Oregon Department of Human Services : Health Insurance and Medical Assistance : State of Oregon (2024)

FAQs

What is the monthly income limit for Oregon Health Plan? ›

If you are 65 or older, blind or have a disability:

You may qualify for Medicaid benefits or long-term care services. You can qualify even if you are working. You get these benefits through the Oregon Department of Human Services (ODHS) and Area Agencies on Aging (AAAs).

Medicaid is a federal-state program. It varies from state to state and is run by state and local governments within federal guidelines. In Oregon, it's known as the Oregon Health Plan (OHP). If you are under age 65 and you don't have Medicare, you may qualify for the OHP.

If you don't qualify for OHP, you may qualify for a Medicare Savings Program. These programs can help pay premium costs. Learn more about Medicare Savings Programs​. To apply, older adults and people with disabilities should call the Aging and Disability Resource Connection (ADRC) at 1-855-ORE-ADRC (855-673-2372).

For a single person, income should be less than $1,507/month or household income of $3,076 for a family of four. OHP is available to kids and teens whose family earns up to 300 percent of the Federal Poverty Level.

Contrary to how income is counted, all resources are counted regardless of whether they belong to the applicant, the spouse or both of them. The resource limit for a single person is $2,000. If the Medicaid applicant is married, his or her spouse is allowed to retain an additional amount between $30,828 and $154,140.

Countable vs.

Nearly all income that a Medicaid applicant receives is counted towards the income limit. Countable income includes employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends.

When determining OHP eligibility, calculate the amount of the eligibility group's countable resources by counting only cash and types of resources that can be readily converted to cash; i.e., bank accounts, stocks and bonds.

Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.

Through OHP Bridge, people in Oregon can get medical, dental and behavioral health care with no member costs. Members will also have access to additional benefits, like transportation to medical appointments and other health-related services.

Can you have Oregon Health Plan and Medicare at the same time? ›

Medicare acts as the member's main health coverage. If you have both Medicare and OHP: OHP can help pay for things like Medicare premiums, deductibles, and coinsurance. OHP also covers things Medicare does not, such as rides to appointments and dental care.

Kaiser Permanente offers the best health insurance in Oregon for 2024. MoneyGeek's guide identifies the top-rated providers according to premiums, age, maximum out-of-pocket cost, plan flexibility and claims management.

The OHP Redetermination process occurs annually and requires you to provide updated information about your income, household size, and other factors that may impact your eligibility for OHP. You will receive a letter from OHP several weeks before your Redetermination date asking you to provide this updated information.

The fee for not having health insurance (sometimes called the "Shared Responsibility Payment" or "mandate”) ended in 2018. This means you no longer pay a tax penalty for not having health coverage.

Not having health insurance can lead to large debt, affect your health if you delay care and may even hurt you at tax time, depending on your state.

What is changing? Starting July 1, 2024, CareOregon is taking part in the implementation of OHA's CCO-administered OHP Bridge program. OHP Bridge will expand access to affordable health coverage to approximately 100,000 Oregon residents that meet the eligibility criteria statewide.