oregon uses Qualified Income Trusts (Miller Trusts / Income Cap Trusts) for persons whose income exceeds the limit. Oregon does not have a Medically Needy / Spend-Down program for long-term care Medicaid.
Oregon Medicaid Programs
Aged & Physically Disabled (APD) Waiver
Assists seniors and adults with physical disabilities in transitioning from an institutionalized setting, like a nursing home, back home or into a community setting such as assisted living or adult foster care.
Independent Choices Program (ICP)
A self-directed option that allows participants to manage their own care services. Via monthly cash assistance, one can hire the care provider of their choosing, including spouses and adult children.
Consumer-Employed Provider Program (CEP)
Formerly the Client-Employed Provider Program. Seniors can hire and manage their own personal care provider to assist with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), including bathing, mobility, eating, housekeeping, and meal preparation.
K Plan (Community First Choice Option)
More formally called the Community First Choice (CFC) Option. This state plan option provides supportive services for Oregon residents who require a Nursing Home Level of Care. Benefits include personal care assistance, home modifications, meal delivery, and more.
Spousal Pay Program
A unique program that pays a non-applicant spouse to assist their senior applicant spouse with daily living activities, including personal hygiene, bathing, dressing, meal preparation, and light housecleaning.
State Plan Personal Care (SPPC)
Under Oregon's Regular Medicaid program, this benefit is an entitlement and covers personal care in the home.
Oregon Project Independence – Medicaid (OPI-M)
Medicaid-funded program for seniors and adults with physical disabilities who require assistance with daily living activities and are at risk of requiring long-term services and supports. Benefits include adult day care, assistive technology, emergency response systems, and home modifications.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. Additional benefits, such as dental and eye care, may be available.
How to Apply
- Apply online at ONE.Oregon.gov
- Apply in-person at a local Oregon Department of Human Services (ODHS) office
- Call ONE Customer Service at 1-800-699-9075
- Mail a completed paper application to OHP Customer Service, P.O. Box 14015, Salem OR 97309-5032
- Fax a completed application to 503-378-5628
- Contact the local Area Agency on Aging for questions and application assistance
Applicants must be certain all eligibility criteria are met prior to submitting a Medicaid application. Persons with excess income and/or assets should strongly consider Medicaid Planning. The application process can be lengthy and specific documentation must be included.
More Oregon Long-Term Care Resources
Take the Next Step for Oregon Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Oregon Department of Human Services (ODHS) — Oregon Medicaid — Official site